Beyond the Scalpel, Learning About Humanities in Medicine

From left to right: Alexis Hatch, MD student and organizer of the Two-Minute Talks in the Medical Humanities; Suzanne Garfinkle, MD, Director, Academy for Medicine and the Humanities; and Jacob Appel, MD, JD, MPH, Assistant Director, Academy for Medicine and the Humanities.

Training to be a researcher or physician at the Icahn School of Medicine at Mount Sinai isn’t just about excellence at the bench and bedside but also understanding the humanity that underpins these callings.

Thus exists the field of “medical humanities,” an area of study that draws upon the arts, the humanities, and the social sciences to enhance medical practice. On Thursday, September 18, members from the Mount Sinai Health System were invited to share and learn about topics where humanities and medicine intersect at the inaugural Two-Minute Talks in Medical Humanities.

With just 120 seconds each, 18 presenters—spanning faculty members, medical students, master’s students, and PhD students—covered topics they were passionate about: Where did Leonardo da Vinci think the soul was located in the body? How has the medical stretcher evolved through time? Can listening to Indian classical music have therapeutic effects?

“As a student admitted through Flex Med, a program designed to bring students in the humanities into medicine, I know firsthand how valuable a humanities background is when learning how to be a compassionate physician,” said Alexis Hatch, a second-year MD student, who came up with the idea for the event.

The inspiration for Two-Minute Talks came from Ms. Hatch’s time as an undergraduate at the University of Chicago, where she participated in a similar event. “When I started as a student ambassador for the Academy for Medicine and the Humanities at the Icahn School of Medicine, I immediately thought a similar event would draw students and faculty to share their interests outside of clinical medicine or research,” she said. “I knew the interest was there—every time I shadowed a physician, they seemed much more interested in discussing my history degree than any scientific research I did!”

“We loved the idea because you can teach an audience a great deal in two minutes, and the time limit made each talk extra dynamic,” said Suzanne Garfinkle, MD, Founding Director of the Academy, and Assistant Clinical Professor of Medical Education. “The event offered a very special window into participants’ creative and scholarly passions. I could see these two-minute lectures developing into a real Mount Sinai tradition.”

Take a look at what some of the presenters talked about during the event in the slideshow below.

Alexis Hatch, medical student and organizer of the Two-Minute Talks in Medical Humanities, gave a presentation on things that exist today thanks to the existence of tuberculosis.
In addition to tuberculosis camp towns—the roots of places like Colorado Springs, Colorado, and Pasadena, California—Stetson hats and the fictional character Sherlock Holmes had origins relating to the disease. For the latter, author and physician Arthur Conan Doyle based Sherlock Holmes’ deductive reasoning traits on the methods he used to debunk a failed tuberculosis remedy at the time.
Jeffrey Laitman, PhD, Distinguished Professor of Medical Education, talked about Leonardo da Vinci’s search for where the soul is located in the body anatomically.
Leonardo da Vinci, said Dr. Laitman, was obsessed with the human skull, and searched for the “senso commune,” which he thought was where the soul was located. The polymath thought he had found its location: at the floor of the third ventricle, just superior to the pituitary fossa.
Vasundhara Singh, MD, Associate Professor of Medicine (Hospital Medicine), and Medical Education, elaborated on the history of the medical stretcher. “Why do I care about stretchers? Because I spend half my time bent over them,” she said.
The earliest stretchers date back more than 150 years, and were also called “ambulances.” Over the decades, stretcher designs were informed by wartime constraints for space, and eventually paid more attention to comfort and materials, said Dr. Singh.
Some spiritual healing retreats in “hot igloos” in Mexico promoted on social media are simply co-opted traditional birthing huts, said Jaime Gonzalez, medical student, who talked about indigenous Mexican birthing practices.
Giving birth in hot houses is still practiced in parts of Mexico. Culture and tourism might have been intertwined, but it important for tourists to be mindful of the origins of some of these practices, said Mr. Gonzalez.
Enna Selmanovic, PhD candidate, spoke about brain donation law and representation in the United States.
Brain donation has the potential to greatly advance understanding of human disease but is complicated by law, culture, family dynamics, and ethics. “These choices shape the stories that medicine tells us about disease, and whose medical history is left out,” said Ms. Selmanovic.

Bridging Cultures in Medicine: A Mount Sinai Student’s Time at Dhulikhel Hospital in Nepal

Sunset view from a valley hike

As a fourth-year medical student at the Icahn School of Medicine at Mount Sinai, I spent one month in February in Nepal for my clinical elective. This experience was humbling, challenging, and deeply meaningful, undoubtedly shaping my career in medicine.

