Poor: a deadly diagnosis in America, ft. Sarah Smarsh

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A look at the people valued more as functioning machines than as people

Sarah Smarsh

This past week, the Carver College of Medicine hosted its 12th annual Examined Life Conference.  Our featured presenter, journalist and memoirist Sarah Smarsh, grew up in a family of farmers and teen mothers in Kansas.  Her family, laborers trapped in a cycle of poverty, made the kinds of choices that poor people must make in rural America–whether to eat or seek medical attention, for instance.  Decades of inattention–and scorn–from politicians and the media have widened this class divide, and have sent the inexorable message that their voices don’t matter.  Ms. Smarsh’s recent book, Heartland: A Memoir of working Hard and Being Broke in the Richest Country on Earth, tells the tales of her family’s struggles with poverty, addiction, workplace injuries, and family violence that many economic and political elites don’t have the background or will to truly understand.

Though Ms. Smarsh has managed to escape the cycle, she has retained her citizenship in–and love for–that largely unexplored country, and offers a deep look at what it’s like to be poor in the wealthiest and most powerful society on the planet. Our executive producer Jason T. Lewis, Rob Humble, Gabe Conley, Teneme Konne, and Christopher Portero Paff talk with Ms. Smarsh about what the working poor are facing, how our willful lack of understanding shapes our perceptions of their struggles, and why it’s crucial that medicine encourages and welcomes them as providers.

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Your voice does matter.  So call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.

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Hit By A Bus

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Our newest co-host has already had a taste of fame.

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“And that’s when I new I wanted to be a doctor.” Photo by ThoseGuys119

Abby Fyfe joins the crew this time, along with Aline Sandouk, Jayden Bowen, and Aditi Patel.  Turns out, Abby is an old hand at being internet famous, because she was (trigger warning) once run over by a bus. True story.  She has since regained her 3-dimensional shape, but did she mine that experience for her med school applications?

But first, listener Tyler wants to know: is your undergrad institution’s reputation an important factor for med school admissions committees? And we got some feedback from Alex, an actual registered dietician, and Blake responds to a recent question from Courtney about raising kids during med school.

Later, Jayden quizzes us: can we guess what these genes do based on their very geeky names?

This Week in Medical News

In light of recent scandals in research and retractions of studies, an article in Molecular Cell proposes a Hippocratic Oath for scientists.  And there’s a new opioid possibly coming to market that is 500 times more powerful than morphine.

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What experiences did you mine for your med school application? Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  Do all three!

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Nebraska has questions.

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Jennifer Andersen, a sociology PhD student at the University of Nebraska-Lincoln, teaches a course called Sociology of Health and Health Care.  She reached out to us to propose that her students would send in questions for us as an extra credit assignment, which was a great idea we jumped on because it meant Dave would barely have to prepare for this show…I mean, it’d be a great education opportunity for her students’ young, fertile minds.

Ahem. Aaanyhow, her students really stepped up with some great topics for Aline Sandouk, Aditi Patel, and new co-hosts Kelsey Anderson and Jacob Chrestenson.  So come along with us as we dive into questions like, have you ever had to do something in med school that wasn’t ethical,  is it better to come to medical school with an open mind about your eventual career, and what’s it like working with different attendings all the time? They’ve got answers to all these queries and a lot more.

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What do you want us to talk about on a future show?   Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  Do all three!

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Listeners Revolt!

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We love listener feedback…even when it’s negative 🙂

And this whole obesity thing is really great for generating negative listener feedback.  For instance, Marlene thought our comments on nutrition were mostly wrong.  And Laura didn’t seem happy with what we thought was our neutral stance on keto, either, as she’s having some success with it…although a lack of carbs looks just as bad as a bunch of carbs.  We could ride this obesity gravy train all the way…but Dave is le tired.

Fortunately for our egos, a while back we managed to give some good advice to Victoria on interviewing , who called back to give Irisa Mahaparn, Aline Sandouk, and newbs Justin Hababag and Annee Rempel some GREAT news!  Go, Victoria!

This Week in Medical News

Are you ready to share your brains with other people?  Are you ready to drink your own urine?  Are you ready to not choose a medical school based on it’s ranking in US News & World Reports?  We think hard about those important questions.

We Want to Hear From You

Have we stepped on your sacred cow?  Are you happy with our advice? Have we done anything useful today? Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  Do all three!

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Bonus Episode! Why You Might Want an MD/PhD

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All about Medical Scientist Training Programs

The MD isn’t the only degree offered by many medical schools.  For those who get excited about data, research, and advancing medical knowledge, you can add a Doctor of Philosophy degree.  Of course, there are those who get their PhD separately from their Medicinae Doctor.  Others get their PhDs from combined degree programs, including Medical Scientist Training Programs (MSTP).

Aline Sandouk and Jayden Bowen took on the topic with a number of first-year MSTP students–why is an MD/PhD something you should consider?  Join them and Ossama Abu-Halawa, Hassan Ahamed, Akansha Jain, Madi Mix, Nate Mullin, Miranda Schene, Hannah Van Ert, and Qi Wang as they reveal reasons you might want to consider this sort of combined degree and the types of programs to choose from.

We Want to Hear From You

What questions do you have about MSTP or MD/PhD programs? Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  Do all three!

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Ambien Dreams

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This week, listener Jen sent us an article from JAMA in which the author bemoans his tendency to let the electronic health record (coupled with his data-entry difficulties) dominate his attention at the expense of his ability to really see and empathize with his patients.  The cost: missing clues that indicate a patient’s progressive decline and family dynamics that contribute to the condition.

