First Opinion Podcast

This week, medical student Amelia Mercado and her professor J. Wesley Boyd talk about the stressors of medical training, privacy concerns within academic institutions, and how high insurance costs affect access to mental health care.The conversation is based on their co-authored First Opinion, "How medical schools are failing students who need mental health care."

The term "excited delirium" has been used for years by law enforcement and other first responders, including health care workers, to describe people who exhibit behavior that is considered "out of control." This diagnosis has been applied again and again, even posthumously, as a justification for extreme and sometimes deadly, interventions by law enforcement. It came up most recently in the trials of two police officers accused of causing the death of Elijah McClain, a Colorado man; both officers were acquitted this week.But excited delirium is not an evidence-based medical diagnosis. The American College of Emergency Physicians recently withdrew a 2009 white paper endorsing the concept, and California has banned it as a cause of death. Other states may follow suit. This week, we are joined by emergency phyisicians Utsha G. Khatri and Brooks Walsh, who speak about why the "excited delirium" label is both unnecessary and dangerous. Check out our episode of Color Code about "excited delirium" as well as a previous episode of the First Opinion Podcast on the topic. And sign up for the First Opinion newsletter.

Have you ever taken phenylephrine for a stuffed-up nose and then felt better? If so, you might have been perplexed when Food and Drug Administration experts recently said that that the drug — which is in some versions of DayQuil, Sudafed, and other medicines — is no more effective than a placebo. But to Michael H. Bernstein, an assistant professor of diagnostic imaging at the Warren Alpert Medical School of Brown University, it all makes sense. On this episode, Bernstein discusses the placebo effect and its counterpart, the “nocebo effect.”

In just two weeks, the brutality of the Israel-Hamas conflict has shocked the world. But one of its most heartbreaking aspects — the destruction of the already-struggling health care system in Gaza — is part of a decades-long pattern during war both in the region and around the world. Leonard Rubenstein is a distinguished professor of practice at the Johns Hopkins Bloomberg School of Public Health and author of “Perilous Medicine: The Struggle to Protect Health Care From the Violence of War.” On this episode of the First Opinion Podcast, we spoke about health care in war, the Geneva Conventions, and why it’s so difficult to hold those who break international law accountable.

After physically debilitating cancer treatment, Laurie Brunner encountered another medical hurdle: She had developed lymphedema that required surgery, but her BMI was over the cutoff. To receive the necessary treatment, she would have to lose weight. I spoke with Laurie and her physician Jody Dushay about how the ongoing shortages of GLP-1 medications are creating logistical and medical problems. Our conversation was based on Jody’s recent First Opinion essay, “How the Wegovy shortage is making life impossible for my patients — and for me.”

We're popping into your feed on a Sunday because we wanted to share an episode of The Nocturnists: Post-Roe America. You may have already heard the First Opinion Podcast interview with Ali Block, an abortion provider and executive producer of The Nocturnists, and Nikki Zite, an OB/GYN in Tennessee. (If you haven't listened yet, please do!) On this episode of The Nocturnists, you'll hear more from Nikki, Ali, and other doctors trying to navigate reproductive health landscape after the end of Roe.

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.