The Podcast by KevinMD

"Each patient I have seen over these four decades has made me a better doctor. Books do not impact long term memory the way a real patient can. I once heard the chair of medicine at a teaching hospital say that the worst thing about being on call every other night as an intern is missing half the patients. I now know he was right. Each patient becomes a colored light in our sky." John F. McGeehan is an internal medicine physician. He shares his story and discusses his KevinMD article, "Every patient makes me a better doctor." (https://www.kevinmd.com/blog/2020/06/every-patient-makes-me-a-better-doctor.html)

"We know that the past two months haven't been easy. We know about the sleepless nights, anger, tears, depression, and anxiety. We know all of this because we know what trauma does to a person, and you are in the middle of experiencing a repeated trauma. The trauma of watching patients die in ways you've never seen, the trauma of watching colleagues die, the trauma of knowing what exactly this virus could do to you if you were to become infected. We know that some of you feel helpless in your role as a physician, and that inability to control things that you are used to controlling is disrupting your confidence. For some of you, the frustration with your institutions is making it difficult to make through each shift." Nicole B. Washington is a psychiatrist and can be reached at her self-titled site, drnicolepsych.com. She shares her story and discusses her KevinMD article, "To every physician from the psychiatrists who are here to support you." (https://www.kevinmd.com/blog/2020/05/to-every-physician-from-the-psychiatrists-who-are-here-to-support-you.html)

"The COVID-19 pandemic has upended health care, with telemedicine emerging as a strategy to reduce risk exposures for patients and clinicians. Video visits, in particular, can be effective for many types of clinical care and offer convenience and savings for patients. As care shifts to this virtual modality, however, there is a risk of jeopardizing the meaningful human interaction that is critical to clinical care and impactful to patients and clinicians alike. The communication challenges of telemedicine, further compounded by COVID-19 related stress, call for strategies to help clinicians forge meaningful interactions with patients during virtual visits. The Presence 5, published earlier this year in JAMA, comprises evidence-based guidelines to foster humanism and connection in clinical care. Reconceptualizing this framework for video visits offers several strategies aligned with the Presence 5 practices: prepare with intention, listen intently and completely, agree on what matters most, connect with the patient's story, and explore emotional cues. Prioritizing explicit humanistic practices can help clinicians foster meaningful virtual connections with patients amidst this challenging pandemic and in the future as telemedicine becomes more widely integrated into clinical care." Megha Shankar is an internal medicine physician. She shares her story and discusses the KevinMD article that she co-wrote, "Strategies to foster meaningful connection during telemedicine visits." (https://www.kevinmd.com/blog/2020/04/strategies-to-foster-meaningful-connection-during-telemedicine-visits.html)

"Faced with the prospect of not being able to provide all COVID-19 patients with the life support that they may need, physicians and nurses are working in conditions that have been described as 'hell.' How are providers to cope with the trauma they are experiencing in New York and Italy, and presumably other nations as well? How are they to cope with the moral implications of the brutal decisions they will be called on to make if two critically ill patients compete for the same life-sustaining treatment when only one is available?" Geoff Tyrrell is a palliative care chaplain. He shares his story and discusses his KevinMD article, "Faced with terrible decisions, but making the right choices." (https://www.kevinmd.com/blog/2020/04/faced-with-terrible-decisions-but-making-the-right-choices.html) This podcast represents his private opinion and not that of the VA, his endorser, or board certification organization.

"After almost 30 years in this profession, I have come to the conclusion that there is some truth to that, as no day or week passes that I do not have a depressed, anxious or suicidal teen on my 'to see list.' Could it be my own personal history of depression and suicidal ideation? Could it be my own history of being bullied as a young child? My insecurities as a teenager? My personal history of sexual assault as a young, bright-eyed medical student? Or my own history of private pain and suffering? We may never know. But one thing is for sure I do want my patients, my teens, and tweens to stop hurting. And I plan on doing something about it. One patient's mother thinks I have a 'healing spirit.' That is why they come to me. I say: I hear the call and am ready to be sent." Uchenna Umeh is a pediatrician and can be reached at Teen Alive (https://www.teenalive.com/) and on Facebook and YouTube. She shares her story and discusses her KevinMD article, "A pediatrician's healing spirit: treating depressed, anxious, and suicidal teens." (https://www.kevinmd.com/blog/2018/07/a-pediatricians-healing-spirit-treating-depressed-anxious-and-suicidal-teens.html)

