First Opinion Podcast

This week is a special two-part episode focusing on last week’s controversial — some say inflammatory — decision to approve aducanumab, a new Alzheimer’s drug. In these episodes, I talk with two Alzheimer’s experts with vastly different viewpoints on the news. First up: Dennis J. Selkoe, a physician and scientist whose research is at the core of how Aduhelm works.

This week, two First Opinion contributors join Pat to talk about the toll that medicine can take on a professional's mental health, and how the pandemic has only exacerbated those consequences. Corey Feist co-wrote his essay with his wife Jennifer Breen Feist, the sister of Lorna Breen, who died by suicide last year after contracting Covid-19. Wendy Dean is a psychiatrist who wrote an iconic First Opinion in 2018 about the moral injury that physicians experience. Corey and Wendy joined Pat for a discussion on how to heal the healers.

This week, Pat is joined by two members of the National Academy of Medicine’s Committee on the Future of Nursing. We discuss full practice authority, which gives advanced practice nurses the ability to diagnose, write prescriptions, and care independently for patients. It’s a contentious issue, but Regina Cunningham and Marshall Chin believe that with more autonomy, nurses are capable of dismantling the country’s health inequities.

Danielle Ofri experienced the pandemic firsthand at Bellevue Hospital in New York. As a primary care physician, Ofri makes life-long connections with her patients. She talks about the importance of recognizing the emotion that comes when a patient dies, how her experiences as a medical resident during the AIDS crisis shaped her career, and how the Covid-19 pandemic will have a similar career-sculpting effect on today's trainees. The conversation starts with Ofri's First Opinion essay, "My ‘postmortem’ folder and the intensely personal nature of the latest Covid-19 surge."

This week, Pat is joined by Chelsea Clinton, who recently wrote a First Opinion on the health dangers of fracking with two of her colleagues at Columbia University's Mailman School of Public Health, Terry McGovern, and Micaela Martinez. The conversation covered global public health crises such as fracking, oxygen shortages, and the pandemic.

Reporter and editor Kalpana Jain details how India got to today's crisis with Covid-19. Although some blame hypernationalism, she calls on her two decades of writing about health and health care for the Times of India to show that the real issue is neglect of the health sector during India’s growth and development. Having covered multiple pandemics and epidemics, Jain says that she's seen the toll it can take on families. In some ways, Covid-19 is different, she says. But in others it's heartbreakingly the same.

It's easy to identify the physical manifestations of long Covid — severe fatigue, weakness, palpitations, brain fog, and more — but far trickier to understand what's causing them. Pat talks with critical care physician Adam Gaffney and philosopher Diane O'Leary about the blurred distinction between the direct effect of a viral infection and potential psychosomatic origins. The conversation jumps off from each guest's recent First Opinion: Gaffney's "We need to start thinking more critically — and speaking more cautiously — about long Covid" and O'Leary's "Needed for long Covid: a less authoritarian approach to understanding, treatment."

In this episode of the First Opinion Podcast, Pat gets a history lesson on the deadly and disgusting diseases of the American Civil War and the important public health lessons to be learned from them, in a conversation with medical historian Jonathan S. Jones.  Diseases like smallpox, measles, and dysentery killed two-thirds of the one million people who died in the Civil War. "Chronic diarrhea" plagued soldiers for decades after the war. And while we no longer depend on digging ditches for latrines, we're still struggling with faith in national public health measures, racial disparities in healthcare, and more. The conversation was based on Jones' recent First Opinion, "Lessons learned — and forgotten — from the horrific epidemics of the U.S. Civil War."

Pat speaks with Baghdad-trained physician Lubab al-Quraishi about her disappointment with the medical licensing system in the United States. She worked for a decade as a pathologist in Iraq, but ended up working at Popeyes in the US because she could not afford the studying time or financial costs of the exams needed to transfer her license. The conversation is based off al-Quraishi's recent First Opinion, "Foreign-trained doctors like me were asked to help fight Covid-19. Now we’re being tossed aside."

Pat speaks with two addiction doctors who have seen delirium first-hand, and wrote last week's First Opinion, "Excited delirium: valid clinical diagnosis or medicalized racism? Organized medicine needs to take a stand." Though the term was first used back in 1985, little evidence exists that the diagnosis of excited delirium is a valid one.  Brody and Jordan break down the difference between delirium and "excited" delirium, contextualizing the racist systems of medicine and policing that created it.