The Podcast by KevinMD

"We know the ER's revolving door will continue to spin for so many children and adolescents who seek help in the heat of their personal crisis. Some will need to stay in the hospital – to heal their bodies and minds and even fight for their lives. Some – the lucky ones – will be able to go home, but by no means are they out of danger. Their lives too are threatened, and they will need ongoing support from parents, family, friends, teachers, and mental health providers – who will likely care for them across a virtual platform. Human contact has been gravely compromised this past year, and we, as pediatric ER doctors, as members of our community, and as parents, are seeing the fallout in the children we care for." Rachel Kowalsky and Shari Platt are pediatric emergency physicians. They share their stories and discuss the KevinMD article, "Dying of loneliness: the COVID-19 epidemic in children and adolescents." (https://www.kevinmd.com/blog/2021/04/dying-of-loneliness-the-covid-19-epidemic-in-children-and-adolescents.html)

Listen to psychiatrist Emily Watters' work with the homeless population and how she got her start writing cartoons, educating patients using out-of-the-box communication strategies. Emily Watters is a psychiatrist and can be reached at The Cartoon Shrink. She shares her story and discusses her KevinMD articles, "Blood clots and the Johnson & Johnson vaccine: a comic explanation" (https://www.kevinmd.com/blog/2021/05/blood-clots-and-the-johnson-johnson-vaccine-a-comic-explanation.html) and "If the COVID vaccines don't make you sick, why do some people feel sick?" (https://www.kevinmd.com/blog/2021/03/if-the-covid-vaccines-dont-make-you-sick-why-do-some-people-feel-sick.html)

"For the folks who are either physicians or becoming care providers, I hope you choose to familiarize yourself with this odd yet common form of loss. I encourage you to respect a woman's right to decide at what point and to what degree her fetus and its life or loss has meaning to both her regardless of your views. I implore you to become familiar with laws, regulations, and general procedures surrounding fetal death and disposal of remains in the state(s) in which you choose to practice and how it may vary in pregnancy. Last, I hope this helps the women who yearn to know the personal experience of someone with VTS, as I did during my pregnancy." Nichole Cubbage is a biomedical researcher. She shares her story and discusses her KevinMD article, "Let's talk about vanishing twin syndrome." (https://www.kevinmd.com/blog/2021/04/lets-talk-about-vanishing-twin-syndrome.html)

"I often think about how I can make you see these things about yourself that others see. I think about the ways I can tell you that things will get better even though the darkest of days is upon you right now. But I know I can't make you see these things; no one can. I know these things may not be helpful to hear, irrelevant, noisy. So instead of trying to convince you, dear one, I'm going to be here for you. I'm going to listen to you. I'm going to advocate for you. I'm going to help pull you out of this depression. I'm going to help you live a valued life with chronic pain. I'm not going anywhere. Please, please stay here too." Melissa Geraghty is a psychologist and can be reached on Twitter @mindfuldrg. She shares her story and discusses her KevinMD article, "To the patient who wants to die: a psychologist's perspective." (https://www.kevinmd.com/blog/2021/04/to-the-patient-who-wants-to-die-a-psychologists-perspective.html)

"As a species, we have been an abject failure in dealing with a worldwide crisis. We politicize things for money, political reasons and some kind of weird power, even when it kills us in the process. We already have a World Health Organization (WHO). Would it be so difficult to staff it with the best scientists from every country, without any political pressure and follow their recommendation worldwide, without local bureaucratic interference? The first vaccine approved by the WHO — no prizes for guessing — mRNA Pfizer. Humans have a way of complicating life by breaking even common sense into silos guided by politics, power, hubris, and finance. We read history and shake our heads when we see some of the haunting tragedies of mankind. And yet, we continue making the same fundamental mistakes. To paraphrase, "The tragedies will continue; we just will have different entries and exits."" Dinesh Arab is a cardiologist. He shares his story and discusses his KevinMD article, "The vaccine rollout's tragic dance." (https://www.kevinmd.com/blog/2021/05/the-tragic-dance-of-the-vaccine-rollout.html)

