This Podcast Will Kill You

Our sign-off, “wash your hands, ya filthy animals”, has never been more appropriate than with this episode on puerperal or childbed fever, now known as maternal peripartum infections. It took us over seventy episodes to get here, but today we finally tell the tragic story of Ignác Semmelweis, the “father of hand hygiene” and “savior of mothers”, whose keen observations and devotion to his patients earned him ridicule in his time and respect in ours. But the tragedy of this episode’s topic doesn’t reside solely in the past. Today maternal peripartum infections are still a major contributor to maternal morbidity and mortality worldwide, and, surprise surprise, the impact is not equally felt across racial, ethnic, and socioeconomic groups. Join us as we dive into this historically rich, medically complicated, and still appallingly prevalent group of infections. See omnystudio.com/listener for privacy information.

18 Mai 20211h 26min

The COVID-19 pandemic has touched all of our lives in incredibly varied ways, with no two experiences exactly alike. Despite this, we all probably share the same thought: how can we stop this from happening again? In this episode of our Anatomy of a Pandemic series, we ask that question in the context of wildlife conservation. Why is protecting biodiversity synonymous with protecting our own health? If spillover events themselves are inevitable, how can we limit the likelihood that they will become epidemics or pandemics? Where do commercial wildlife markets and subsistence hunting fit into the equation? To help us answer these questions and more, we are thrilled to be joined by Dr. Chris Walzer, Executive Director of Health at the Wildlife Conservation Society (interview recorded April 6, 2021). And for more information on the topics discussed, check out the WCS’s COVID-19 News and Information page and read a recent Op-Ed piece by Dr. Susan Lieberman and Dr. Christian Walzer about why biodiversity is crucial for preventing pandemics. As always, we wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we’ve listed the questions below: Now that we are over a year into this pandemic, what do we know about the sequence of events that led to this pandemic?  People have been studying spillovers and the emergence of novel viruses for a long time and have been saying that a pandemic like this was inevitable. So what did we do wrong on a national or international level? What things did we do right, or what things did we adequately prepare for during this pandemic?  What are the ways in which we’ve made scientific progress or the ways in which the world has fundamentally changed that have allowed this pandemic to play out differently than it could have 20 years ago?  Can you talk us through some of the nuance in the interactions between commercial wildlife markets, spillover events, and wildlife hunting for subsistence purposes? How predictable are spillover events themselves? Or perhaps, how predictable are the scenarios that would increase risks for spillover and how predictable are the events that follow? Since another spillover event could happen at almost any time, what measures do we have in place to prevent these events from turning into another pandemic? Where does wildlife and forest conservation fit into this equation?  Pandemic preparedness and pandemic response are two different things. How do these two aspects of dealing with a pandemic differ and who is involved in each of these efforts? What are people who study this the most concerned about when it comes to the next pandemic? What are the areas in which we still have big improvements to make in how we prepare for or predict or try to prevent pandemics based on what we’ve learned during this one? What do you hope we keep or learn from this pandemic, either personally or as a society? See omnystudio.com/listener for privacy information.

11 Mai 20211h 1min

A fluffy white fungus and a little brown bat. A deafening silence and an uncertain future. In this episode, we explore one of the most devastating wildlife diseases in recent times, white-nose syndrome. Since its debut in North America in 2006, this fungal pathogen has spread across much of the continent, leaving millions of dead bats in its wake. Why is it so deadly? Which bats are at risk? Where did it come from? And most importantly, what can we do about it? We attempt to answer these questions and more about this pernicious pathogen, and we are so delighted to be joined by Dr. Winifred Frick, Chief Scientist at Bat Conservation International and Associate Research Professor at UC Santa Cruz, who helps us take a closer look at the ecology and impact of this disease on North American bat populations. See omnystudio.com/listener for privacy information.

