First Opinion Podcast

Physicians Alison Block and Nikki Zite knew what they were getting into when they became abortion providers early in their medical training. Family planning has long been a politicized, divisive area of medicine. And even though they knew that Roe v. Wade — the 1973 Supreme Court case that protected abortion access across the country — was being threatened, it still hit them hard when that ruling was actually overturned in June 2022.

From our colleagues at Globe Opinion comes a new podcast: Say More. Say More, hosted by Globe columnist Shirley Leung, is all about exploring our backyard for the cultural trends, scientific discoveries, and breakthrough startups that are shaping the nation.

Stephanie W. Edmonds and Ginny L. Ryan are both doctors. Edmonds, a registered nurse, has a Ph.D., while Ryan is a traditional M.D. But as part of a fight over “scope creep” in health care, many medical doctors might bristle at the idea of calling Edmonds “doctor.” In the last episode of the season, Edmonds and Ryan speak about the health care hierarchy, why calling health care workers by their first names might help patients, the tendency for physicians to mock "noctors," and much more.

"You can't pour from an empty cup" is what registered nurse Tara Rynders learned the hard way after two decades of work and one heartbreaking, life-threatening experience of being a critical care patient herself. Before that experience, she'd always found found that dance, play, and other types of movement helped her express and heal from the trauma she encountered and held in her body every day. After recovering from her experience as a patient, she brought that to several other nurses in a workshop.

Duchenne muscular dystrophy is a devastating disease and, until very recently, was one without much hope. When Hawken Miller was diagnosed at age 5, the physician told his parents to enjoy the time they had with him, as there wouldn't be much. Over 20 years later, Miller is a journalist and content strategist for CureDuchenne, an organization started by his mother when he was diagnosed, and new treatment is on the horizon. Last month, the FDA approved a new gene therapy from Sarepta Therapeutics that will provide hope for many patients and families. The new drug, however, has its limitations — it's only approved for children age 4-5, for example. Miller joined the podcast to discuss how this drug may change lives, what more needs to happen, and what his personal experience has been living with Duchenne.

Physician and professor Jason Karlawish argues that new promising drugs like lecanemab, an anti-amyloid antibody expected to be approved by the FDA July 6, will introduce complicated issues into the field of Alzheimer's care. These medications require a great deal of testing and patient monitoring, trained physicians, and other resources in a system that is already stretched thin.

Drug shortages are a growing problem in the U.S., and a shortage of live-saving cancer drugs has reached crisis levels. Oncologist Kristen Rice explains that drug shortages have been happening for several years but have been getting progressively worse in the last few months. Oncologists are facing critical shortages of common, generic cancer medications and have even begun to ration care for certain patients who are able to delay treatment, according to Rice.

Under the Affordable Care Act, health insurers are required to cover all costs associated with preventive care — including PrEP, or pre-exposure prophylactic treatment for HIV. But now all preventive care coverage is under threat, thanks to a lawsuit filed by employers who believe they shouldn’t be required to pay for care that violates their religious beliefs. While coverage for PrEP access largely unchanged as the court case makes its way through the legal system, Richard Hughes IV, a partner with the law firm Epstein Becker Green, says that protecting the status quo isn’t enough.

Just days after the end of Roe v. Wade, Caitlin Bernard, an OB/GYN in Indiana, told the Indianapolis Star a heartbreaking story: She had recently been asked to perform an abortion on a 10-year-old Ohio girl who had been raped. In late May, the Indiana Medical Licensing Board held a hearing on Bernard. While they did not revoke her license, they fined Bernard $3,000 and issued a letter of reprimand, saying that by speaking out, she had violated the 10-year-old girl’s privacy. This week, Gabriel Bosslet and Tracey Wilkinson, who are both friends and colleagues of Bernard, talk about her story, its lessons for physicians, and why advocacy is a professional responsibility.

When a loved one is living with serious substance use disorder and refuses to get help, sometimes it seems like the only solution is to force them into it. In many states, people can be “arrescued” — that is, forced under penalty of law into a treatment program that is nearly identical to being incarcerated, down to orange jumpsuits. But Sarah Wakeman, an addiction medicine physician, says that while she understands the love that makes people see involuntary treatment as a solution, it doesn’t actually work.