The Podcast by KevinMD

"Today, we got called on a patient in the ICU who recently had a new brain mass removed surgically. The specimen came back positive for an aggressive brain tumor known as glioblastoma multiforme. We discussed his diagnosis and prognosis with him at bedside alone, with his wife and daughter on speakerphone given visitor restrictions due to the current coronavirus pandemic. Unfortunately, this type of situation is rather familiar to us. We are used to breaking bad news, comforting patients during their times of need, and then shifting to our usual survival tactic of orchestrating a treatment plan. While many aspects of this exchange were similar, there were unique variables that grabbed my attention, given our current circumstances." Azam J. Farooqui is a hematology-oncology physician. He shares his story, global health perspective, and discusses his KevinMD article, "Breaking bad news to patients when they are alone." (https://www.kevinmd.com/blog/2020/03/breaking-bad-news-to-patients-when-they-are-alone.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

"The events over the last couple of weeks have affected me deeply. Of course, I'm concerned about a novel virus that is infecting and killing people. But, I'm more distraught over the reaction of the people, the response of the state and federal governments, the blatant disregard of science/epidemiology, and the warnings of our physicians on the front lines. Most of us will get this virus and be OK. But slowing it down is 100 percent vital. Why? Because our health care system has limited resources. We only have so many hospital beds in this country and, at last count, only 62,000 ventilators. If the forecasted numbers of infected Americans reach the projected peak in the millions, we will have no choice but to ration those resources. This means a physician will be tasked with choosing who gets a chance to live and who does not. This is the reality in other countries." Michelle C. Hure is a dermatopathologist. She shares her story and discusses her KevinMD article, "A pathologist's message to the public." (https://www.kevinmd.com/blog/2020/03/a-pathologists-message-to-the-public.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

"Most physicians have spent decades training for the day that they see their first patient or perform their first surgery. This extended time involved to become a physician does not leave a lot of spare time in college or medical school for most physicians to take any significant coursework in economics, finance, or investing. Yet, physicians have a tremendous amount of knowledge with regards to all aspects of health care, including patient evaluation and physiology, medical technology, and electronic health records. We recognize the relevant positives and negatives and the benefits and shortcomings of current medical technology and computer-based patient care platforms. Most physicians have keen insight into what is currently working for them and their patients, and what might be done to improve the status quo. This knowledge and insight is a major reason why startup companies with new technology, and venture capital investors, often look to partner with physicians and bring them on as investors and advisers. There is a growing desire and need for physicians to be more actively involved in venture capital funds and physician networks for this purpose." Chris Kager is a neurosurgeon. He shares his story and discusses his KevinMD article, "A physician in the venture capital world." (https://www.kevinmd.com/blog/2020/03/a-physician-in-the-venture-capital-world.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

"Each morning before the doctors came in for rounds; I'd paint feverishly whatever abstraction came to mind and what evolved from my situation. When I completed my pieces, I felt like I had not only gotten out my frustrations and worry, but also found a place of joy and gratitude. I would put each canvas outside my hospital room, and soon the unit began to catch on, even taking patients by my room to see whatever I had created that day. Now, I was sustaining my aliveness and inspiring others, which filled myself with unanticipated meaning and satisfaction. Ironically, the darker the circumstances became, the more joyous my paintings seem today. Every tree seems to be singing and dancing, although the tear-drops and lightning bolts are always streaked across the bold backgrounds. Once I discovered painting, my world changed. I had found a way to express things that were too painful, complicated, and overwhelming for words. Suddenly, when the uncertainty around me seemed frighteningly unmanageable, the strokes of my paintbrush could soothe me as I created a peaceful world that my soul longed to rest in as a place of peaceful solace. My passion could ignite instead of my anger and despair. And slowly, the good feelings overwhelmed the bad because I could control the positive world portrayed on my canvases with what my subconscious chose to create." Amy Oestreicher is the author of My Beautiful Detour: An Unthinkable Journey from Gutless to Grateful (https://amzn.to/2AHSwhH) and can be reached at her self-titled site, Amy Oestreicher. She shares her story and discusses her KevinMD article, "Art therapy and the intersection between chronic illness and mental health." (https://www.kevinmd.com/blog/2019/07/art-therapy-and-the-intersection-between-chronic-illness-and-mental-health.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

"Do all physicians and scientists not on the frontlines of this pandemic feel this, or is it unique to women? Women in medicine and science have long struggled with the sense of never having 'done enough' and have pushed themselves even harder to get the same recognition accorded our male colleagues. Does that make us more vulnerable to guilt, or are we holding ourselves to unreasonable expectations? We arranged to meet for a 'wellness session,' and as we shared our experiences, we realized one thing was common: We all felt guilt." Theresa Rohr-Kirchgraber is an internal medicine-pediatrics physician. She shares her story and discusses her KevinMD article that she co-authored, "The guilt of not being on the frontlines of the pandemic." (https://www.kevinmd.com/blog/2020/04/the-guilt-of-not-being-on-the-frontlines-of-the-pandemic.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

