A New Series of Essays on Substack: Close to the Bone with Lauren Kosinski, MD
The Medicine Between Us is a personal essay series about the invisible architecture of medical relationships—and what happens when the structure no longer holds.
Part 1, “From Rupture to Redesign,” explores a moment when my inner compass remained intact, but the system around me veered off course. Rather than contorting myself to fit what medicine had become, I chose to leave and rebuild from the ground up.
For anyone who has felt disoriented by the institutions we once trusted—this is for you.
Part 2. “Disproportionate Responsibility and Leveling the Hierarchy in the Operating Room.”
A surgeon asked if this piece was written by AI—maybe that’s a compliment? It wasn’t. This one’s personal. I drafted it in 2012 but couldn’t share it—until now. It felt risky to offer a counter-narrative (really, a diagnosis of the program’s foundations), and I didn’t yet have the language to name what I was reaching for. So here it is, exactly as I left it.
Don’t get me wrong—I respect the aim of flattening the OR hierarchy. But in some ways, it’s not possible. And in others, it doesn’t go far enough to heal the tensions we feel in the room.