The Podcast by KevinMD

"I love stories, either told, written, or listened to. Songs tell stories, as does art. Blogs such as the rich content open so many doors for rich conversations. Telling stories is part of who I am. My father loved to tell them, as did my grandfather, whose name I took. They were called bull-sh*tters – and perhaps some refer to me that way at times. In medicine, I find storytelling to be critical. Each time we present a case, we are telling a story. Those residents and students who can present a case to me in a way that draws me in while giving me the necessary facts, but goes the next step that allows me to see that person in their life are the ones I know will be amazing doctors." John F. McGeehan is an internal medicine physician. He shares his story and discusses his KevinMD article, "Why storytelling is critical in medicine."

"In the months just prior to the infantile spasms, as Josephine's mind had begun to develop and grow, so, finally, had my love for her. My lack of affection for her up until that point had troubled me, and it was with relief that I had realized I was beginning to look at her with adoration—that a random thought of her was accompanied by delight as often as sadness. I knew that my lack of acceptance had been at the root of my difficulty bonding with her, and I had felt that I was beginning to find peace with the person that she was, limitations included. Looking back, I see that my reaction to her that night in the rocker—my denial of her personhood, my despair at the thought of being obligated to mother her—reveals that what I mistook for love and acceptance was actually something much more tenuous and conditional. I wasn't truly beginning to love her, I was beginning to love who she might become. It was only her potential I valued, not her current self. The odyssey to fully embracing her, disabilities and all, was one I had yet to make." K. Jane Lee is a pediatrician and author of Catastrophic Rupture: A Memoir of Healing. She shares her story and discusses her KevinMD article, "A shift from the medical perspective of disability to a mother's perspective."

"Medical debt is the mortal enemy of the patient, the physician, the hospital, the community, the state, and the nation. When we think of others' debts, we tend to think such debts are their personal responsibility. If they're unable to pay the debt, it's their problem. (We make it a You problem, not a Me problem) Society tells us a problem with personal debt is a direct result of bad decisions, poor personal financial habits, profligate spending, living beyond one's means. We blame those with medical debt for their bad choice of buying substandard health insurance, or else for not purchasing any health insurance at all. We say the consequences of debt are rightly visited on the debtor. Whatever the impact — canceled credit cards, low credit, wage garnishment — it's on them. Personal responsibility. Is this true? In the big picture, we individuals and society both bear the costs and burdens of personal "bad debt." For individuals who fall into arrears in their payments, who cannot pay their financial obligations, unpaid debt means their ability to buy goods and services is curtailed or perhaps ended. If new credit is not extended, the person must live on cash. For any business, any debt that's not paid by the customer creating it becomes a cost to the enterprise extending credit. The business recoups its loss by raising prices on products or services for all future customers. The business may stop its loss by not providing goods or services to a debtor, disciplining those not paying their bills. In such cases, the consequences of unpaid bills fall on the debtor and creditor, usually ending there." Robert E. Goff is a health care consultant and co-author of End Medical Debt: Curing America's $1 Trillion Unpayable Healthcare Debt. He shares his story and discusses his KevinMD article, "Medical debt is the enemy of everyone."

"My practice consisted of patients who suffered from serious injuries and illnesses. Concerning the latter, a significant number had cancer, especially breast cancer. The issue all patient groups have in common to a certain degree is protein calorie malnutrition (PCM). The most dramatically affected are those stricken with a malignancy. PCM leads to increased morbidity, mortality, complications, length of hospital stays, and hospital readmissions. As physicians, we must bring awareness to this devastating problem and offer solutions based on education and new product innovation." Steve Snodgrass is a surgeon and founder, Dr. Steve's Nutri Snax. He can be reached on Instagram @drstevesurgeon. He shares his story and discusses his KevinMD article, "Protein calorie malnutrition is devastating for patients."

