First Opinion Podcast

When the Covid-19 pandemic began tearing across the country, it hit nursing homes hard. More than 200,000 residents and staff members at long-term care facilities have died from the disease. But as this week's guests point out, the care of nursing home residents and support for those providing that care have been long-standing issues. Jasmine Travers and David Grabowski discuss the current state of affairs in nursing homes across the country, the important progress that needs to be made, and key steps for making improvements.

As a psychiatrist, Christin Drake has to turn away potential new patients every day — there just aren’t enough hours in the day to take them on. She doesn’t relish the rejection, especially when it’s for another Black woman who is looking to find one of the few psychiatrists who shares that identity and experience. But with the mental health crises brought on by the pandemic and an aging, shrinking population of psychiatrists, the strain on Drake and her colleagues is getting worse. This week, she speaks about what’s causing a dearth of mental health clinicians across the country, why it’s so damaging, and what can be done to ease it.

For trans people who want to receive gender-affirming medical care such as hormone treatments or surgery, one requirement is often a diagnosis of "gender dysphoria," which the Diagnostic and Statistical Manual of Mental Disorders defines as deep psychological distress around one's gender. But not all trans people experience gender dysphoria. Many are just searching for the feeling of gender euphoria. This week, Dallas Ducar discusses issues around gender dysphoria and the need for trans-inclusive providers to take a holistic, person-based approach to care.

Like many of us, Tom Sequist had no idea what was about to happen as he began his new job as chief medical officer of Mass General Brigham hospital system in Boston during the first weeks of 2020. Through his position, he saw firsthand how Covid-19 tore through low-income communities like Chelsea, just north of Boston. From 2,000 miles away, he also saw how the virus ravaged the Taos Pueblo tribe in New Mexico that he is a member of. This week, Sequist talks about Indigenous health disparities, and the ways in which these two communities, which can feel worlds apart, were similarly vulnerable to the pandemic's deadly nature.

Sneha Dave has been living with a chronic disease for 17 years — almost her entire life. Diagnosed with ulcerative colitis when she was 6 years old, she has experienced firsthand the frustrating and often terrifying side effects of drugs that were not tested on people her own age. So when she sees Instagram posts and TikTok videos from pharmaceutical companies that are geared toward her generation, she bristles that many companies haven't bothered to include adolescents and young adults in clinical trials testing new medicines. In this episode, Pat talks with Sneha about the ways in which pharmaceutical companies and clinical research organizations should be reaching out to adolescents and young adults to include them in clinical trials.

It's a sad reality that people with diabetes know all too well: the price of insulin, a medicine they depend on to stay alive, has skyrocketed. Some people have trouble paying for insulin, forcing them to ration it or go without, which can be deadly. Alina Bills was diagnosed with diabetes when she was four, and can't remember life without it. Now age 26, she wrote a First Opinion essay about having to turn to social media to crowdsource insulin when she unexpectedly ran out and an extra vial would have cost her nearly $400 out of pocket.

Science journalist Faye Flam explores medical information in part by unpacking the three-hour exchange about Covid-19 between scientist-turned-misinformant Robert Malone and Spotify podcaster Joe Rogan. Flam points out the holes in Malone's logic and how listeners can be aware of similar politically motivated tactics. "People are foregoing vaccines that would save their lives and people are actually dying because they didn't get vaccinated," Flam said. "So I think the consequences of misinformation are enormous for people in this pandemic."

Two years into the pandemic and in the midst of the latest hospital staffing crisis, nurses have finally gotten the country’s attention when it comes to burnout and attrition within the country’s most trusted profession. And it’s an important shift, because nursing is in trouble. This week, nurse and researcher Jane Muir describes some of the issues that are nudging more and more nurses to trade staff positions for jobs as travel nurses, or to leave nursing entirely, and offers ways to retain staff nurses. She says hospital systems need to put cash toward the nurses who make those systems so profitable. First Opinion Podcast is technically on a break! We'll have one more episode next month before we're back to our weekly schedule in March.

We started the "First Opinion Podcast" in February 2021 because we knew there was incredible value in the perspectives shared by our essay contributors.  We'd hoped there could be added value in sharing those perspectives through real, in-depth conversations too. Now a little under one year and 43 conversations later, we've been thrilled by the results. To celebrate our last podcast of the year I sat down with producer Theresa Gaffney to look back at some of the year's most memorable moments, both on- and off-the-record.

Alison Singer learned how to advocate for a child with autism by watching her mother do it for her brother. When Singer had her own child with autism, Jodie, she immediately got involved with the activist community. But Jodie's condition doesn't look like the kind seen in television shows like "Atypical" or "Love on the Spectrum." She needs special support 24 hours a day. This week on the "First Opinion Podcast," Singer breaks down why she believes the use of the overarching label "autism spectrum disorder" fails to take people like Jodie into account, and why she's pushing for a new, more specific label: "profound autism."