The Podcast by KevinMD

"Researchers should make clinical trials more accessible by providing patients with simple explanations of studies at a variety of locations, including community clinics and medical centers. Increased flexibility regarding transportation and visit timing is essential. Researchers should also allow the participation of people who do not speak English and those living with chronic conditions whenever it is safe to do so. If the treatment will be approved to use on these populations, it is unethical to exclude them. These are considerations that researchers must think about not only when designing COVID-19 studies, but all clinical trials, as this is essential to reducing health care disparities overall. Moving forward, we must put fairness and our patients' safety above increased cost or administrative burden; perhaps this is how we begin to make amends for the atrocities of the past." Amelia Trant is a medical student. Andrea Silber is an oncologist. They share their stories and discuss their KevinMD article, "Medicine must create inclusive clinical trials." (https://www.kevinmd.com/blog/2020/09/medicine-must-create-inclusive-clinical-trials.html)

"I am thankful to you SARS-CoV-2 virus as you allowed me to be human again, to make mistakes, and learn from them. You taught me to slow down so that I could reset and redefine my goals. You allowed me to have time for myself, to dream again, and plan my future. You pushed me out of my comfort zone and re-explore what I thought was possible or impossible. You helped me re-embrace my imperfections and love myself just the way I am! You showed me that this pandemic is a circumstance beyond my control and that there will many more circumstances, such as this one in life. However, what will always remain within my control or reach is my own thoughts about, and reaction to, such times. It is up to me now how I want to re-shape them to get to the results I want to see. Thank you, COVID-19, for being a great teacher. I respect you. I am not afraid of you but will always be cautious of you." Annie Nawab is a pulmonary and critical care physician. She shares her story and discusses her KevinMD article, "Beyond the medical lessons learned from COVID." (https://www.kevinmd.com/blog/2020/09/beyond-the-medical-lessons-learned-from-covid.html)

"To care for dependents, the carer must be cared for, both for the sake of her charge and for her own sake. Without such basic infrastructure, we have anxiety, confusion, and chaos. Contagion knows no independent individuals. Its boundaries are not the boundaries of our skin. It relies on the inevitable sociality of human beings. But our vulnerability is also our defense: bonds of care minimize, and can even defeat, the power and reach of COVID-19. Care must move out of the private domain, out of the recesses of hospital rooms and nurseries, nursing homes, and day-care centers. We seem to recognize now that a leader of a nation is entrusted with its care. Care is no longer personal. It never was. Care is political." Eva Kittay is a philosopher and author of Love's Labor: Essays on Women, Equality, and Dependency (Routledge) and Learning from My Daughter. (https://amzn.to/38rxEb5) She shares her story and discusses her KevinMD article, "Care is no longer personal. Care is political." (https://www.kevinmd.com/blog/2020/09/care-is-no-longer-personal-care-is-political.html)

"The first 100 days of COVID made me confront and reflect on a lot of aspects of myself and life, as philosophical as that sounds. Often times, I'm exhausted talking about COVID every single day and frustrated because we should be in a much better place right now as a nation. The wound is still fresh, and it deeply hurts to see more people suffering due to a lack of proper health care infrastructure and guidance as an underlying cause rather than the virus itself. I remind myself to be mindful, be kind to myself, allow myself to feel whatever I want without holding back emotions, and stay present. Emotional ups and downs are a part of life, but how you process them matters. It has also given me a glaring reminder that life is not guaranteed. It has reminded me that medical school is only a facet of my life, and the rest of my life is happening now. So why do we say, I'll do that after I've reached 'X' stage in my life? Within reason, just do it, and you won't regret it. Writing this has given me a lot of peace and clarity, and I hope whoever is reading this can reflect on their experience to gain some level of calm." Priyanka Shindgikar is a medical student. She shares her story and discusses her KevinMD article, "A medical student's 100 days of COVID." (https://www.kevinmd.com/blog/2020/08/a-medical-students-100-days-of-covid.html)

"The flu vaccine can strengthen your immune system, prevent the disease spread among those closest to you, protect your children, and reduce the health care system's burden. Protecting ourselves and others as we traverse a pandemic is paramount in saving lives and keeping our communities safe and healthy. Along with our ongoing initiatives through Covid Rapid Response Team Chicago to maintain an adequate supply of PPE, host blood drives, and perform screenings in homeless shelters, increasing the rate of flu vaccinations is essential to protect the community. Our country has suffered more than enough during this COVID-19 pandemic – do your part and protect yourself, your loved ones, and our health care heroes this fall by getting your flu shot." Marina Lentskevich is a medical student. She shares her story and discusses the KevinMD article that she co-wrote, "Why flu vaccines are more important than ever in this pandemic." (https://www.kevinmd.com/blog/2020/10/why-flu-vaccines-are-more-important-than-ever-in-this-pandemic.html)

