The Clinical Problem Solvers

In this episode, the hosts discuss the approach to a new headache, physical exam findings for headache patients, and the workup for headache and suspected giant cell arthritis. They explore the possibility of tuberculous meningitis as a cause of the patient's headache and discuss the role of lab results and MRI in diagnosing giant cell arthritis. The speakers also highlight the management of giant cell arteritis, including the use of IL-6 blockers.

https://clinicalproblemsolving.com/wp-content/uploads/2024/01/RTP_EditedNeuroPodcastJanuary2024.mp3Episode title: Episode 317: Neurology VMR – Generalized weaknessEpisode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Kirtan presents a case of generalized weakness to Vivek and Hannah.Neurology DDx Schema Kirtan Patolia@KirtanPatolia  Kirtan Patolia is a second-year Internal Medicine resident from John H. Stroger Jr., Hospital of Cook County, Chicago. He relishes being the CPSolvers team member, as solving cases and generating differential diagnoses are his biggest passions. You will frequently find him sharing clinical cases on VMR. Outside of medicine, he likes to read fiction, particularly Agatha Christie and Nancy Drew novels. He also loves kite flying, especially using various techniques and maneuvers to fly the kites. Vivek Paul@vjpaul88  Vivek Paul is a medical graduate from Bharati Vidyapeeth University in Pune (India), now based in Chicago, Illinois. Having worked as a junior doctor in India after completing medical school, Vivek has more recently been involved in clinical research at Northwestern University Feinberg School of Medicine and is working towards a residency in Internal Medicine. He is also an avid musician with a Spotify account where he releases songs he has written through the years. When not working, Vivek can be found making loud and angry music, playing tennis, exploring local food joints, or on long walks with his dog, Melody. Hannah RobertsUnavailableDownload CPSolvers App hereRLRCPSOLVERS To join us live on virtual morning report, sign up here.  

Math and magic behind becoming better learners. Strategies for continuous learning and processing information. Deliberate practice and motivation for effective learning. Retaining information and creating a narrative without direct patient access. Approaching medicine with joy and prioritizing learning.

Approaches to diverticulitis complications discussed through a case. Treatment options, ruling out other causes of abdominal pain, and importance of post-diverticulitis colonoscopy. Perforation, abscess, obstruction, and fistula as complications. Role of antibiotics explored. Gratitude to listeners.

 https://clinicalproblemsolving.com/wp-content/uploads/2023/12/RLR-for-podcast-DECEMBER-FINAL-RTP-1.mp3 Episode descriptionReza and Rabih discuss a case of a patient with flank pain and systemic features Student discounthttps://www.rlrcpsolvers.com/student-discounts/ IMG discountUse coupon code RLRIMG at check out  https://rlrcpsolvers.com/annual-plan

Hepatology specialist Dr. Rafael Medina discusses a case of a woman with fatigue and splenomegaly. Topics include liver disease complexities, physical exam findings, advancements in Wilson's disease diagnosis and treatment.

https://clinicalproblemsolving.com/wp-content/uploads/2023/11/editedNeuroVMRnovember2023frequentstumbling.mp3Episode title: Episode 312: Neurology VMR – Frequent stumblingEpisode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Valeria presents a case of frequent stumbling to Nilayan and Subhangi.Neurology DDx Schema Valeria Roldan  Valeria is a medical student at Universidad Peruana Cayetano Heredia. She was born and lives in Lima, Perú. She hopes to pursue Neurology residency. Her interests include neuro-infectious diseases, transgender health and medical education. Her work with CPSolvers involves being a part of the Virtual Morning Report team and serving on the Spanish schemas team. Outside of Medicine she loves running, hiking, cooking pasta and spending time with her dogs. Nilayan Sarkar@nilayansarkar Nilayan is a first year Internal Medicine Resident at Lady Hardinge Medical College in New Delhi, India. He has been an avid fan of the CPSolvers since his third year of medical school. Clinically, his interests include Point of Care Ultrasound (POCUS), Critical Care, Cardiology and Medical Reasoning. Outside of work, Nilayan enjoys quiet evening walks with his family, meditation, and nature jaunts. He hopes this episode brings you as much joy as it did to him and believes Dr. Aaron Berkowitz is the best thing that has ever happened to #beatingNeurophobia. Subhangi Chandanhttps://clinicalproblemsolving.com/meeting-join-live/“To join us live on virtual morning report, sign up here.”Download CPSolvers App hereRLRCPSOLVERS 

Experts in hypercalcemia, seizure management, and vision loss discuss a case of severe hypercalcemia, seizures, and vision impairment. They delve into the significance of parathyroid hormone levels in diagnosing parathyroid disorders and explore the differential diagnoses for the patient's symptoms. They also discuss the potential long-term effects of hypercalcemia on vision and the importance of expanding understanding in this area.

