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.→
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.
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.
The opinions expressed in this feed and podcast are not those of the University of Iowa or the Roy J. and Lucille A. Carver College of Medicine; nor do they reflect the views of anyone other than the people who expressed them. If you have feedback on anything you hear on the show, positive or not, let us know.
Dave’s feeling a bit concerned for the future of the world these days. As a consumer of science fiction movies and books, he’s long noticed a theme therein: that of the old people holding on to the reigns of power, both economic and political, while the young people struggle for a foothold. As society continues to skew older–with medicine becoming better and better at keeping the elderly healthy longer–will the youngsters lose whatever agency they have? John Pienta, Nick Sparr, Tony Rosenberg and Taz Khalid humor Dave by talking about it. Also, since Tony’s here, there is somehow more talk of poop.
Do you, dear students, have tons of money? No? Weird. Luckily, Joe Saul-Sehy of the Stacking Benjamins podcast joins us on the show this week. Joe was a financial advisor for many years, he was known as the Money Man on WXYZ-TV in Detroit, and he’s a financial contributor in a bunch of places around the print and web news media. He and his wife Cheryl, a pediatrician, have gone through all the stages that pre-meds and med students go through. So we asked him to join us to talk about the strategies they employed to claw their way back from med school debt, educating yourself about how money works, having fun with managing your money, and why it’s particularly important for doctors to understand money. Joe’s got plenty of information, resources and ‘fintech’ apps to recommend for succeeding in this area that many people (never mind med students) have not adequately explored.
On a recent show, Dave opined that shaving one’s armpit hair might cut down on deodorant failure, and a listener called into vindicate him, much to Mark Moubarek’s shame. Another listener, PharmD and author Tony (he’s written a book you might want to try if you’re looking for “a relaxed approach” to memorizing pharmacology), wants to know how a medical student gets to the point where they can be confident enough to say to a patient, “There will be no problems.” Mark, Amy Young, John Pienta, and newcomer Julie Gudenkauf weigh in on the acquisition of confidence and the art of reassurance.
John Pienta, Cole Cheney, Amy Young, and newbie Rob Humble join Dave to discuss the recent winter break, the Rose Bowl, and Stanford’s half-time band performance. We discuss doctors who are non-compliant with their own recommendations for patients. Is that something they should be condemned for, or is it human nature? And when patients are non-compliant or engage in risky behavior, should docs acknowledge that as normal human behavior and avoid shaming them for it? Continue reading Normalizing Human Behavior, Transvaginal Speakers, and Deflating Outsized Egos→
Cole Cheney returns from our state capital, where he’s been doing his clerkships at our kind-of satellite campus (more about this program specifically is here, if you’re interested). He and Kaci McCleary, John Pienta, and Rachel Schenkel talk about the differences between doing rotations in a teaching hospital and doing them in a community hospital. For example, how are community hospital patients different? And in that setting, what does it really mean if your patient is non-compliant? Cole reveals that he’s ‘afraid’ he’s going to love psychiatry and wants to know: are other students also wary of the specialty? We talk about the downsides of the field, as well as the rather big professional and caregiving upsides. Continue reading Losing the white coat, psych fears, and Internet questions answered→
After Martin Shkreli’s arrest, John Pienta, Marc Toral, Greg Woods, and Amy Young, discuss why Pharma Bro Martin Shkreli is so hated, given that capitalist enterprises have profit as their overarching goal–hasn’t he just done his job? Meanwhile, two ongoing clinical trials have been experimenting on human subjects without consent. Those subjects: residents and their patients. The experiment: what happens if hospitals return to the longer hours that prevailed for residents before they were restricted in 2011? We explore the limitations of consent, residents’ satisfaction with their working conditions, how many residents may not feel that restricting their hours is best for their patients, and what working and being a patient at an academic medical center means.