"From a charting standpoint, the sins of commission easily outnumber the sins of omission. Our group's progress note template begins with a summary that eventually becomes the narrative for the discharge summary. Most of the time, most of the important stuff is in there. It's just obscured by what data scientists technically describe as 'oodles' of no-longer-relevant details. Like a package of cheap ramen, the single cube of chicken meat is in there. Your job is to find it. Why do we do this to ourselves? Why do we keep simply adding details to a note rather than subtracting the no-longer relevant ones?" Craig Bowron is an internal medicine physician and can be reached at his self-titled site, Craig Bowron, MD. He shares his story and discusses his KevinMD article, "Bloated notes are a huge problem and a time suck." (https://www.kevinmd.com/blog/2021/05/bloated-notes-are-a-huge-problem-and-a-time-suck.html)

"We believe optimal postoperative pain management should provide adequate pain relief, minimize adverse effects, and reduce chances of drug misuse. While we cannot undertreat pain, we also cannot go back to the practice of over-prescribing or unnecessarily prescribing opioids for minor operations. There needs to be a carefully nuanced balance in treating pain, especially for pediatric and adolescent patients. Going forward there needs to be continued parent and patient education about expectations for recovery post-surgery and proper pain management. This needs to include consistent messaging to families regarding safe use, storage, and disposal of opioids as well as the risks for non-medical use and substance use disorder. This critically important topic deserves more research and clarification so that the medical community can properly treat pediatric and adolescent pain. Stigmatizing the select use of opioids for children and adolescents after surgery is counterproductive and additional guidance should not emphasize the fear of opioid diversion or misuse over appropriate pain management." Rita Agarwal is an anesthesiologist. She shares her story and discusses the KevinMD article, "Pediatric patients need appropriate pain management after surgery." (https://www.kevinmd.com/blog/2021/03/pediatric-patients-need-appropriate-pain-management-after-surgery.html)

"The symptoms of EDS aren't limited to the musculoskeletal system and commonly affect everything from hearing and vision to integumentary issues such as prolonged wound healing and easy bruising. It also became apparent that the specialists I had seen had contributed valuable information to the overall puzzle but were simply not able to put it all together. I had accrued an impressive list of diagnoses commonly associated with EDS: migraine, gum disease, anxiety, fibromyalgia, chronic fatigue, restless leg syndrome, sleep disorder, lumbar spondylolisthesis, sacroiliac dysfunction, hiatal hernia, hearing loss, and early-onset osteoarthritis. EDS explained everything right down to the bumps on the sides of my heels called piezogenic papules and my velvety soft, delicate skin. One physician explained how she makes sense of this constellation of multi-system symptoms by using the phrase: 'If you can't connect the issues, think of connective tissues.' Finally, it all made sense." Julie Griffis is a physical therapist. Linda Bluestein is an integrative medicine physician. They share their stories and discuss this KevinMD article, "The difficult to diagnose comorbidity that plagues Ehlers-Danlos syndrome patients." (https://www.kevinmd.com/blog/2021/05/the-difficult-to-diagnose-comorbidity-that-plagues-ehlers-danlos-syndrome-patients.html)

"The impact of the pandemic on the lives of Americans will be felt for years, if not generations, to come. This includes its alarming effect on health behaviors that contribute to the already formidable challenge of obesity in this country. Now, more than ever, we must look for creative solutions within the broader health ecosystem that can help individuals adapt their behaviors, in spite of socio-environmental challenges, to prevent, manage, and maybe even reverse chronic disease. The very health of our nation depends on new solutions to our country's age-old societal, cultural, and behavioral challenges." Rami Bailony is an internal medicine physician. He shares his story and discusses his KevinMD article, "The overlooked factors driving weight gain in the pandemic." (https://www.kevinmd.com/blog/2021/03/the-overlooked-factors-driving-weight-gain-in-the-pandemic.html)

"Interviewing for medical schools was intense, excruciating, and terrifying. Despite the difficult questions, there are three that stand out to me. The first was to differentiate sympathy from empathy, where I spent 30 minutes defending my answer to be met with complete silence. He could have asked me anything, yet he sat in silence for almost my entire interview and asked me to explain emotional differences between two incredibly similar words. Or are they? I have been left to contemplate this repeatedly, and I have come to realize my first medical school lesson happened before I was even in training. That day, he taught me to see how we as physicians need to examine emotions, become aware of our capacity to both feel and heal, understand our patients, share their struggles and triumphs even if we haven't walked in their diagnoses, and take the time—even if it is painful and met with silence—to realize the gravity of our position is not only responsibility for people's lives but to be emotionally available." Erika Visser Aragona is a family physician. She shares her story and discusses her KevinMD article, "The life cycle of emotion in medicine." (https://www.kevinmd.com/blog/2021/05/the-life-cycle-of-emotion-in-medicine.html)