Internal Medicine
Diagnosticians and healers tackling complex adult medical conditions
Internal medicine ranks consistently in the upper tier of burnout prevalence, with hospitalists experiencing even higher rates due to the intensity of inpatient care, per Medscape and JAMA Internal Medicine surveys.
Internal medicine is the specialty of deep diagnostic reasoning — the discipline where physicians are trained to synthesize vast arrays of data into coherent clinical pictures. This intellectual rigor makes internists both the least likely physicians to accept unexplained phenomena at face value and, paradoxically, the most meticulous documentarians when something genuinely defies their diagnostic frameworks. When an internist says a case cannot be explained, the weight of that statement reflects years of training designed specifically to explain the unexplainable.
Dr. Scott Kolbaba practiced internal medicine, and his decision to write Physicians' Untold Stories was rooted in precisely this tension. As a board-certified internist, he understood the professional risk of acknowledging experiences that fall outside evidence-based medicine. Yet his own clinical practice produced enough anomalous cases — spontaneous resolutions of confirmed diagnoses, patients with knowledge they could not have acquired through normal means, laboratory values that reversed without intervention — that silence began to feel less like scientific integrity and more like intellectual dishonesty. The book's credibility rests substantially on the fact that its author and many of its contributors are internists: physicians whose professional identity is built on finding rational explanations.
Internal medicine's broad scope also means its practitioners encounter the extraordinary across an unusually wide clinical spectrum. Unlike specialists who see a narrow slice of pathology, internists manage everything from autoimmune disorders to infectious diseases to metabolic crises. This breadth exposes them to a correspondingly diverse range of anomalous events — from the autoimmune condition that inexplicably enters permanent remission to the septic patient whose survival defies every prognostic score. The sheer volume and variety of these encounters, accumulated over a career, creates a body of experience that is difficult to dismiss as selective memory or confirmation bias.
What Internal Medicine Physicians Report
Internists — trained above all to explain the unexplainable — describe a particular disquiet when biopsy-confirmed diagnoses resolve completely without treatment, or when critical lab values normalize between draws with no intervention. As an internist himself, Dr. Kolbaba built Physicians' Untold Stories partly from the cases that his own diagnostic rigor could not account for, lending the book a credibility rooted in the specialty's demand for evidence.
Extraordinary Phenomena in Internal Medicine
Spontaneous Disease Resolution
Confirmed diagnoses — verified by biopsy, imaging, and laboratory markers — that resolve completely without treatment or with treatment that should have been insufficient. Internists, trained to trust their diagnostic workups, find these cases particularly unsettling because they undermine the very framework by which they practice.
Anomalous Laboratory Reversals
Blood work showing critical, life-threatening values that normalize between draws without any intervening treatment. While lab error is always considered, internists report a subset of cases where repeated testing confirms the original abnormality, followed by equally confirmed normalization that has no physiological explanation.
Diagnostic Intuition Beyond Data
Experienced internists describe moments of clinical certainty about a diagnosis that precedes — and occasionally contradicts — the available evidence, only to be confirmed by subsequent testing. This phenomenon, studied in the context of clinical reasoning, sometimes extends into territory that exceeds what pattern recognition alone can explain.
The Unexplained Rally
Hospitalized patients with multi-organ failure or advanced disease who experience sudden, dramatic clinical improvement without a clear medical precipitant. These rallies sometimes coincide with specific emotional or spiritual events — a reconciliation, a prayer, a visit — in ways that internists find difficult to attribute to placebo effect alone.
The Kind of Case Internal Medicine Physicians Report
Composite archetype based on reported patterns — not a specific case
The patient with advanced, biopsy-confirmed autoimmune hepatitis and rising liver enzymes who was being evaluated for transplant listing. Between the referral appointment and the transplant workup two weeks later, every marker normalized and repeat biopsy showed no inflammation. The referring internist, the hepatologist, and the pathologist reviewed the case together and none could offer a mechanism for what occurred.
Read Real Cases in the Book →Physician Burnout by Specialty
Percentage reporting at least one symptom (Medscape, 2024)
Reader Ratings Distribution
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Why Internal Medicine Physicians Encounter the Extraordinary
Internal medicine is the specialty of explanation — its practitioners are trained to leave no finding unaccounted for. This makes the cases that genuinely resist explanation especially significant. When an internist exhausts every diagnostic pathway and still cannot account for what happened, the resulting uncertainty is not casual; it is the failure of a system designed never to fail.
Kolbaba's background in internal medicine gives Physicians' Untold Stories its distinctive credibility. Readers who practice internal medicine recognize the meticulous, almost reluctant way these cases are presented — not as miracles claimed, but as mysteries documented with the same rigor applied to any differential diagnosis.
Questions About Internal Medicine and the Unexplained
How does an internist reconcile unexplained recoveries with evidence-based medicine?
Are spontaneous remissions more common than medical literature suggests?
What role does diagnostic intuition play in internal medicine?
Why did Dr. Kolbaba, an internist, feel compelled to document these stories?
Read the Stories That Changed Everything
Over 200 physicians interviewed. 26 stories that will challenge what you believe about life, death, and everything in between.
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Every medical specialty has its own encounters with the extraordinary. Explore stories from other fields.
