This episode is all about false dichotomies–situations or ideas that seem like dilemmas (and thus require a difficult choice to be made) but which really aren’t. Much of the public discussions of things like the hours that residents work, the funding for medical research, the lifestyles that residents are forced to lead, the choices that prospective medical students make are couched in terms of either/or choices. Corbin Weaver, Matt Wilson, John Pienta, and Kaci McCleary discuss the alleged dilemmas that we encounter in medicine and medical education, and conclude that these choices are often not mutually exclusive. It is possible to have both shorter hours and safer patient handoffs and quality education, despite rules that seem to indicate otherwise. It is possible to adequately fund basic science research and fund a sensible national defense, despite presidential budgets that slash NIH funding. Should listener Justin study during the summer prior to med school to begin medical school on the right foot, or will he struggle if he takes a break to live a little? And listener Julian is super annoyed at the admissions process. Is his ire justified? Listeners, share your thoughts and questions with us each week. Call us at 347-SHORTCT any time.
This week we start with some feedback from listener Paulius, who has a suggestion for a future show on the unsung heroes of primary care. Thank you! Dave bats the idea around with John Pienta, Kylie Miller, Tarek Karam and Elizabeth Shirazi. Meanwhile, as biomedical science grapples with a study-replication crisis perhaps caused by structural problems that discourage repetition in favor of novel findings and breakthroughs, we consider the advice of Ioannis Yannas, one of the inventors of artificial skin. Are cat lovers really at risk for schizophrenia? A large UK study says piffle, although cat-lover Kylie points out that there are some caveats. And though Tarek and Kylie are well-behaved on the mic, their individual approaches to weather-related flight delays reveal some points of contention. Listeners, share your thoughts with us each week. Call us at 347-SHORTCT any time, and ask us questions on Fridays at noon as we record the show while broadcasting on Facebook Live!
On Inauguration Day, listener Tekia (and we hope that’s spelled right) called to let us know that we were helping her stay frosty. Another listener, Liza, wrote wondering if her peers with MD family members are at an advantage in medical school. Co-hosts John Pienta and Adam Erwood (who have physicians in their immediate families) and Kylie Miller and Rob Humble (who don’t) are happy to discuss the blessings supposedly showered upon those for whom medicine is a family business, and how those who aren’t so fortunate can soldier on without those advantages. Also, the spirit of intellectual curiosity is alive! Thanks to that–and a twitter hashtag–we learned this week that birds don’t break wind. Listeners, share your thoughts with us each week. Call us at 347-SHORTCT any time, and see our Facebook page for a question to consider every week.
[With Thanksgiving late week, we didn’t record a new episode. Enjoy this rerun, instead!]
Just hours before a new crop of medical students are to be welcomed into the world of medicine, Kaci McCleary, John Pienta, Aline Sandouk, Mark Moubarek, and Lisa Wehr confront one of the most uncomfortable topics in medical education: resident and student suicide. Among doctors, suicide rates are much higher than among the general population. The long hours, high pressure (from both one’s internal monologue and from outside sources) to succeed, fear of public humiliation regarding one’s shortcomings, isolation, inadequate supervision, the stigma against mental illness, the career penalties faced by those who admit to unwellness, and more, all contribute to the problem. Institutions also have a difficult time addressing incidents of physician suicide effectively, as they try to walk a tightrope strung between respect for the privacy of the deceased, the needs of colleague survivors to talk about it, the desire to avoid adverse publicity. Meanwhile, the work does not stop. The only breaks are a moment of silence, a visit with a grief counselor, or an “open forum” to discuss one’s feelings.
Fortunately, the culture may be changing to allow for more discussion, prevention, transparency. Institutions like the University of Iowa and Harvard University are adding counseling capacity, student groups to support struggling peers, and a greater openness to acknowledging without shaming the fact of mental illness among physicians.