4 Mai 20211h 24min

This pandemic has certainly taken its toll on all of us, but one group that has been particularly hard hit are those who have been on the front lines, continuing to take care of patients even when PPE was running low or nonexistent, even when there were no more ICU beds available. During both non-pandemic and pandemic times, physicians and other healthcare workers experience a tremendous deal of stress and pressure that can lead to depression, isolation, anxiety, moral injury, and other mental health issues. In this episode of our Anatomy of a Pandemic series, we seek to understand the factors contributing to the prevalence of these mental health issues among healthcare workers, the stigma that often prevents the seeking of treatment, the role that the COVID-19 pandemic has played in exacerbating these issues, and the ways in which the medical system has done or can do better. We are very excited to be joined by Michael Myers, MD (interview recorded March 29, 2021), psychiatrist and Professor of Clinical Psychiatry at SUNY-Downstate Health Sciences University in Brooklyn, NY and author of several books, including his latest, Becoming a Doctors’ Doctor: A Memoir.As always, we wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we’ve listed the questions below: How did you become interested in the field of physician mental health, and what made you choose to pursue it? Can you talk us through some of the challenges healthcare workers face and what impact they have on their mental health? Does this field experience things such as depression, anxiety, substance abuse, and suicide at higher rates than the general public? What does the stigma surrounding mental illness look like in the medical field and how does it contribute to the high rate of mental health issues in healthcare workers? Can you talk a bit about where these mental health issues among healthcare workers originate and how each step of medical training and beyond contributes to the problem? How much of this is a problem unique to the US and how much of it is universal? What are some of those changes you have seen throughout your thirty-five year career as a psychiatrist primarily treating other physicians? How have we gotten better, and what are the areas in which we have failed to make improvements? How do these public health crises, especially COVID-19, amplify the issues that physicians are already facing in terms of mental health? Can you talk a bit about the “healthcare heroes” narrative and how damaging it can be? What is some of the fallout you think we can expect to see in the long-term from the COVID-19 pandemic? As family members or friends or partners of healthcare workers, what are worrying signs that we can look out for? How do we recognize these signs in ourselves as well? For those who maybe have friends or partners or family members who are frontline health workers, what are some of the ways in which we can help and provide meaningful support during these times as well as in non pandemic times? What do you feel are the biggest failings of the medical system in terms of emotional and mental health support for those in medicine? How can we begin to change things? What role should medical school play? Hospitals? Other physicians? See omnystudio.com/listener for privacy information.

27 Apr 20211h 8min

In this classic TPWKY episode we travel down rivers and into worm-laden nodes as we take a look at the complex world of Onchocerca volvulus, the vector-borne parasite that causes river blindness. Join us as we learn why the name ‘river blindness’ captures only one dimension of the devastation caused by this parasite, how the short evolutionary history of this worm is at once surprising and enlightening, and why grasping the disease ecology of this system has been crucial in successful control efforts. As a bonus, if you tune in, you’ll get to hear how on earth The J. Geils Band fits into this story and the integral role that dog digestion has played in the history of this parasite. See omnystudio.com/listener for privacy information.

20 Apr 20211h 13min

The COVID-19 pandemic has disproportionately impacted racial and ethnic minorities, especially here in the United States. Higher infection, hospitalization, and death rates due to COVID-19 have been observed for historically marginalized groups, and the harmful effects stem beyond those relating to health, with higher unemployment and food and housing insecurity also reported. Yet these disparities did not emerge anew from this current pandemic; rather, this pandemic has served to amplify existing structural inequalities in the healthcare, educational, legal, and housing systems, among others. In this episode of our Anatomy of a Pandemic series, we explore the deeply entrenched roots of racial disparities in the US, how our narrow focus on outcomes often fails to capture the complex causes of inequalities, and ways in which we can begin to work towards health equity in this country. We are so thrilled to be joined by Harriet Washington (@haw95) (interview recorded March 10, 2021), writer and medical ethicist, whose groundbreaking work on this subject through books such as Medical Apartheid, A Terrible Thing to Waste, Carte Blanche, and others has led to much-deserved critical acclaim.As always, we wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we’ve listed the questions below: Can you tell us a bit about your new book, Carte Blanche: The Erosion of Medical Consent, and what inspired you to write it? Although health disparities have been around forever, it was only within the last few decades that the term itself was coined, and it’s often only vaguely defined. Would you mind describing what we mean when we talk about health disparities? Can you talk a bit about how it’s not just being able to go to a doctor or afford a doctor, but how things like access to education, chronic stress, and environmental justice interact with and compound each other when it comes to health disparities? What are some of the different ways that we measure health disparities?  Can you talk about why it is important to understand the context of these disparate outcomes?  Can you talk about the disproportionate impact that COVID-19 has had on communities that were already facing significant barriers to healthcare? How has the narrative of ‘race-based medicine’ shown up in discussions of the disproportionate impact of COVID-19 on certain groups of people? How can we increase health equity in this country? What can we do at an individual level to help, and what are some policies at the state or national level that could help narrow this gap? How can the medical establishment work to earn back the trust of these communities that we have historically disenfranchised (and in many ways continue to disenfranchise) when it comes to health? See omnystudio.com/listener for privacy information.

