First Opinion Podcast

During his long career as a pediatric oncologist and cancer researcher, William Woods thought highly of the FDA's work evaluating and approving new cancer drugs. But his opinion of the agency changed when he was diagnosed with amyotrophic lateral sclerosis, or ALS, a progressive disease that damages nerves in the brain and spinal cord. This week on the "First Opinion Podcast," Woods talks about living with ALS, and watching what he sees as the glacial pace of approving an experimental ALS drug called AMX0035.

The number of children who become orphans because of Covid-19 rises each week: over 10.5 million children around the world have lost a parent or other caregiver living in the home, a staggering and heart-breaking figure. For comparison, it took 10 years years to create as many orphans as Covid-19 created in just two years.  Seth Flaxman and Susan Hillis have been tracking this grim statistic as part of their work with Global Reference Group on Children Affected by Covid-19. These losses can reverberate for years. This week, Flaxman and Hillis discuss the trials of children who have lost parents during the pandemic, and what can be done to help keep them safe and healthy.

For two decades, nurses have been considered the most trustworthy professionals in the country, above physicians. Yet the rigid hierarchy within hospitals and health systems places physicians at the top, creating a fraught power dynamic and a double standard when it comes to discipline. This week, nurses and educators Michelle Collins and Cherie Burke discuss this double standard as it relates to the recent cases of a former nurse and another former physician.

When Covid-19 began tearing across the U.S. in March 2020, Alex Goldstein started posting on Twitter the pictures and stories of people who had died from the disease.  Over two years later, as the U.S. marks the grim milestone of 1 million people dead from Covid-19, Goldstein is still at it. The account, @FacesOfCovid, has now memorialized more than 7,000 people.

Sickness can beget debt, which can then turn around and beget more sickness. That's the all-too-unfortunate cycle for people across the country who find themselves with overwhelming medical debt, the most common reason a debt collector might come after someone, with 1 in 5 households going into debt to pay for medical care. This week, Michelle Proser addresses ways to prevent medical debt and offers potential stopgaps that could help people get out of debt and into necessary, supportive health care environments.

Clinicians walk a tightrope when trying to help their patients with chronic pain. They want to be able to ease a patient's suffering with medication, but must be mindful of the risks of addiction. There are some non-medication treatments for pain, but they're often hard to access or not covered by insurance.  Finding the balance can be challenging and emotionally taxing. And in the wake of the opioid crisis, many clinicians tend to err on the side of caution and under-treat pain. This week, two physicians discuss how to treat chronic pain adequately and ethically.

The roll out of a new mental health crisis line for the entire U.S., is scheduled to happen on July 16 — the blink of an eye in bureaucratic time. People in mental health crises or their family members will soon be able to dial 988, instead of 911 or the harder-to-remember 800-273-8255, the number for the National Suicide Prevention Lifeline. The thinking is that calls to 988 will route people to the care they need instead of to law enforcement or emergency personnel with limited training in working with people in the midst of mental health crises. This week on the "First Opinion Podcast," Benjamin Miller probes at some more concerns: Who will be answering the calls? And does the system have the capacity to take care of callers right away?

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.