The Podcast by KevinMD

"Many of us suffer in silence for myriad reasons. Being a physician with infertility presents a perfect storm of stress, anxiety, guilt, and shame – all of which we know don't contribute to managing any medical problem. Consider what it's like to undergo a typical cycle of in vitro fertilization. You administer nightly hormone injections to grow your follicles in preparation for an egg retrieval procedure. The process usually takes 1-2 weeks, but you don't know exactly how fast your follicles will grow. For the first week, maybe you just need to arrange to get away from the hospital or clinic for a couple of blood draws. But during the second half of your stimulation cycle, you must physically go into your clinic for daily transvaginal ultrasounds to monitor the progress." Dawn Baker is an anesthesiologist who blogs at Practice Balance. She shares her story and discusses her KevinMD article, "The voices of women physicians with infertility." (https://www.kevinmd.com/blog/2021/12/the-voices-of-women-physicians-with-infertility.html)

"Patients communicate immense amounts of information through body language. The primary understood, universal body language is choking. Anywhere in the world you go, if someone is choking, they use both hands to grab their throats. No matter what country you are in or what language is spoken, you can recognize someone choking and provide aid if trained. Body language is also understood to convey various subconscious emotions – crossed arms can be used by someone who is angry, frustrated, or scared, or shutting down in a conversation; open arms and uncrossed legs can be used by individuals who are open to new ideas, and willing to communicate with those they are talking to." Jennifer Ribar is an osteopathic physician. She shares her story and discusses her KevinMD article, "Listening to patients with our eyes." (https://www.kevinmd.com/blog/2021/11/listening-to-patients-with-our-eyes.html)

"Medicine is not a business You fools. Healing is your blueprint, activated to complete itself. A doctor does not broker it, The best anyone can do is align you With what you should be, And stay out of the way. (Like a teenager setting off an illegal firecracker.) Mostly, you pay the doctor for the alignment, And the nurse To keep the doctor out of the way. If you're not ready, to get on with the business of what you should be, You come back later. Or, maybe, next lifetime. It's not complicated. And it's not a business. You fools. The doctor knows what you should be, when they know what they are, And if they don't And the nurse can't tell them, You come back later, Or, maybe, next lifetime. It's simple, but It's not easy, And it's not a business you fools. I've seen it, GNP and recurring revenue and prayers so many pairs of high-intervention end-of-life care. It's cosmic law That you cannot profit from someone else's suffering. You only appear to, When you do not know what you are. When you are blind to the part of yourself that suffers with them. Which is why medicine is not a business it's a relief, A chance to make yourself right, Whole. When you are whole, you come back later if you want or next lifetime, To heal." Drea Burbank is a physician-entrepreneur. She shares her story and discusses her series of poems, "When you die: a poem," "Medicine is not a business: a poem," and "A physician's pain poem."

Welcome to an expedited episode of The Podcast by KevinMD. Trevor Bedford is a computational biologist and infectious disease scientist, Fred Hutchinson Cancer Research Center. He was selected as a recipient of the 2021 MacArthur Fellowship and can be reached on Twitter @trvrb.

"The holiday season is rapidly approaching, and it is not uncommon for us to gain up to 10 pounds between Thanksgiving and Valentine's Day. But what if we do not want to put on some insulation? What can we do? I specialize in medical weight loss, and my first recommendation would simply be to be aware of the food around us and recognize that seeing food in itself can be a trigger to eat." Angelice Alexander-Martin is a family physician. She shares her story and discusses her KevinMD article, "Don't let the holidays sabotage your weight loss goals." (https://www.kevinmd.com/blog/2021/11/dont-let-the-holidays-sabotage-your-weight-loss-goals.html)

