The Podcast by KevinMD

"It's maddening to see the differences in health outcomes between the rich and the poor. Even more unsettling is reflecting upon the psychological pain accumulated when living in a fad-obsessed materialistic comparison-creating society, the postponed dreams, and the day to day compromise that those with less have to endure – thoughts that may be far removed from the ruminations of the those who have abundance. I don't mean to stereotype, and this is not intended to be a polemic, but the country is divided, and many are living in two different worlds. The resultant health consequences should be contemplated upon, especially in the midst of a pandemic where the differences have the opportunity to be most blatantly highlighted." Harsh Bhavsar is an internal medicine resident. He shares his story and discusses his KevinMD article, "Coronavirus exposes the reality of income-driven health inequality." (https://www.kevinmd.com/blog/2020/04/coronavirus-exposes-the-reality-of-income-driven-health-inequality.html)

Since the coronavirus outbreak, reports of anxiety have increased, especially among physicians. Physicians face numerous stressors, including fears of contracting the coronavirus, concerns about potentially infecting loved ones, PPE shortages, testing delays, and frequently making quick decisions with limited information. Common symptoms of anxiety are increased worrying about one's self and/or loved ones, difficulty sleeping, difficulty eating, poor concentration, increased heart rate, hyperventilation, and struggling to control worrying. Christine Tran-Boynes is a psychiatrist. She shares her story and discusses her KevinMD article, "5 ways to manage anxiety during the coronavirus pandemic." (https://www.kevinmd.com/blog/2020/03/5-ways-to-manage-anxiety-during-the-coronavirus-pandemic.html)

"As the COVID-19 pandemic unfolds day by day at an exponential rate, we as doctors have been called to duty in unprecedented ways. Speak with any physician in the last few weeks, and you will be hard-pressed to find one who didn't feel an intrinsic obligation- indeed, wish- to rise to the occasion with an all-hands-on-deck attitude, despite the taxing and indefinite toll this will take. Speak with any physician mother, and you will quickly see that our intense drive to lead on the frontlines is matched with an equally intense anxiety about protecting and preserving the wellbeing of our families. Indeed, for most of us, the conflict between being a physician and mother has never felt greater." Tamara Goldberg is an internal medicine physician. She shares her story and discusses her KevinMD article, "The duality of being a physician-mom in the age of COVID-19." (https://www.kevinmd.com/blog/2020/04/the-duality-of-being-a-physician-mom-in-the-age-of-covid-19.html)

"Based on the evidence of the effects of trauma, we can predict that our health care teams, patients and families will exhibit signs of this assault through a variety of symptoms–sleeplessness, apathy, depression, and anxiety. The warning signs are already here. We read the desperate accounts and pleas of frontline workers describing the indescribable, holding the hands of patients dying alone, communicating with stunned and distraught families isolated away from death beds of their loved ones. Dr. Breen is symptomatic of a larger undercurrent of the fatal moral injury of the system currently at work. We need to face it head-on or risk additional losses as tragic as this." Mary R. Talen is a psychologist. Deborah Edberg is a family physician. They share their stories and discuss their KevinMD article, "Flattening the curve of COVID's emotional impact." (https://www.kevinmd.com/blog/2020/05/flattening-the-curve-of-covids-emotional-impact.html)

"Someday, I suspect I will recount this time of fear with mixed emotions. Sadly, there are people who have died and more to come, and this time will also lead us to reassess our way of life and make changes for the better. I work from home, juggling the management of patients by telemedicine with homeschooling my daughters, still working to find meaning and direction to do the right thing. With movie theaters all shuttered right now, and likely to struggle after this crisis, I hope the simple pleasure of watching these pictures in the theater can still be my escapist comfort. I yearn to go to the movies, and for me, streaming on Netflix can't match that theater experience. Still, I find purpose and meaning in reminding myself that we are characters in this movie, and just as in Hitchcock's thriller, the deeper meaning is in how we as people respond to extreme circumstances." Jules Lipoff is a dermatologist. He shares his story and discusses his KevinMD article, "Alfred Hitchcock, COVID-19, and the MacGuffin." (https://www.kevinmd.com/blog/2020/05/alfred-hitchcock-covid-19-and-the-macguffin.html)