The Role of Family and Spirituality in Patient Care

I split my time between the pediatric and psychiatry departments at Dhulikhel Hospital, each offering a unique lens into health care delivery in a resource-limited setting. One of the most striking differences I observed, particularly in psychiatry, was the active role of family members in patient care even within the secure psychiatric unit.

Unlike in the United States, family members in Nepal were allowed to remain with patients throughout the entire day. I witnessed firsthand how this level of involvement improved patient outcomes, elevated morale, and deepened the family’s understanding of mental illness. While one might assume this model could compromise safety, staff reported surprisingly few security issues.

Another aspect that stood out to me was the integration of religious and spiritual beliefs into psychiatric treatment. Religion was one of the strongest protective factors for patients experiencing depression, making it imperative for providers to build upon those beliefs to create a safety plan for patients. It was a powerful reminder of the impact of culture on medical treatment and patient-provider trust, a factor often overlooked in medicine in the United States.

The view of Kathmandu from the top of Swayambhunath Temple

Engaging With Nepali Culture

Outside of the hospital, we experienced Nepali culture in countless meaningful ways. Each afternoon, we ate traditional meals like momos, a type of dumpling, and thalis, a variety of dishes served together on a single platter, at small canteens and cafes near the hospital. We visited historic temples and witnessed funeral processions and religious rituals along the Bagmati River. Observing these ceremonies was particularly moving as we were able to see how spirituality, grief, and community are such a visible part of everyday life.

Each evening, we hiked along trails adjacent to small huts, farms, and croplands. This was one of the most peaceful ways to spend the close of the day, among the sounds of the birds, goats, and dogs that would follow us deep into the valley.

The Impact of International Exchange

My time in Nepal was truly inspiring not just within the hospital but also through meeting incredibly caring people and experiencing delicious food and breathtaking nature. It was a privilege to experience both the medical and cultural aspects of the country. I hope to visit again one day as a physician!

Author Salonee Shah, MD, right, shown with Abhi Mogili and Cecilia Katzenstein. They are recent graduates of the Icahn School of Medicine at Mount Sinai. Dr. Shah completed her clinical elective at AMPATH Nepal through funding provided by the Arnhold Institute for Global Health at Mount Sinai. She is a psychiatry resident at Baylor College of Medicine in Houston and plans to pursue a child and adolescent psychiatry fellowship. Her goal is to eventually work with refugee and immigrant families in trauma-focused care.

Your Guide to the Latest Trends in Breast Cancer Prevention and Treatment

Breast cancer remains one of the most prevalent cancers among women, with 13 percent of women—approximately one in eight—receiving a diagnosis in their lifetime. Early detection and advanced technology are vital to improving survival rates and treatment success.

Mount Sinai offers mammography screening and excellent care at numerous locations in New York City and the surrounding suburbs. Click here for information about screening locations and making an appointment.

Here are three important ways that updates in breast cancer screening and technology have the potential to significantly improve early detection, according to the experts at the Center of Excellence for Breast Cancer at The Tisch Cancer Institute at Mount Sinai.

Elisa Port, MD, FACS

New Mammogram Guidelines

In 2024, the U.S. Preventive Services Task Force recommended that women begin regular mammograms at age 40, shifting from the previous guideline of age 50. Mount Sinai strongly supports this important change, as it can lead to earlier detection and a reduction in late-stage breast cancer cases.

“Starting mammograms at age 40 can facilitate earlier diagnoses, which are crucial for effective treatment,” says Elisa Port, MD, FACS, Chief of Breast Surgery for the Mount Sinai Health System and Director of the Dubin Breast Center. “An annual mammogram can mean the difference between catching a cancer early when it’s most treatable or missing it entirely. Mount Sinai Mammogram May® is about reminding women that they have the power to take control of their health. We urge women to schedule their screenings.”

Advances in AI for Mammography and Breast Ultrasound

Artificial intelligence (AI) is transforming mammography and breast ultrasound, significantly improving diagnostic capabilities. AI algorithms can analyze mammogram and breast ultrasound images with advanced precision, and have become a powerful tool in identifying potential abnormalities that traditional methods might overlook.

Laurie Margolies, MD, FACR FSBI

“Artificial intelligence is a phenomenal tool. It does not replace the expertise of our radiologists—it enhances it,” said Laurie Margolies, MD, FACR, FSBI, Vice Chair Breast Imaging, Mount Sinai Health System, and Chief of Breast Imaging at the Dubin Breast Center. “It gives us an added set of eyes, highlighting areas that deserve closer scrutiny. That means more accurate results and, ultimately, better outcomes for our patients.” Mount Sinai has performed more than 100,000 AI-assisted mammograms as of March 2025.