Dr. Risheen Reejhsinghani, cardiologist extraordinaire, discusses her journey in medicine, her love for cardiology, and combining her passions for medical education and mentoring. The podcast covers topics such as navigating uncertainty in medical careers, building relationships and breaking down hierarchies in medicine, and the importance of work-life balance in the field.

https://clinicalproblemsolving.com/wp-content/uploads/2023/11/CPSolvers-Episode-23_-Anti-Fat-Bias-FINAL-Post-Auphonics.mp3CPSolvers: Anti-Racism in Medicine SeriesEpisode 23 – Anti-Blackness, Anti-Fatness, and Food ShamingShow Notes by Humza A. SiddiquiOctober 31, 2023 Summary: This episode highlights the culture of food shaming and anti-fatness as it relates to anti-Blackness. During this episode, we hear from Da’Shaun L. Harrison, a community organizer and trans theorist, and Dr. Psyche A. Williams-Forson, an author and chair of the Department of American Studies at the University of Maryland. Together, our guests offer context around the history of anti-Blackness and how it is deeply intertwined with the culture around eating in America as well as the way anti-fatness manifests. Further, they expand on this to discuss how it relates to policing and the court systems in the U.S. This discussion is hosted by Sudarshan Krishnamurthy and Ashley Cooper. The show notes for this episode were written by Humza A. Siddiqui. Episode Learning ObjectivesAfter listening to this episode, learners will be able toExplain how anti-fatness and food shaming culture in the U.S. is rooted in anti-Blackness.Describe the intersection of policing and the court systems with anti-fatness and food shaming.Identify ways to navigate clinical interactions with patients while respecting them and affirming their experiences with food and fatness. CreditsWritten and produced by: Sudarshan Krishnamurthy, Ashley Cooper, TeamHosts: Sudarshan Krishnamurthy and Ashley CooperInfographic: Creative Edge DesignAudio Edits: Ashley Cooper and Noah NakajimaShow Notes: Humza A. SiddiquiGuests: Dr. Psyche A. Williams-Forson, Da’Shaun L. Harrison Time Stamps00:00 Opening00:45 Introductions03:07 Guest Introduction 104:46 Guest Introduction 208:15 On the Intersection of Black, Fat, and Trans Communities and the Medical-Industrial Complex13:35 History and the Racial Underpinnings of Food Shaming in the U.S. Landscape21:48 Policing, the Court Systems, Anti-Blackness, and Anti-fatness 46:45: Language Matters: The War On Obesity1:02:09 On Caring For Black, Fat, and Trans Patients1:15:37 Fatness is Not Killing People and Other Pearls1:21:25 Closing Remarks Speaker biographies (Abbreviated)Dr. Psyche Williams-Forson is a Professor and Chair of the Department of American Studies at the University of Maryland College Park. She is the author of two award winning books:  Eating While Black: Food Shaming and Race in America (James Beard Foundation) and Building Houses Out of Chicken Legs: Black Women, Food, and Power (American Folklore Society); as well as the co-edited Taking Food Public: Redefining Foodways in a Changing Food World. Her work can also be found in several other publications and on podcasts and documentaries. Dr. Williams-Forson received her BA from the University of Virginia and her MA and PhD in American Studies from the University of Maryland.Da’Shaun Harrison is a trans theorist and Southern-born and bred abolitionist in Atlanta, Georgia. They are the author of Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness, which won the 2022 Lambda Literary Award for Transgender Nonfiction and several other media/literary honors. As an editor, movement media and narrative strategist, and storyteller, Harrison uses their extensive history as a community organizer—which began in 2014 during their first year at Morehouse College—to frame their political thought and cultural criticism. Through the lens of what Harrison calls “Black Fat Studies,” they lecture on blackness, fatness, gender, and their intersections. Harrison currently serves as Editor-at-Large at Scalawag Magazine, is a co-host of the podcast “Unsolicited: Fatties Talk Back,” and one third of the video podcast “In The Middle.” Between the years 2019 and 2021, Harrison served as Associate Editor—and later as Managing Editor—of Wear Your Voice Magazine. Episode TakeawaysOrigin Stories – For Dr. Psyche A. Williams-Forson and Da’Shaun L. Harrison, the work that they do is deeply informed by the history of chattel slavery in the United States, through which eugenicists, white anthropologists, and racial realists created entire disorders to medicalize and bastardize enslaved folks who were interested in freedom. Natal alienation is, in part, the under-structure of the wider Medical-Industrial Complex and the gratuitous violence that fat, Black, trans folks experience. All of this contributes uniquely to social death.Soul Food – Food cultures are more complex, multilayered, and storied than Black stereotypes will lead even Black communities to believe. For this reason, labeling food in categories, and the moralizing that follows, can be extremely dangerous. A toxic cycle of disordered eating can emerge, and treatment for recovery can be rooted in anti-Blackness as physicians view the Black habitus as out of control, unruly, not