13 Apr 20211h 3min

Of the many topics our podcast has covered in the past, from smallpox to scurvy, vaccines to birth control and beyond, one factor has linked nearly all of them: HeLa cells. These cells and the woman from whom they were taken have often remained behind the scenes in the coverage of these topics, but they have nevertheless been absolutely fundamental in the development of technologies, the advancement of knowledge, and the discussions of ethics, ownership, and informed consent. In this week’s episode, we want to do more than acknowledge the contribution of Henrietta Lacks and her cells to the field of biomedical science. We want to explore what it is about HeLa cells and other cell lines that makes them ‘immortal’. We want to learn what Henrietta was like as a person. We want to ask how it was possible for her cells to be taken from her without her consent or knowledge. And we want to share the tremendous impact Henrietta and her cells have made and continue to make on our world in so many ways.For more information about the Henrietta Lacks Foundation, check out the website. See omnystudio.com/listener for privacy information.

6 Apr 20211h 13min

We’re over a year into the COVID-19 pandemic, and our understanding of this virus and the disease it causes has grown immensely. And while we’ve learned so much about the spectrum of disease severity, the wide array of symptoms, and the effectiveness of various treatments, there is still so much we are discovering about this illness. In this installment of our Anatomy of a Pandemic series covering the COVID-19 pandemic, we review what we currently know about the disease caused by the SARS-CoV-2 virus as well as emerging questions such as what exactly is long COVID or how well do vaccines work against the new variants? To take us through this massive topic, we enlisted the help of two experts, Dr. Krutika Kuppalli (@KrutikaKuppalli), infectious diseases physician and assistant professor at the Medical University of South Carolina (also featured in Ch. 3: Control of this series), and Dr. Jason Kindrachuk (@KindrachukJason), assistant professor and Canada research chair in molecular pathogenesis and emerging viruses at the University of Manitoba (interview recorded March 16, 2021). As always, we wrap up the episode by discussing the top five things we learned from our experts. To help you get a better idea of the topics covered in this episode, we’ve listed the questions below: How much does the infectious dose, or the amount of virus a person is exposed to, play a role in whether they will get the disease and/or how severe the disease might be? How soon after being exposed does someone become infectious and how does that infectivity change over the course of infection? How much does infectiousness or viral shedding vary across disease severity? Are people who are severely infected more contagious than those who are asymptomatic? Could you walk us through the spectrum of COVID-19 in terms of symptoms or clinical observations, touching on first asymptomatic, then mild, then moderate or severe cases? What proportion of cases are severe vs mild vs asymptomatic? How much do symptoms or the general course of disease vary from person to person? How predictable is this virus? Can you talk about some of the lingering effects of infection and how frequently long COVID seems to occur? How has our estimate of the case fatality rate changed over this pandemic? Can you talk about some of the risk factors that seem to be associated with severe infections? Is there any link between blood type and risk of infection? What do we know about pregnancy and infection with COVID-19? Do risks regarding pregnancy vary depending on when during pregnancy someone may be exposed or infected?  What do we know about the duration or nature of immunity and the risk of reinfection? How has treatment for COVID-19 cases changed throughout this pandemic? Are we any better at treating patients with severe cases now than we were eight or so months ago? What do we know at this point about the vaccine candidates in terms of their effectiveness against new variants that have emerged? What does it mean if these vaccines are slightly less effective against some variants than others? What do the latest studies show about vaccines preventing asymptomatic as well as symptomatic infection? What is something you hope to take away from this pandemic, either on a personal level or as a society? See omnystudio.com/listener for privacy information.

30 Mar 20211h 2min