FDA Ruling on Breast Density

The FDA recently mandated that mammogram reports include uniform information about breast density. Dense breast tissue can obscure tumors on mammograms and is associated with an increased risk of breast cancer.

“This new requirement will provide women with essential information about their breast density, helping them make informed decisions about additional imaging if needed,” says Dr. Margolies. “We are committed to offering comprehensive care and using all available information to enhance screening accuracy at all of Mount Sinai’s breast health locations.”

Three Things Women Should Do

  • Schedule your mammogram: Follow the new guidelines to begin regular screenings at age 40.
  • Review breast density information: Understand your breast density from your mammogram report and discuss any additional screening needs with your health care provider.
  • Know your risk: Breast cancer is the second leading cause of cancer-related death in U.S. women, behind only lung cancer. Click here to learn more about the causes of breast cancer and risk factors

Improving your chances of survival often begins with early detection. Mount Sinai encourages women to stay informed, be empowered, speak with their health care professional, and access the latest technologies and interventions as needed.

A Physician Focused on Children and Multiple Sclerosis

Rachel Zolno, MD, Assistant Professor, Neurology, at the Icahn School of Medicine at Mount Sinai, is bringing a new dimension to identifying and managing multiple sclerosis in youngsters, underscoring the benefits of a center that offers the latest treatments and a wide range of services in one place.

“Most people, even a lot of physicians, don’t realize that children can get MS,” says Dr. Zolno, who joined the Corinne Goldsmith Dickinson Center for Multiple Sclerosis in 2024. As many as 10 percent of the people living with MS in the United States have Pediatric-Onset MS (POMS).

“The addition of a pediatric MS/neuroimmunologist specialist serves to broaden our reach and allows us to serve a larger segment of the population,” says Center Director Fred D. Lublin, MD. “Importantly, this gives us an expanded window into the origins of MS, which appear to occur, at least in part, during childhood.”

Rachel Zolno, MD

While most people under age 18 who have POMS are in their late teens, Dr. Zolno has seen children as young as four years old. “It’s rare to find very young children with MS, which is why we want to exclude everything else before we make the diagnosis,” she says.

People in their 20s and 30s comprise the most prevalent age group for first diagnoses of MS. Confirmation three years ago of a strong connection between the Epstein-Barr virus or mononucleosis and MS is one indicator that ailments experienced at younger ages may be precursors to presenting MS.

“With relapsing-remitting MS, when someone looks back they may realize that when they were 14 or 16, they had a few weeks or a couple of months when their arm was really tingly, but they didn’t think much of it as the symptoms went away,” says Dr. Zolno. “MS is not on the radar of pediatricians. It’s not something they look for when a 16-year-old has vague neurologic symptoms.”

Early diagnosis is as important for children as for adults to determine if someone has MS and, if confirmed, to begin a treatment to prevent progression of the disease. Among children, the diagnosis sometimes can be more challenging as there are other diseases affecting the nervous system that may mimic MS and are more common in kids, such as Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) and Neuromyelitis optica (NMO), other nervous system abnormalities. A physician will want to rule out those diseases before concluding an MS finding.

How MS evolves in youths and adults is different. MS in people under the age of 18 “tends be slightly more aggressive” because they “have strong immune systems,” says Dr. Zolno. But managing the disease can be easier among youths. “Children’s bodies are really resilient, so when they are in the relapsing-remitting stage, and not in the middle of a flare, they can recover a lot better because they are younger.”

After diagnosis, an MS pediatric neurologist may prescribe a disease-modifying therapy (DMT) to manage the disease. “MS is a lifelong disease process,” says Dr. Zolno. “We want to recognize the disease as early as we can so that we can start children on treatment as early as possible to prevent relapses from happening and prevent any sort of disability. They are going to be in treatment for the rest of their lives.”

The Food and Drug Administration has approved only one medication for POMS patients (fingolimod). However, depending on a physician’s assessment, other approved therapies that are used mainly for adult patients may be prescribed, such as B-cell medications like rituximab. “The POMS research community has determined that it is better to use higher efficacy medications earlier to prevent any accrual of disease in  pediatric patients,” she says.

Dr. Zolno joined the Center staff in September 2024. “I love the fact that with MS you get to stay with your patients for a long time,” she says. “Of course, I don’t stay with my patients forever, as they eventually will go to an adult doctor.”

Her interest in neurology and POMS began when she was as young as some of her patients. “I actually knew I wanted to be a pediatric neurologist since I was in high school,” she says. Meeting teenagers newly diagnosed with MS, along with having a pediatric MS neurologist as her mentor during residency, gave her further inspiration.

