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.
Dave helps Mark Moubarek, Amy Young, Rob Humble, and Corbin Weaver to practice their clinical skills by answering random people’s “health” questions from the saddest place on the Internet. But first we discuss the AMA’s policy to support the ban on direct to consumer advertising of drugs and implantable devices, and how such advertising makes the doctor-patient relationship complicated. Will drug companies retaliate by advocating for bans on advertising doctors and hospitals to patients. Researchers in the UK may be about to get the green light to edit the genes of human embryos seeking answers to why some miscarriages happen. Are we approaching the slippery slope?
Left to right, Rob Humble, Sean Astin, and Doug Russo being awesome.
This week, Dave, Aline Sandouk, John Pienta, Doug Russo, and Tony Rosenberg reflect upon the joy that podcasting brings, as we were recording the show on International Podcasting Day (Sept. 30). Something else to celebrate: Doug (and Rob Humble) got to chill with an actual hobbit. Or maybe it was Sean Astin, it isn’t entirely clear. But whoever it was, Samwise was in Iowa stumping for Hillary Clinton. Hobbitses are very liberal, what with their hairy feet and pipeweed. Meanwhile, Doug was listening to the recent show in which Mark Moubarek discussed Rhoto eye drops, and bought some for us to “do.” After the burning subsides, we discuss the advice from an attending overheard recently: should everyone really try to know everything?
After listening to our recent show that featured a review of a wrist-worn device that you can shock yourself with to punish you for engaging in bad habits, listener Paulius drops us a line to ask what Amy Young, Corbin Weaver, Aline Sandouk, and John Pienta do to reward themselves when they do the right things. Like watching YouTube videos of people doing things well. Or turning your life into a video game. Next, Amy attempts to learn some sort of lesson about clinical medicine as a result of her recent nasty bike wreck, aside from, “Being in a nasty bike wreck isn’t at all a good idea.” And Dave’s fear of someday ending up on YouTube video recorded while he recovers from anesthesia leads to a discussion on online privacy. Continue reading Reversing Pavlok, and What You Can Learn From Your Bike Wreck.→
Close your eyes, and picture an opioid abuser. If you’re like me, you see a man in a flophouse or dark alley. He’s cooking up heroin in a spoon over a lighter. Maybe he has a loop of tubing around his upper arm, and he’s shooting the heroin into a vein in the crook of his elbow. Once he’s done with the injection, he leans back with a euphoric sigh. Fade to black.
Maybe it’s just me, but this is the image that, for years, mediated my perception of the opioid epidemic, but it’s a stereotype created by television and movies. Even as a stereotype, it’s outdated, though. For decades, now, much of the epidemic is one of prescription drugs. The CDC says 78 people die from opioid overdoses every day. At least half of all opioid overdoses are from prescription drugs. Meanwhile, deaths from illegally made opioids, like the synthetic Fentanyl which is often mixed with heroin or cocaine to increase the high, increased 80% from 2013 to 2014. The American Society of Addiction Medicine says that prescription pain reliever overdose deaths among women increased more than 400% from 1999 to 2010, compared to 237% among men. In 2014, 168,000 adolescents were addicted to prescription pain medications. More than 2 and a half times that number of kids were taking prescription pain relievers for non-medical uses.
Next week, from September 26 to September 30, 2016, the University of Iowa Carver College of Medicine will host the Opioid Overdose Prevention Summit. Second-years med students Sarah Ziegenhorn, Petra Hahn, and Cameron Foreman helped organize the conference, in which students from the Colleges of Medicine, Dentistry, Pharmacy, Social Work, Public Health, and Nursing will join together to increase their knowledge and to influence public policy and legislation; personal perspectives; and student advocacy. , Sarah, Petra and Cameron were joined by Assistant Dean Denise Martinez and Nurse Kim Brown, whose son Andy died of an overdose, to talk about the issues of opioid addiction, treatment, and overdose prevention. Continue reading The Modern Opioid Epidemic→
This week, Dave volunteers to wear a device that’s received a lot of buzz lately, Pavlok. It’s creator says that through classical conditioning it will help eliminate bad habits–nail biting, unhealthy eating, procrastination, for instance. It’s ubiquity on Dave’s social media feeds this past summer got Dave thinking about how much of human disease is based in behavior, bad habits. So Dave asked the company to send it’s crowdfunded, wrist-mounted electrical shocker for evaluation, and they inexplicably said yes. Aline Sandouk, Lisa Wehr, and Nick Sparr all had a crack at it, and share their experience. Along with Rachel Schenkel, they attempt to use it to teach Dave not to say “Uh.” Is it effective and worth the $169 price tag? Are its integrations with the Internet of Things or its Chrome plugin a help for those looking to kick their bad habits? Are there better, cheaper alternatives?