Thank you for listening to the podcast. There were some audio difficulties during this interview, which I hope you can overlook. It certainly does not take away from Dr. Sheikh's message and her wonderful interview. "'It's a strange time to be having a baby,' my patient said as she sat alone in her labor room. The state order to shelter-in-place in California had left her family with few options as her husband had to stay home to take care of their toddler. She is one of many pregnant women who do not have the choice to even consider a home birth due to her congenital heart condition, which puts her at risk for sudden cardiac death. She understood that she was part of a 'high-risk' population, the ones with preexisting conditions that are more likely to have severe disease if they contract COVID-19. If she got sick, it would mean total isolation and separation from her baby and family for weeks. I sat with her a little longer. She smiled, but I could see the fear and uncertainty in her eyes — fear of giving birth alone and of what life would look like with a newborn in our new apocalyptic reality. Pre-pandemic, I would have sat closer to her and even held her hand to ensure her that she was not alone. But I sat six feet away and consoled her from a distance and simultaneously wondered if she could sense my own fear and apprehension. 'I'm sorry that your husband can't be here with you. These are unprecedented times for all of us, and we'll do the best we can to keep you and your baby safe.' We must be strong for our patients. As young physicians, we have seen our fair share of trauma, death, and despair. But most of us have never had to come face-to-face with our own mortality. Now, we have fear." Maria Sheikh is an obstetric anesthesiologist who blogs at The Epidural Doc and can be reached on Twitter @MariaSheikhMD. She shares her story and discusses her KevinMD article, "Giving birth during the COVID-19 pandemic: an obstetric anesthesiologist's perspective." (https://www.kevinmd.com/blog/2020/04/giving-birth-during-the-covid-19-pandemic-an-obstetric-anesthesiologists-perspective.html)

"As a nearly graduated medical student, I have come to the conclusion that the focus of medical school is split between training and distinguishing medical students. Modern pedagogy has not found its way into the modern medical school classroom. Preclinical students spend mounds of time on impossible tasks, like memorizing First Aid for the USMLE Step 1, without learning concrete skills that can be applied to clerkships. As for clerkships, the quality of teaching is highly dependent on the attending's or resident's level of commitment to education. Oftentimes, we feel like flies on the wall rather than active participants in patient care." David Chen is a medical student. He shares his story and discusses his KevinMD article, "Why are medical students non-essential?" (https://www.kevinmd.com/blog/2020/05/why-are-medical-students-non-essential.html)

"Come with me on this journey, this very ancient journey. To experience the age-old story of a very modern foe. This foe is invisible; it is neither living nor dead. You cannot smell it, and you cannot taste it. While it is not alive, it can become alive, with a flick of the right kind of switch. While it is not dead, it can masquerade as the dead, until the perfect moment. This is the journey of the 2019 novel coronavirus." Frank Han is a cardiology fellow. He shares his story and discusses his KevinMD article, "A journey through time with a very modern foe." (https://www.kevinmd.com/blog/2020/05/a-journey-through-time-with-a-very-modern-foe.html)

"It is no secret that we started off combating COVID-19 with disadvantages. Lately, news is rampant with coverage of the paucity of ventilators, hospital beds, and N95 masks. But it is important not to forget the deficits in our workforce. Last year, the American Medical Association estimated that our nation faces a projected shortage of up to 122,000 doctors in the next decade. In the midst of this, 27,000 physicians are DACA recipients, and a myriad of international medical graduates suffer the disquiet of whether or not they will get timely visas or green cards. As I think of these doctors, some of whom are my own colleagues and are fellow minorities in medicine, I cannot help but consider the repercussions to public welfare if their status was rescinded." Natalie Moreno is a medical student and can be reached on Twitter @NatalieAMoreno1. She shares her story and discusses her KevinMD article, "Immigrant and minority physicians at the frontline of pandemics." (https://www.kevinmd.com/blog/2020/04/immigrant-and-minority-physicians-at-the-frontline-of-pandemics.html)

"The donation of hydroxychloroquine, in contrast to the accompanying donation of 1,000 ventilators, is unethical as either humanitarian aid or as a 'research study.' The United States has a moral responsibility for any human harm that results. We cannot simply send medications off to potentially vulnerable populations without regard for the lives that could be negatively affected. It is not enough to intend to do good and avoid harm; we must ensure it." Charles E. Binkley is a bioethicist and general surgeon. He shares his story and discusses his KevinMD articles, "It is unethical for the United States to send hydroxychloroquine to Brazil" (https://www.kevinmd.com/blog/2020/06/it-was-unethical-for-the-united-states-to-send-hydroxychloroquine-to-brazil.html) and "Mike Pence and the Mayo Clinic's moral failure." (https://www.kevinmd.com/blog/2020/05/mike-pence-and-the-mayo-clinics-moral-failure.html)