"Where did the myth of vampires come from? Like many myths, it is based partly in fact. A blood disorder called porphyria, which has has been with us for millennia, became prevalent among the nobility and royalty of Eastern Europe. A genetic disorder, it becomes more common with inbreeding. Porphyria is a malfunction in the process of hemoglobin production. Hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs to the body tissues. It seems likely that this disorder is the origin of the vampire myth. In fact, it is sometimes referred to as the 'Vampyre Disease.'" Michael Hefferon is a pediatrician and author of Of Plagues and Vampires: Believable Myths and Unbelievable Facts from Medical Practice. (https://amzn.to/3eREPeP) He shares his story and discusses his KevinMD article, "The medical basis of vampires." (https://www.kevinmd.com/blog/2020/03/the-medical-basis-of-vampires.html)

"As women physicians, especially physician-moms and women physicians of color, we have handled and achieved more than the vast majority of the population, in order to reach our current status of physician. We do because we can. We are Superwomen. Until we're not. Without thought, we take on others' responsibilities, because we can. In addition to our own personal responsibility to ourselves and to our loved ones, we take on the responsibilities of our patients' well-being, the failures of dysfunctional medical and political systems, and even the disastrous effects of diseases, such as COVID-19. Our patients hand over their poor health to us, and we accept it. Our dysfunctional medical systems hand over their inadequacies to us, and we accept them. We carry the weight of the world on our shoulders. Because we can. Until we cannot." Rebecca Elia is an obstetrics-gynecology physician and physician coach. She can be reached at her self-titled site, Rebecca Elia, MD. She shares her story and discusses her KevinMD article, "What does it mean to be responsible during the COVID-19 pandemic?" (https://www.kevinmd.com/blog/2020/06/what-does-it-mean-to-be-responsible-during-the-covid-19-pandemic.html)

What are the challenges facing psychiatry? How does psychiatry need to innovate the continue to thrive? What is the future of psychiatry What's your #1 tip for those considering the profession? What advice can you give to primary care clinicians as it relates to behavioral health issues? Owen Muir is a psychiatrist and host of the podcast, Pandemic Check In. (https://podcasts.apple.com/us/podcast/pandemic-check-in/id1503107429) He shares his story and discusses the present state and future of psychiatry as a profession.

"Death is not meant to be rushed. Saying goodbye shouldn't be rushed. Celebrating a life once lived cannot be rushed. And yet, we must. Taking a moment, a minute, an hour, maybe a day to feel something that normally takes far longer. Because we must. And in our hearts, the grief remains. Frozen in time in this state of mourning that we are all experiencing. We say the same words to our friends, to the families of patients that we ourselves have been the recipient of. The awkward moment when we realize that offering our condolences, again and again, has begun to lose meaning. There is a certain degree of numbing that occurs, perhaps protective, when faced with traumatic situations day in and day out. What do you when the tears no longer fall?" Julie B. Trivedi is an infectious disease physician. She shares her story, explores the pandemic from the perspective of a Texas-based infectious disease physician, and discusses the KevinMD article, "How do you grieve when you are still mourning?" (https://www.kevinmd.com/blog/2020/04/how-do-you-grieve-when-you-are-still-mourning.html)

"Over the last 100 years, the U.S. has had to respond to five avian flu pandemics. The most severe was the 1918 avian influenza infecting 1/3 of the world's population and killing 650,000 Americans. It was also the last time wide-spread containment, mitigation, and isolation strategies were used in the U.S. Seldom mentioned about the 1918 pandemic are the three 'waves' or cycles of resurgence and the subsequent deaths associated with them, especially in cities and towns that failed to implement timely mitigation restrictions or rescinded them too quickly. When considering the rescindment of mitigation restrictions, a bottom-to-top approach (local-state-federal governments) must be followed precisely to account for the kinetics of the virus. It is the virus that will truly dictate when American lives can return to some semblance of normal. The goal is to taper restrictions to avoid a cycle of new COVID-19 outbreaks and thus minimize the similar cycle of deaths, which followed in the 1918 pandemic." Nicolas K. Fletcher is a public health student. He shares his story and discusses his KevinMD article, "Strategies for lifting COVID-19 mitigation restrictions." (https://www.kevinmd.com/blog/2020/04/strategies-for-lifting-covid-19-mitigation-restrictions.html)