As recognition that MS can occur in children and teens has grown, interest in pediatric MS among aspiring neurologists has risen, says Dr. Zolno.

“There are not many of us treating POMS. It’s a growing field, but it can be hard to find an institution where you get the kind of support that a comprehensive MS care center can provide,” she says.

“The great thing about the Center is that even though I come from the pediatric neurology world, I am still part of the Center. My patients are able to see the Center’s social workers, psychologist, neuropsychologists and other specialists. It’s so important to have access to that multidisciplinary care, for pediatric patients as well.”

By Kenneth Bandler, a multiple sclerosis patient, advocate, and member of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis Advisory Board.

What You Should Know About Autism and Medications

Autism spectrum disorder is a developmental disability. People on the autism spectrum have varied abilities and support needs. Some may have advanced conversation skills and can live with minimal  support, whereas others may use few to no words and require 24/7 care.

Autism has been in the headlines recently. On Monday, September 22, the U.S. Food and Drug Administration (FDA) took two steps that drew widespread interest and prompted criticism from a number of medical and science organizations.

  • The agency alerted physicians that the use of acetaminophen, the active ingredient in the pain reliever Tylenol and other generic medications, by pregnant women may be associated with an increased risk of neuropsychiatric conditions, including autism. The FDA said clinicians should consider minimizing the use of acetaminophen during pregnancy for routine low-grade fevers, which is already the existing guidance.
  • The agency took steps to make it easier for clinicians to prescribe an older medication, leucovorin, or folinic acid (a naturally occurring form of vitamin B9), to treat children with autism.

The actions by the federal government prompted many to seek answers. Here are answers to some of the most frequently asked questions from experts at the Icahn School of Medicine at Mount Sinai: Joseph Buxbaum, PhD, Director of the Seaver Autism Center for Research and Treatment; Joanne Stone, MD, Chair of Obstetrics, Gynecology and Reproductive Science; Lisa Satlin, MD, Chair of Pediatrics; and Alex Kolevzon, MD, Chief, Division of Child and Adolescent Psychiatry.

How common is autism?

The rate of autism in children increased over recent years and is now estimated to be 1 in 31, according to the latest monitoring data released in April by the U.S. Centers for Disease Control and Prevention. The survey was conducted in 2022 across 16 sites in the United States, and cases were identified based on school and medical records. Autism occurs among all racial, ethnic, and socioeconomic groups. It is three times more common among boys than among girls. Experts say a number of factors have contributed to a rising rate of autism, including expanded criteria for diagnosis, greater awareness, and improved screening and diagnostics.

What causes autism?

There are strong data indicating that genetics are the major cause of autism. However, not all genetic risk is inherited; some genetic changes leading to autism occur as spontaneous mutations in the egg or sperm, according to Mount Sinai’s Seaver Autism Center for Research and Treatment. Experts also believe some environmental factors may be involved.

What do you advise women about using acetaminophen during pregnancy?

The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine continue to recommend acetaminophen as one of the safest options for treating pain and reducing fever during pregnancy when used as directed and emphasize that pregnant patients should always discuss any medication use with their clinicians. The FDA says acetaminophen is the safest over-the-counter alternative for pregnant women. It is also well documented that an untreated high fever in a pregnant woman increases the risk of birth defects and premature birth, and there is some suggestive evidence that fever in a pregnant woman may also be associated with an increased risk for autism in the child.

Did a recent Mount Sinai study demonstrate a connection between acetaminophen and autism?

Researchers at the Icahn School of Medicine at Mount Sinai, together with national collaborators, published a systematic review in BMC Environmental Health examining the use of acetaminophen during pregnancy. The research applied a rigorous framework for evaluating environmental health data and analyzed 46 studies involving more than 100,000 participants worldwide. The study found an association, but not a causal link, between prenatal acetaminophen exposure and an increased risk of autism spectrum disorder and attention-deficit/hyperactivity disorder in children. As the authors note, these do not prove that acetaminophen use during pregnancy causes these conditions. In fact, several large studies, including one that came out after the BMC Environmental Health study, indicate that acetaminophen does not cause these conditions and that there is likely a shared relationship between the reason acetaminophen is taken and the risk for behavioral outcomes in the child (for example, fever). Careful clinicians and researchers will continue research to optimize management of pain and fever during pregnancy using current or future medications but results to date do not demonstrate a causal relationship.

Can you explain the difference between association and causality?