"The victims of this now distorted concept of liberty are ones that we physicians encounter every day. The one that inspired this essay for me is an 11-year-old boy that I saw three weeks ago. He is a patient of mine in my pediatric practice who came to see me with typical respiratory symptoms that led to a diagnosis of COVID-19. While he recovered uneventfully, his father got sick the next day and died from the same illness five days later. Like the vast majority of people who die from COVID-19 now, he was unvaccinated, believing that getting vaccinated was unnecessary and part of a greater effort to undermine his personal liberty. His son is now dealing with the unimaginable grief of losing a parent at such a tender age and asking his mother if he killed his father by getting sick and causing his death. This happens every day now in our communities across our nation. These are wounds that will never heal for this generation of kids." Jason V. Terk is a pediatrician. He shares his story and discusses his KevinMD article, "The dimming of the shining city." (https://www.kevinmd.com/blog/2021/10/the-dimming-of-the-shining-city.html)

"The U.S. Department of Education recently announced some major changes to the rules and qualifications around the Public Service Loan Forgiveness (PSLF) Program. Now, for a limited period of time, borrowers may receive credit for past payments made on loans that would otherwise not qualify for PSLF. The good news is that public service loan forgiveness is now available to more people. The bad news is that there will be more people waiting in line to have their federal student loans waived. This issue impacts anyone from medical residents to physicians who are making payments on loans for at least ten years." Will Koster is a financial planner. He shares his story and discusses his KevinMD article, "The Public Service Loan Forgiveness waiver and its impact on physicians." (https://www.kevinmd.com/blog/2021/10/the-public-service-loan-forgiveness-waiver-and-its-impact-on-physicians.html)

"Finding out I was gene-positive had hit me harder than I could ever have imagined. How was I to know that my decision to get tested would have such an impact on my life? All of the rehearsing I had done in the weeks leading up to my results appointment proved useless. At the genetics clinic that day, the doctor told me most people feel better after about three months. As I sat on the hard plastic hospital chair, staring at the creased piece of paper containing my test results, I thought, That doesn't seem so bad. Three months isn't that long. The problem was it had been longer than that and I still didn't feel better, not even a little bit. I was starting to think something was wrong with me, that I was the cause of my own misery. Am I wallowing in my own self-pity? Do I like feeling this way? I didn't understand why I couldn't make myself better. I had never experienced a depression as deep or as long-lasting as this. I had recently begun to realize that anything I had felt previous to my HD diagnosis that I thought was depression was just sadness. Every day, every moment, was a struggle. There was no more joy in my life. I hadn't smiled in weeks. I had more unanswerable questions now than before I got tested. How am I supposed to live with this? I can't stop it from happening, so how am I ever going to feel OK?" Erin Paterson is a writer and the author of All Good Things: A Memoir About Genetic Testing, Infertility and One Woman's Relentless Search for Happiness. She shares her story and discusses her KevinMD article, "The emotional side of genetic testing." (https://www.kevinmd.com/blog/2021/10/the-emotional-side-of-genetic-testing.html)

"I'm not brave. I'm just me. Full of light and lifted by my light. You see, when you strip away the darkness and lies that others surround you with, you're left only with your light. The genuine you. Moving forward in life in ways that are authentically you. Not because it's brave to rise above and be disconnected from your humanity, but rather because when you become un-brave, you step into your own courage. Courage has understanding of what you're doing and who or what you're doing it for. Courage gives you permission to feel the feels, and connect not only with others, but also with yourself. Whether you're a nurse, an abuse survivor, or whatever has led to your belief that brave is the face you need to show, I hope you give yourself permission to become un-brave. Step into the courage that allows you to embrace the fears that are the keys to your strength, compassion, and humanity. May you show that courage first to yourself and the parts of you that are hurting, so that you can be genuinely and authentically courageous for others." Traci Powell is a nurse practitioner. She shares her story and discusses her KevinMD article, "If you're a nurse or an abuse survivor, you don't have to be brave." (https://www.kevinmd.com/blog/2021/11/if-youre-a-nurse-or-an-abuse-survivor-you-dont-have-to-be-brave.html)

"Some policymakers may be wary of not using case numbers as the primary metric to guide public behavior and policy. As cases become more complex, however, health departments should still monitor infection numbers, but guidance should be tied to hospitalization metrics. When rising cases do not reliably predict hospitalization surges, hitching Covid policies to cases alone is no longer effective policy — or good public health." Monica Gandhi is an infectious disease physician and co-author of the New York Times opinion article, "Why Hospitalizations Are Now a Better Indicator of Covid's Impact."