Also, the Affordable Care Act has begun withholding Medicaid reimbursements to hospitals based on patient satisfaction surveys, and giving bonuses to those which do well on those surveys. We explore medical education’s trade-offs in a game of what if. Hint: it turns out that our little group members are a bit mercenary. Continue reading Shocking the Habits Away→
Stress is a part of medical school. Worrying about tests, studying until you drop, late nights, early mornings, and drinking from the firehose all seem to promote the idea that med students should do nothing else but study. Dave, Aditi Patel, Marc Toral, Levi Endelman, and Kylie Miller agree, which is one reason Aditi and Dave put on a monthly Art Club. Students get together over lunch and have fun with paints, ceramics, drawing, whatever! No pressure, just an hour away from medicine.
And speaking of being away from medicine, a listener calls into 347-SHORTCT with a question about how best to keep in touch with family and friends who might not understand the demands of medical school. And we discuss Aditi’s family (who just happen to be the subject of a documentary available on Netflix) and the methods they’re using to select her future husband. And we play Superfight!
Dave, John Pienta, Mark Moubarek, Matt Maves, and Levi Endelman are aware that the world is full of questions. Nowhere is that more true than on the saddest place on the Internet, Yahoo! Answers. There folks ask the kinds of things that a primary care physician might have to answer. Is removing a layer of skin with a razor a good way to get rid of acne scars? What could be the cause of blisters on one’s lips after kissing one’s dog? How much milk should one use in one’s bath? There are no stupid questions.
But first, since Matt has returned from a year in Des Moines doing clerkships there, we discuss what that’s been like and the benefits of doing some clerkships outside a more academic setting. We also discuss the psychiatric disorder pica and the kinds of things people swallow on purpose (or by accident). Also we talk about drug maker Mylan’s difficulties with, well, everyone after we collectively realized they’re gouging patients who need epinephrine auto-injectors to keep themselves alive. Meanwhile, a company is offering a supplement that its CEO, a pioneering MIT aging researcher, and it’s Nobel-prize festooned board of scientific advisors say might just be a way to extend the human health span.
Ryan Gray, MD, was a physician in the Air Force. He’d planned all along to be an orthopaedic surgeon…but the military had other plans for him: aerospace medicine. Later, when a diagnosis of multiple sclerosis forced him to give up flying, his career plans changed once again, and he decided to set aside the practice of medicine to focus his growing business as the proprietor of MedicalSchoolHQ.net where he advises pre-medical students on their efforts to get into medical school. He’s also a podcaster in that vein, as the host of The Premed Years podcast, the OldPreMeds Podcast, and The MCAT Podcast. As Dave, Nicole Morrow, Amy Hansen, Alex Volkmar, and Tony Rosenberg found, not only is Dr. Gray a thoughtful adviser, but he’s a lot of fun to talk to. His thoughts on being a non-traditional medical student (he was one himself), the efforts of some schools to create competency- and systems-based curricula instead of exam-based curricula, and the types of students admissions committees are most interested in are definitely worth knowing. And check out Dr. Gray’s new book, The Premed Playbook: Guide to the Medical School Interview. Continue reading The Doctor Is In: Ryan Gray Lifts Up the Next Generation of Medical Students→
An honest guide to the amazing and intense world of medical school.