"All of our patients, but especially our most vulnerable Spanish-speaking patients, need to hear concrete, meaningful, and practical instructions on how to care for each other when they live in large multi-generational families, and positive stories from people who have successfully managed infection with COVID-19. They need to hear that, as their physicians, we are here for them. I want them to know that when they are sick, their immigration or insurance status is not my concern. My concern and my oath are to the patient in front of me, and to the community I love." Susan Lopez is an internal medicine physician. She shares her story and discusses her KevinMD article, "The impact of COVID on the Hispanic community." (https://www.kevinmd.com/blog/2020/05/the-impact-of-covid-on-the-hispanic-community.html)

"Trainees like myself travel great distances from home in pursuit of higher edification. Yet the coronavirus makes us worry about the aged family we leave behind – parents and grandparents. A WhatsApp message ensuring they've stocked up on acetaminophen, toilet paper and canned soup (low sodium, of course) the only assuage to our anguish. The rigors of medicine often demand sacrifice, sometimes in the form of long-distance relationships. Residents and fellows work overtime and trade shifts in chess-like strategy to ensure a 'golden weekend' with their significant other. Now with travel being high risk, golden weekends will likely be swapped for Facetime dinner dates. Today the malefactor may be COVID-19; the only certitude is that the future will bring another. And yet, despite the perils that may exist, we toil on, for the sake of our patients and to satisfy the seraphic thirst of our higher calling. As in the end, love conquers all." Mrinali Shetty and Yuvraj Chowdhury are cardiology fellows. They can be reached on Twitter @YChowdhuryMD and @MrinShettyMD, respectively. They share their stories and discuss their KevinMD article, "Love in the time of coronavirus." (https://www.kevinmd.com/blog/2020/03/love-in-the-time-of-coronavirus.html)

"We do not have to continue to blame external forces for the stresses upon us now. By organizing, mobilizing, and finding solutions to the problems facing us and our adopted community today, we can meet the current challenge to be of help, however we can. Perhaps, in this way, we can stop making pandemics a future generation's problem to solve, and instead become the leaders we once needed ourselves." Pratik Doshi is a medical student. He shares his story and discusses the KevinMD article that he co-wrote, "The opportunities for medical students in a pandemic." (https://www.kevinmd.com/blog/2020/04/the-opportunities-for-medical-students-in-a-pandemic.html)

"It is OK to be scared, but it is not OK to let our own anxieties harm our patients. As we tackle the numerous crises created by the COVID-19 pandemic, let's acknowledge our fear and draw on the logic and clinical reasoning that we have spent years cultivating. We can be scared and scientific, anxious, but courageous. Let's not create two causalities from one disease, the patient who dies from coronavirus and the patient who dies waiting for surgery because they could have had coronavirus." Sami El-Dalati is an infectious disease physician. He shares his story and discusses his KevinMD article, "It is OK to be scared, but it is not OK to let our own anxieties harm our patients." (https://www.kevinmd.com/blog/2020/04/it-is-ok-to-be-scared-but-it-is-not-ok-to-let-our-own-anxieties-harm-our-patients.html)

"Although I personally hope to continue to be at or near the frontlines, I understand those that are in a compromised position, and they shouldn't feel ashamed for wanting to protect themselves or their family. There is no portion of the Hippocratic Oath that implicitly or explicitly states that physicians have a duty to patients above their own safety. Even though we're in the midst of the pandemic, I've found it to be a beneficial practice to reflect and think about the way we can improve the safety and efficacy of those delivering care. While it may be commendable to rush to be directly involved in patient care, we need to take a step back and review the role that residents play: who is being put on the frontlines, how is that being decided, and how is this impacting resident burnout? This is one of the many questions I hope can be thoughtfully revisited after the emergency of the pandemic is over." Jon Zaid is an internal medicine physician who blogs at 34justice. He shares his story and discusses his KevinMD article, "Doctors shouldn't feel ashamed for wanting to protect themselves or their family." (https://www.kevinmd.com/blog/2020/04/doctors-shouldnt-feel-ashamed-for-wanting-to-protect-themselves-or-their-family.html)