Meanwhile, Chrissy Teigen and John Legend find themselves chewing on sleeping pill side effects, causing us to wonder–why is Ambien still on the market, unless it’s to create really great slam poetry?  And we practice our teamwork in a mobile game called SpaceTeam, proving perhaps that not all such games make for good podcast fodder–you decide, but don’t @ us, we already know the answer.

This Week in Medical News

Will we see a shift in the standard of care for appendicitis, now that a Finnish study has backed up the mounting evidence that it can often successfully without surgery?  And a study on the high costs of poor healthcare around the world suggests that fixing it will cost 6% of the cost of doing nothing.

We Want to Hear From You

Do you have suggestions for what we should talk about on SCP? Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  Pick your favorite!

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Bonus Episode! Palliative Care: A Perspective from A Land Where It Barely Exists, ft. Dr. MR Rajagopal

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Palliative care is not a thing in India, mostly.

In most of India, palliative care–a medical specialty focused on improving the quality of life of people with life-limiting or disabling diseases–is available to only 1% of people who need it.  But in Kerala, one organization is making lots of headway in promoting this vital specialty.  In this episode, Pallium India’s founder, chairman, and 2018 Nobel Peace Prize nominee Dr. MR Rajagopal visited the University of Iowa College of Medicine to talk about their efforts to introduce to Indian providers a new way of thinking about pain and other symptoms by providing emotional, social and spiritual support.

As you might expect from such a practitioner, Dr. Rajagopal is an extraordinarily thoughtful man with a kind, quiet voice that belies what must be an extraordinary force of will needed to accomplish his goals.  Tony Rosenberg, Ellie Ginn, Rachel Schenkel, and Jayden Bowen discussed how he began his journey, what his fellow Indian providers made of these ideas, and what his hopes are for the future of palliative medicine around the world.

We Want to Hear From You

Do you or anyone in your family have experience with palliative care? Tell us about it at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  We’d love to hear from you!

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What Skinny Doctors Don’t Get About Their Obese Patients

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Let’s just keep talking about treating obesity

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Photo by rawdonfox

Fifi Trixiebell (not her real name) wrote to theshortcoats@gmail.com asking us to discuss what medical students learn about nutrition, and whether they think the keto diet is just another fad.  Luckily, Madeline Slater, Emma Barr, Kyle Kinder, and newbie Sam Palmer–M1s all–just had a unit on nutrition so that’s an easy one.  But Fifi Trixiebell had written in before, a message which–despite his policy of answering every listener question–Dave had passed over.  Why did he ignore it?  He’s not sure; it was a while back, but it may have triggered him (though, to be clear, it wasn’t Fifi’s fault).  We also discuss an article from HuffPo about the “unique and persistent trauma” doctors visit upon their obese patients.

Plus, with the announcement of the 2018 Ig Nobel Prizes, we cover the weird winners in medicine; and Dave puts his co-hosts to the test on their knowledge of past winners.

This Week in Medical News

Sure, when a person is stressed out, the cortisol and adrenaline circulating in the blood mediate the body’s responses, but what about mitochondrial DNA?  Perhaps your mom really is trying to kill you!

We Want to Hear From You

Have you ever heard from a perfect stranger how to fix your life? Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  Do all three!

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Are physicians hopeless in the face of the obesity epidemic?

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Obesity may not be hopeless, but it is very difficult for physicians and sufferers

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Photo by MaAtE

Listener Hannah wrote in after shadowing physicians, noting that many of the morbidly obese patients she observed resisted their doctors’ advice to lose weight.  Is there any hope that doctors can treat this intractable illness when patients don’t “want” to do the work?  Aline Sandouk, Claire Casteneda, Kylie Miller, and newbie Ali Hassan offer their views and what they’ve learned so far about treating this difficult disease.

Also, in Dave’s constant quest to ‘contribute’ to his co-hosts clinical skills, we visit the saddest place on the Internet, Yahoo! Answers, so they can practice their patient education techniques.

This Week in Medical News

Congratulations, Sperm Donor #2757!  You’re the father of 45 girls and boys between the ages of 1 to 21 years old, and your generosity has made things very weird!  And we discuss yet another questionable beauty practice, the vampire facial, which OH COME ON NOW, HOW IS THIS EVEN A THING?

We Want to Hear From You

What are your views on the obesity epidemic…is it hopeless? Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  Do all three!

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Is AOA racially biased?

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Residency applicants get boosted by AOA, but it could be racially biased

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Photo by jurvetson

Aline Sandouk, Jayden Bowen, Aditi Patel, and newbie Madeline Slater are on hand to answer listener questions, such as J’s query about the utility of post-bacc programs for med school applicants, and Chelsea’s question about the use of primary literature in medical school curricula.  We also discuss how membership in Alpha Omega Alpha Medical Honor Society boosts residency applicants’ competitiveness, and what some schools are doing to ensure they don’t leave out minorities underrepresented in medicine.

Plus, have you considered acquiring a medicine bag of polished stones from everyone’s favorite MD, Gwyneth Paltrow?  With the news that her company GOOP has settled a lawsuit in several states alleging some of their products make questionable health claims, we explore some of the items promoted at their recent convention.

This Week in Medical News

Hospitals are tired of shortages of vital medicines, so some are banding together to make them by forming their own non-profit drug company.

We Want to Hear From You

Do you know anyone who uses GOOP products? Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  Do all three!

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An honest guide to the amazing and intense world of medical school.