"To better meet the needs of patients, providers can improve access to treatment and offer more immediate solutions through the use of prescription digital therapeutics (PDTs). With technology, providers can now deliver programming aligned with proven mental health treatment methods, such as cognitive-behavioral therapy, and connect teens and young adults to an immediate, safe, and effective treatment option. Technology cannot replace good patient relationships, but the future of mental health care rests in leveraging technology that complements a clinician's hands-on care. The last year and a half has underscored the need to shift rapidly and use new solutions in a meaningful way. People are becoming increasingly more receptive to telehealth and virtual treatment – especially teenagers and young adults. Now is the time for physicians to consider digital therapeutics to quickly and safely support their patients who need mental health treatment, intervening early to achieve better outcomes." Benjamin Alouf is a pediatrician. He shares his story and discusses the KevinMD article, "How digital therapeutics can strengthen the provider-patient relationship and improve behavioral health outcomes."

"Many of us suffer in silence for myriad reasons. Being a physician with infertility presents a perfect storm of stress, anxiety, guilt, and shame – all of which we know don't contribute to managing any medical problem. Consider what it's like to undergo a typical cycle of in vitro fertilization. You administer nightly hormone injections to grow your follicles in preparation for an egg retrieval procedure. The process usually takes 1-2 weeks, but you don't know exactly how fast your follicles will grow. For the first week, maybe you just need to arrange to get away from the hospital or clinic for a couple of blood draws. But during the second half of your stimulation cycle, you must physically go into your clinic for daily transvaginal ultrasounds to monitor the progress." Dawn Baker is an anesthesiologist who blogs at Practice Balance. She shares her story and discusses her KevinMD article, "The voices of women physicians with infertility." (https://www.kevinmd.com/blog/2021/12/the-voices-of-women-physicians-with-infertility.html)

"Patients communicate immense amounts of information through body language. The primary understood, universal body language is choking. Anywhere in the world you go, if someone is choking, they use both hands to grab their throats. No matter what country you are in or what language is spoken, you can recognize someone choking and provide aid if trained. Body language is also understood to convey various subconscious emotions – crossed arms can be used by someone who is angry, frustrated, or scared, or shutting down in a conversation; open arms and uncrossed legs can be used by individuals who are open to new ideas, and willing to communicate with those they are talking to." Jennifer Ribar is an osteopathic physician. She shares her story and discusses her KevinMD article, "Listening to patients with our eyes." (https://www.kevinmd.com/blog/2021/11/listening-to-patients-with-our-eyes.html)

"Medicine is not a business You fools. Healing is your blueprint, activated to complete itself. A doctor does not broker it, The best anyone can do is align you With what you should be, And stay out of the way. (Like a teenager setting off an illegal firecracker.) Mostly, you pay the doctor for the alignment, And the nurse To keep the doctor out of the way. If you're not ready, to get on with the business of what you should be, You come back later. Or, maybe, next lifetime. It's not complicated. And it's not a business. You fools. The doctor knows what you should be, when they know what they are, And if they don't And the nurse can't tell them, You come back later, Or, maybe, next lifetime. It's simple, but It's not easy, And it's not a business you fools. I've seen it, GNP and recurring revenue and prayers so many pairs of high-intervention end-of-life care. It's cosmic law That you cannot profit from someone else's suffering. You only appear to, When you do not know what you are. When you are blind to the part of yourself that suffers with them. Which is why medicine is not a business it's a relief, A chance to make yourself right, Whole. When you are whole, you come back later if you want or next lifetime, To heal." Drea Burbank is a physician-entrepreneur. She shares her story and discusses her series of poems, "When you die: a poem," "Medicine is not a business: a poem," and "A physician's pain poem."

Welcome to an expedited episode of The Podcast by KevinMD. Trevor Bedford is a computational biologist and infectious disease scientist, Fred Hutchinson Cancer Research Center. He was selected as a recipient of the 2021 MacArthur Fellowship and can be reached on Twitter @trvrb.

"The holiday season is rapidly approaching, and it is not uncommon for us to gain up to 10 pounds between Thanksgiving and Valentine's Day. But what if we do not want to put on some insulation? What can we do? I specialize in medical weight loss, and my first recommendation would simply be to be aware of the food around us and recognize that seeing food in itself can be a trigger to eat." Angelice Alexander-Martin is a family physician. She shares her story and discusses her KevinMD article, "Don't let the holidays sabotage your weight loss goals." (https://www.kevinmd.com/blog/2021/11/dont-let-the-holidays-sabotage-your-weight-loss-goals.html)