Beyond “How Can I Help?”: I Don’t Just Want to Watch the Future of Care—I Want to Help Build It

Tom Garz, Author - Writing to Help Myself and Others

Writing to Help Myself and Others - Firebird Book Award Winner.

February 10, 2026

I’ve been watching the TV series New Amsterdam —especially Max Goodwin and that relentless question: “How can I help?”

A lot of people love Max because he’s inspiring. I relate to him for a different reason: he represents a part of many of us that wants to matter—to help—to make the world a little less harsh for people who are suffering.

I relate to Max… even though I could never be him for various reasons. I’m not a hospital medical director. I’m not running through hallways fixing departments. I’m not going to “hero my way” through broken systems with speeches and authority. I'm a 78 year old retired Engineer/Patent Searcher that has been around illnesses all my life.

But I do feel something real when I watch that show:

I want to be part of something like that—something that helps people in the real world. Not just as a viewer. Not just as a writer. Not just as someone with ideas. I want to be part of the change.

The gap that keeps pulling me back

What the show captures (even with Hollywood shortcuts) is the truth that so many patients live with:

Most of the struggle happens between doctor visits.

People with chronic pain, chronic illness, disability, long-term stress, or limited healthcare access don’t just need a diagnosis—they need a way to live day to day.

• a Patient Listener
• what to track
• what patterns might matter
• how to prepare for short appointments
• how to advocate without getting dismissed
• how to make sense of symptoms at 2 AM (Super Symptom Checker)
• how to stay emotionally steady while the body is doing something scary

This is the “care gap” that I can’t stop thinking about and that I and many others live with in our current healthcare system.

Why the biopsychosocial model feels like the missing operating system

For chronic conditions, biology is only part of the picture.

Pain and symptoms are shaped by the nervous system, stress load, sleep, environment, relationships, meaning, fear, isolation, work pressures, resources, and the body’s learned patterns over time.

That’s why I’m deeply drawn to the biopsychosocial approach—not as theory, but as a practical way to help real people stop feeling lost.

GenAI as a “safe workaround” (not a replacement)

Here’s where my work has been heading:

I’ve written about how tools like ChatGPT can serve as a 24/7 support layer—not as a doctor, and not as a substitute for care, but as something that helps people:

• organize their story
• track symptoms and triggers
• create a one-page brief for appointments
• translate confusing information into plain language
• build health literacy
• reduce panic and “doom scrolling”
• and decide when something is urgent vs watch-and-track

For people with limited access to healthcare, that “between visits” support can be the difference between coping and collapsing.

I'm working on a book about how using the BioPsychoSocial Model patients/people can help themselves manage their own chronic pain/conditions 24/7 and only go to the doctor as needed or wanted. A follow-up book will be something like How to Use ChatGPT to Manage Chronic Pain/Conditions using the BioPsychoSocial Model. Stay tuned for these.

But I don’t want to only write about this

I’ll keep writing practical “how-to” books—because that’s one way I know how to help and scale support.

Here's my book series so far - https://www.amazon.com/dp/B0FXHL6712

But what I really want to say in this article is bigger than my books:

I want to connect with people building the future of care—especially for chronic conditions and underserved communities.

If you’re doing any of the following, I’d love to meet you:

• creating patient-facing AI tools that are safe, humble, and useful
• working in chronic care navigation, care management, or health coaching
• building systems that honor the whole person (not just symptoms)
• exploring narrative medicine, patient storytelling, and “the life context”
• working in safety-net settings where the need is constant and resources are limited
• producing, writing, or consulting for health stories that want to get the future right

My ask (and my offer)

I’m not posting this to “promote.” I’m posting it because I want to find like-minded people.

I want to learn what you’re building. I want to contribute where I can—ideas, patient-advocacy frameworks, biopsychosocial models, practical templates, prompts, structured logs, and the “patient brief” tools that help real clinicians and real patients communicate better.

And if there’s a “New Amsterdam: Tomorrow” future being imagined anywhere—inside healthcare, startups, nonprofits, public health, or media— I’d like to be part of that dream, not just write about it.

So I’ll ask it the Max way: How can I help? And maybe also: Who else is already trying? Let’s connect.

(Note: I’m not a healthcare professional. My work is educational/supportive and focused on helping people organize, reflect, track, and communicate—never replacing medical care.)

#NewAmsterdam #Biopsychosocial #ChronicPain #ChronicIllness #PatientAdvocacy 

#HealthEquity #AIinHealthcare #DigitalHealth #NarrativeMedicine #FutureOfCare

@DavidSchulner @Eric D. Manheimer @NBC @Universal Television

Medical Wristband That Listens

 

The Case for a Medical Wristband That Listens

Using HRV to detect Emotional Stress and/or Pain

One of the biggest blind spots in healthcare—especially for people with chr

onic conditions and for those who cannot communicate—is not a lack of technology, but a lack of continuous listening.