"We have to start understanding these as the real costs of climate change. We are paying these costs now. In my state of Oregon, people are going to start getting sick and dying in the next few days of the wildfire smoke choking the air. When they show up to the hospital with a severe heart attack, or stroke, or respiratory exacerbation, maybe it will be attributed to the wildfires, but probably everyone will just be focusing on getting through their shift, and the context of this one death, this one illness, will be missed. But make no mistake, the coming wave of hospitalizations, ER visits, and deaths is not random; it is due to climate change." Erika Maria Moseson is a practicing, board-certified pulmonary and critical care physician. She shares her story and discusses her KevinMD article, "Apocalypse now: climate change, cardiac arrest, and the price of inaction." (https://www.kevinmd.com/blog/2020/09/apocalypse-now-climate-change-cardiac-arrest-and-the-price-of-inaction.html)

"As we get excited about vaccine news and results, we need to evaluate our messaging and how we can get to high enough COVID-19 vaccination rates to achieve herd immunity. This requires broad and frequent education on the safety and efficacy of the vaccines. It also requires active listening to address concerns so people can make informed decisions. The 7 Habits of Highly Effective People by Stephen Covey are relevant to the task ahead of us to combat COVID-19." Toyin M. Falusi is an infectious disease physician. She shares her story and discusses her KevinMD article, "COVID-19 vaccines: Channeling the 7 habits to get from vaccines to vaccinations." (https://www.kevinmd.com/blog/2020/12/covid-19-vaccines-channeling-the-7-habits-to-get-from-vaccines-to-vaccinations.html)

"Growing up in Puerto Rico, 'babas' (bottles: biberón/botellas) and 'bobos' (pacifiers: chupetes/chupón) were very common among the families and children of the island. I still remember our Abuelita giving us milk in our "babas," so my younger sister and I were sure to fall asleep better. From the time of our births, to when my sister was three years old, the "bobo" was also consistently being used in our home. Now, as a pediatrician, one of the conversations I have most frequently with my Latino families is regarding the proper use of both 'babas' and 'bobos' for their children. Were you aware that children should begin using training cups (commonly referred to as 'sippy cups') as early as nine months of age? It is also very important that your child gradually ween off the use of bottles between the ages of 12 to 15 months. Continued use of bottles after one year of age has been repeatedly documented to increase the risk of tooth decay in children." Johanna Vidal Phelan is a pediatrician. She shares her story and discusses her KevinMD article, "Bottles and pacifiers: advice from a Latinx pediatrician." (https://www.kevinmd.com/blog/2020/07/bottles-and-pacifiers-advice-from-a-latinx-pediatrician.html)

"These encounters made my evening shift much more emotional than usual. I am still not sure what it was exactly that evoked such strong feelings of sadness. Was it having a patient who was a health care worker? Was it the rapidity in which all three patients' conditions deteriorated? Was it realizing that without timely, expert care, all three would die very quickly? Or, was it hearing people wanting to relax the measures and not wear masks, without insight into how quickly things can go wrong and end up deadly? Or, was it the cost of empathy, and just feeling the pains of my patients way too deeply? Or, was it talking to the family members of patients and trying to answer their many questions: How will it be in the ICU? Will it be lonely? Can you please let us visit? Just one time? What can we expect? When will they recover? Or, was it my inability to answer some of these questions? My lack of a crystal ball? Or, was it being already emotionally exhausted from managing everyday challenges of keeping life as normal as possible, with remote learning, running a household, and helping elderly in-laws with lots of medical, emotional, and personal needs?" Jasminka Vukanovic-Criley is a hospitalist and can be reached on Twitter @criley_md. She shares her story and discusses her KevinMD article, "The emotional side of being a doctor during the COVID-19 pandemic." (https://www.kevinmd.com/blog/2020/07/the-emotional-side-of-being-a-doctor-during-the-covid-19-pandemic.html)

"Iodine-based contrast agents are widely used for CT and other X-ray studies. They light up blood vessels and enhance perfusing tissue. These agents are essential for diagnosing everything from clots, to tumor, to bleeding. Unfortunately, many patients do not get contrast studies they may benefit from, due to unnecessary confusion about allergies. The most important step to avoiding confusion is to start calling contrast agents by their names, as you would do for any other drug, and to remove 'iodine' from your allergy vocabulary. Like antibiotics, there is more than one kind of contrast agent. Radiologists routinely dictate the name of the agent used in their study reports, so if a reaction occurs, the information is readily available. The problem comes when we do not distinguish one agent from another. Most patients with a prior reaction were never told the name of the drug they received, and they incorrectly assume that an allergy to one means allergy to all. Not so, just like with other classes of medications." Cullen Ruff is a radiologist and author of Looking Within: Understanding Ourselves through Human Imaging. (https://amzn.to/3qEL23Z) He shares his story and discusses his KevinMD article, "Think you have an iodine allergy? You may want to reconsider." (https://www.kevinmd.com/blog/2018/08/think-you-have-an-iodine-allergy-you-may-want-to-reconsider.html)