Estradiol is not associated with increased breast cancer risk — that's synthetic progestins. Bioidentical hormone replacement therapy may actually lower breast cancer risk. Transdermal estrogen carries no meaningful increased clotting risk, even in patients with prior clots. Women and men both benefit from testosterone — for libido, mood, energy, cognition, muscle mass, and bone density. And a man's prostate is fully saturated at a serum testosterone level of 250 — the common "normal" cutoff — meaning higher levels don't increase prostate cancer risk.

None of this is medical advice. It's an honest account of how the things I was taught had to be unlearned and replaced — years after training ended — because I stayed curious.

The world of commercial real estate is not taught in medical school. Everything about my training was devoted to the science and craft of medicine, precious little to the business. For this task, I had to find a broker, and then he talked to all the other brokers. They talked to the building owners and, when I found a space, the owner and I each had a lawyer to look over the lease and negotiate the final changes. Delays held up my malpractice application, my business loan application. Some spaces were giant 2000 square foot “white boxes” which would need $50,000 build outs to become functioning medical offices. Others were already built but in weird parts of town or creepy buildings, down stairs in damp basements, or tucked behind strip malls in hastily erected shared spaces with fresh drywall.