Happy Thanksgiving! The crew–John Pienta, Marc Toral, Dylan Todd and new guy Jay Blomme–were lucky enough to hear from a couple listeners about our recent post-presidential election episode. For instance, Kayla called 347-SHORTCT to say thanks; we presume she had more to say, but she got cut off. We continue our discussions on logic and logical errors, considering the efforts that Facebook and Google are making to reduce the effects of ‘fake news.’ John has some suggestions on how to have a productive conversation with people whose opinions you don’t share. Dylan is the master of strange analogies that ultimately are right on target. We discuss one idea in DIY medicine we might be able to get behind, a device that allows women to take some control of their breast reconstruction journey. And we mark the passing of ‘The Radioactive Boy Scout,’ David Hahn, who attempted to build a working nuclear reactor in his back yard as a teenager. And some podcasters who couldn’t join us this week send in their thoughts on what they’d do with an extra day no one else could mess with. Listeners, share your thoughts with us each week. Call us at 347-SHORTCT any time, and see our Facebook page for a question to consider every Monday.
With the close of the election of 2016, many people, including us, found themselves dismayed and surprised by a great many things. But why were we so shocked? Now that our hindsight has been LASIK’d, some are noticing the truth that was hiding in plain sight: people were feeling ignored. And those people were the ones that the electoral college protects: rural Americans. In this episode, we (that is, Dave, Mark Moubarek, John Pienta, Rob Humble, and Amy Hanson) try to step out of our bubble. We cast our eyes on our own ignorance and speculate a little on what our fellow Americans want. We try to avoid politics in this episode in favor of thoughtful, empathetic consideration. Let us know whether or not we were successful.
John Pienta, Levi Endelman, Kylie Miller, and Adam Erwood get to answer some probing questions: what’s the first thing a student wants to know upon starting a new clerkship? What’s the most important skill they’ve ever learned? And what medical specialty should Vladimir Putin pursue? Also–helpful tip for medical students–if you want to perform the best you can, science says you just need to be reminded that one day you will be worm food. And men seem to be having trouble with the idea of having minor procedures and experiencing side effects in exchange for the privilege of having sex without certain undesirable consequences like babies. And we discuss the apparent YouTube trend of DIY braces made by 13-year-olds from wires, superglue, and rubber bands. If you can ignore the risks of your face falling off, it’s a real money saver!
Compassion fatigue is a problem for many practitioners. In medicine, some of the needs are so great, and the resources are often so finite. Aline Sandouk, John Pienta, Rob Humble, and Kaci McCleary discuss what happens when caring itself becomes a limited resource, the reasons empathy can dwindle, ways to cultivate it, and the role that compassion can play in caring for oneself. We also learn what monks and nuns are teaching us about how compassion manifests positivity and even neural plasticity.
Continue reading Compassion Isn’t Easy
Halloweeeeeeennnn! It’s upon us, and while we’re women and men of science around here, we’re not completely able to shed our lizard-brain’s need to take shortcuts. Which is why we are not at all surprised to know that ER docs still think the moon’s revolutions around the big blue marble are in any way important. Fortunately, the post-cave-dwellers at the Marburg Center for Undiagnosed and Rare Disease are putting IBM’s Watson to good use by diagnosing–in seconds– rare diseases that defy the efforts of meatier doctors. And a Rutgers study finds that med school faculty severely underestimate students’ stress and mental health issues.
WHO researchers in Uganda are keen to teach schoolchildren there how to spot dubious health claims. This leads Dave to ask Levi Endelman, John Pienta, and newcomers Alice Ye and Adam Erwood whether their generation was taught the principles of logic and scientific thought in a way more effective than his own generation was taught, while Alice questions the motives of the researchers themselves. On a related note, listener Jake writes in to remind John that even we on The Short Coat Podcast, careful as we are to disclaim any logic whatsoever, should be wary of “shallow/uncontrolled” arguments. We discuss emerging ideas on treating ICU patients in ways that minimize ICU delirium and PTSD, a problem once known as ICU psychosis, including changing the ways patients are sedated, their environments, the emphasis on convenience for healthcare personnel, and other factors that may be making patients crazy.