in conformance with a wider racial project as described by Michael Omi and Howard Winant. The developing attitudes about food scarcity and deficit models, and mass media’s manufacturing consent, has to be challenged, especially because there is a deep and rich history of Black people as farmers, gardeners, and ranchers that belies what Chimamanda Ngozi Adichie calls the danger of a single story.Afterlife of Slavery – We are living in what Saidiya Hartman calls the Afterlife of Slavery, in where skewed life chances, limited access to health and education, premature death, and surveillance, incarceration, and impoverishment are overdetermined by slavery’s racial calculus. Da’Shaun L. Harrison explains the role of fatness in all of this and offers examples across medicine, law, and sociology that demonstrate fatness and Blackness cannot be divorced from each other. Dr. Williams-Forson expands on this history with respect to Black women, whose bodies are fetishized, and Black children, whose bodies are adultified, respectively. All of this contributes to various mental health challenges that are consistent with surveillance in not only a wider police-state but also the patient-physician relationship.The War on Obesity – We cannot make recommendations to our Black and Brown patients about diet and exercise without acknowledging that white supremacy is statistically more likely to kill Black and Brown patients than obesity. The conditions through which the United States’ socio-politico-economic apparatus is maintained, and the cultural mores that we encourage as a society, make it difficult for Black and Brown patients to eat a healthy diet or move their bodies freely.Fatness is Not Killing Black People – Historically, what is killing Black people is a medical industry that is not primarily built to offer care and is otherwise disinterested in learning more about the experiences of Black bodies. Anti-obesity initiatives that aim to reduce weight and encourage healthy diet and exercise, while they may nudge choices on a population level and put pressure on corporations in their harmful advertising, may be reductive in their understanding of fatness as a function of obesity. Fat people can lead healthy lives, and we need to think about the structural issues that keep the populace from being healthy at all sizes. This demands teleological explanations and policy interventions. On one hand, we must not moralize food choices. On the other hand, we cannot let hyper-capitalism off the hook, especially those industries that target Black and Brown communities and seek to profit from the manufactured consent that lends itself to insecurities about weight loss or weight gain.PearlsRespect cultural mores about diet and exercise. Acknowledge that Black and Brown patients understand their bodies at some level and what sustains them nutritionally. Be precise instead about the care we can offer beyond weight loss. Fatness is not killing Black people. However, consider that Black patients are navigating disordered eating as a function of moralizing their food choices under white supremacy and a standard of care that was created by eugenicists, white anthropologists, and racial realists that inappropriately value the heterosexual, cis-gender, white European male habitus. References Cox, J. (2020). Fat girls in Black bodies: creating communities of our own. North Atlantic Books. Harrison, D. (2021). Belly of the Beast: the politics of anti-fatness as anti-blackness. North Atlantic Books. Taylor, S. R. (2018). The body is not an apology: the power of radical self-love (First Edition). Berrett-Koehler Publishers. Williams-Forson, P. A. (2022). Eating while Black: food shaming and race in America. The University of North Carolina Press. Possley, M., & Armstrong, K. (1999, January 11). Part 2: The flip side of a fair trial. Chicago Tribune. https://www.chicagotribune.com/investigations/chi-020103trial2-story.html Purkiss, A. (2017). “Beauty Secrets: Fight Fat”: Black Women’s Aesthetics, Exercise, and Fat Stigma, 1900–1930s. Journal of Women’s History, 29(2), 14–37. https://doi.org/10.1353/jowh.2017.0019 Waxman, O.B. (2022). “The White Supremacist Origins of Exercise, and 6 Other Surprising Facts About the History of U.S. Physical Fitness.” Time Magazine. https://time.com/6242949/exercise-industry-white-supremacy/  Harrison, D., Tovar, V. (2021, January 5). Fatphobia (& Foodphobia) is Anti-Blackness with Da’Shaun Harrison, Season 2, Episode 1. Rebel Eaters Club. https://podcasts.apple.com/us/podcast/fatphobia-foodphobia-is-anti-blackness-with-dashaun/id1495401238?i=1000504393373 Harrison, D., Young, R. (2023, September 21). Destruction w/ Da’Shaun Harrison. Episode 6. Weight for it. https://podcasts.apple.com/us/podcast/destruction-w-dashaun-harrison/id1686599391?i=1000628697389 Disclosures The hosts and guests report no relevant financial disclosures. CitationHarrison DL, Williams-Forson P, Cooper A, Krishnamurthy S, Siddiqui H, Calac A, Pitre A, Pierce G, Essien UR, Fields NF, Lopez-Carmen V, Nolen L, Onuoha C, Watkins A, Williams J, Tsai J, Ogunwole M, Khazanchi R. “Anti-Blackness, Anti-Fatness, and Food Shaming” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. November 7, 2023. Show Transcript Download CPSolvers App hereRLRCPSOLVERS