First Opinion Podcast

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.

This week, the podcast takes on antimicrobial resistance and "superbugs," a topic that should be worrying all of us, but somehow isn't. Pat talks with David Hyun and Rachel Zetts, both with The Pew Charitable Trusts' antibiotic resistance project, about their recent First Opinion, "Many hospitalized Covid-19 patients are given antibiotics. That’s a problem."

In this week’s episode, Dr. Jason Karlawish and Richard Bartholomew, the husband and caretaker of one of his patients, share insight into the relationship between caregivers and clinicians when looking after someone with Alzheimer's. The conversation covers how diseases like Alzheimer's and Covid-19 ramify to affect more than just its patients, and how caregivers shouldn't be thought of as typical hospital visitors, but as essential members of the care team.

Host Pat Skerrett talks with Kara Zivin, a physician, research scientist, and professor of psychiatry and of obstetrics and gynecology. She wrote a moving and informative First Opinion, "Meghan Markle gave voice to the despair I once felt during pregnancy," soon after Oprah Winfrey's interview with the Duchess of Sussex.  In their conversation, Kara talks about her own struggles, as well as the balancing act between protecting one's privacy and advocating for changes in policy and stigma. A caution to listeners: This episode includes discussions of suicide during pregnancy.