Pain, emotional stress, and nervous-system overload rarely arrive as single dramatic events. They accumulate quietly, often over days, weeks, or months. By the time symptoms escalate enough to trigger a doctor visit, the system has already been under strain for a long time.

This is where a medical-grade wristband, built around Heart Rate Variability (HRV), could fundamentally change how we detect and respond to suffering.

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Why a Wristband?

A wristband is uniquely suited for medical and chronic-care use:

• Always on
• Non-stigmatizing
• Familiar to patients and staff
• Usable in hospitals, long-term care, and at home
• Ideal for trend detection, not just spot checks

Unlike episodic measurements (vitals taken once or twice a day), a wristband can quietly track how the autonomic nervous system is behaving over time.

Not just “Are you in pain right now?” But “How long has your system been under load?”

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HRV as a Signal of Cumulative Stress

HRV reflects how well the body is balancing between:

• Sympathetic activation (stress, vigilance, pain)
• Parasympathetic recovery (rest, safety, healing)

In people with chronic illness or emotional strain:

• HRV may stay suppressed for long periods
• Recovery between stressors becomes incomplete
• Small triggers produce outsized reactions
• Pain and distress become “background noise”

This is what I’ve long referred to as cumulative stress—not spikes, but stacking load.

Years ago, before today’s wearables existed, I explored this idea in depth:

• That stress is integrative and time-based, not momentary
• That physiology can reveal overload before symptoms explode
• That continuous signals matter more than absolute thresholds

Those ideas are outlined in posts like:

• Cumulative Stress Monitor https://tgideas.blogspot.com/2019/04/cumulative-stress-monitor.html Introduces the idea that stress builds over time and needs trend-based monitoring, not alarms based on single events.
• Emotion-Sensing Technology Improves Care https://doctor-within.blogspot.com/2018/12/emotion-sensing-technlogy-improves.html Explores how physiological sensing can support patients whose emotional or physical distress is under-recognized.
• Design Notes: Measuring Emotional Stress https://tgideas.blogspot.com/2018/12/design-notes-how-to-measure-emotional.html Early design thinking on translating raw physiological signals into meaningful, humane indicators.
• How to Make a Medical Monitor (Prototype Thinking) https://tgideas.blogspot.com/2018/03/how-to-make-medical-monitor-with.html Looks at practical, low-cost approaches to medical sensing with patient context in mind.

What has changed since then is that HRV wristbands can now do this continuously, passively, and at scale.

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From ICU Technology to Everyday Care

In clinical environments, HRV is already used where patients cannot speak.

HRV-based systems like the Analgesia Nociception Index (ANI) translate heart rhythm patterns into indicators of:

• Pain
• Distress
• Autonomic imbalance

They allow clinicians to detect discomfort before visible agitation appears.

The same principle applies to a wristband for chronic care:

The body often signals overload before the patient can name it.

Now imagine this outside the ICU.

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What a Cumulative-Stress Wristband Could Do

A thoughtfully designed medical wristband could:

• Establish a personal HRV baseline
• Track rolling stress load across days and weeks
• Detect sustained autonomic suppression
• Flag “recovery debt,” not just acute events
• Support patients who under-report pain
• Give clinicians context before visits
• Validate patient experience with objective trends

Instead of alerts that scream “something is wrong now,” it could quietly say “this system has been struggling for a while.”

That distinction matters.

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Why HRV Over GSR for This Role

GSR (galvanic skin response) is useful, but HRV is better suited for cumulative monitoring because it:

• Reflects whole-system regulation
• Is less reactive to momentary artifacts
• Connects directly to emotional and cardiovascular health
• Supports recovery tracking, not just arousal

For long-term, real-world use, HRV becomes the backbone signal, with others layered on when needed.

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A Necessary Guardrail

HRV is deeply individual.

A meaningful wristband system must:

• Learn each person’s baseline
• Account for medications and conditions
• Focus on patterns, not scores
• Support—not replace—clinical judgment

This is not about diagnosing disease. It helps reveal physiological stress that often goes unnoticed in traditional care.

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Where This Points Next

The future is not just wearables. It’s wearables + narrative + clinical context.

A wristband that tracks cumulative stress becomes most powerful when paired with:

• Symptom journaling
• Patient stories
• Clinician insight
• AI used as a pattern-finder, not a decision-maker

That combination turns raw data into understanding.

Healthcare doesn’t fail because it lacks numbers. It fails because it misses quiet signals over time.

A medical wristband that listens for cumulative stress—using HRV—could help us finally hear what many patients have been living with all along.

Disclaimer - Article is for information only and is not medical advice.