Association is when two things happen at the same time, but one doesn’t necessarily cause the other. In a very simple example, more people eat ice cream in the summer, and more people get sunburns in the summer, but that doesn’t prove ice cream causes sunburns. There is an independent cause for both more sunburns and more ice cream in the summer: both are due to the warmer weather. In the case of autism, here is an example cited by the Autism Science Foundation: Women take acetaminophen when they are pregnant to reduce fever. Fever during pregnancy is a known autism risk factor. But this question remains unanswered: Could an increase in autism be due to the fever or the acetaminophen? At least one study showed that fever during pregnancy indeed increased risk for autism and that risk was significantly reduced when the mother took acetaminophen.

What are the treatments for autism?

The Seaver Autism Center for Research and Treatment says treatments include intensive behavioral and educational therapies and possibly medications. Many children benefit from a multidisciplinary team that may include board certified behavior analysts, speech and language pathologists, occupational therapists, physical therapists, and other professionals. It’s important to recognize that autism is a spectrum, and not all individuals or families view support through the lens of “treatment.” For many, the focus is on providing tools and accommodations that help autistic people thrive, while also celebrating their unique strengths and differences.

What do we know about leucovorin, which has recently been suggested as a treatment for autism?

The data suggesting that leucovorin may improve some symptoms of autism come from five small clinical trials. The Autism Science Foundation says a higher standard of science would be needed to determine if leucovorin is an effective and safe treatment for autism. The Foundation says the science is still in very early stages, and more studies are necessary before a definitive conclusion can be reached. As with all research in this field, experts emphasize that interventions should be considered in the context of each individual’s needs, and that supporting quality of life and respecting neurodiversity remain central priorities.

What about other research into autism?

Autism research is being conducted across many areas, including genetics, neurobiology, behavioral interventions, and targeted medications. One promising area of research seeks to identify autism genes in order to develop new medications, according to the Seaver Center. Some of the most exciting advances in autism are tests of new treatments tailored to the genetics of the patient.

What should I do if I think my child may have autism?

First, have a conversation with your child’s pediatrician. The American Academy of Pediatrics recommends that all children be screened for autism at their 18-month and 24-month well-child checkups. If there are concerns, your pediatrician should refer you to a specialist for a more extensive evaluation. The Seaver Autism Center is one important resource for our families.

Mount Sinai Queens Performs Its First-Ever Iliac-Branch Endovascular Aortic Repair Using Fixed Imaging

Patient Najib Saoui with Christopher Smolock, MD, left, and John Phair, MD

Mount Sinai Queens has achieved a milestone in surgical innovation with the successful completion of its first iliac-branch endovascular aortic repair (IBE)—a complex, minimally invasive procedure to treat an abdominal aortic aneurysm and iliac artery aneurysm—performed for the first time using fixed imaging in the hospital’s newly equipped operating room.

The groundbreaking procedure was successfully completed by vascular surgeons Christopher Smolock, MD, and John Phair, MD, and marks a significant advancement in the hospital’s ability to offer comprehensive vascular interventions that previously required transferring patients to Manhattan campuses.

Najib Saoui’s aneurysm was discovered incidentally during a CT scan, It had no symptoms and was monitored closely for several years. When the aneurysm reached a size that required intervention, the care team at Mount Sinai Queens was able to offer a state-of-the-art solution close to home.

In the procedure, aneurysms are treated by re-lining them with a covered stent, inserted through a small catheter in both groin arteries. This minimally invasive approach prevents the arteries from continuing to enlarge while preserving blood flow through the major artery branches to the abdomen and pelvis.

“This was a more technically complex repair,” Dr. Smolock says, “but with the advanced capabilities of our fixed imaging suite, we were able to perform the entire procedure on Mr. Saoui through a minimally invasive approach by accessing the artery from inside while preserving critical arterial branches to the pelvis.”

The two-hour procedure was a success, and Mr. Saoui was discharged the next day with no postoperative restrictions, able to resume normal activities without any limitations. This is a stark contrast to traditional open aortic surgery, which often involves a lengthy hospital stay and recovery period.

“This is a perfect example of how we’re expanding access to advanced surgical care in Queens, which has tripled over the past two years” Dr. Phair says. “Patients don’t need to travel to Manhattan to get the same high-quality, leading-edge treatment.”

All aortic aneurysms—whether treated or untreated—require lifelong monitoring. The patient will be followed with routine CT scans and ultrasounds, beginning one month after surgery and then annually, to ensure the repair remains functional. In some cases, additional maintenance procedures may be needed down the road, but those too are minimally invasive with virtually no downtime.

This case exemplifies Mount Sinai Queens’ ongoing commitment to bringing world-class surgical expertise and technology to the local community, the physicians said, enabling patients to receive exceptional, personalized care without leaving their borough.