The Podcast by KevinMD

"Was I that different? I had severe anxiety necessitating medication, compounded by stress, my own narcissistic tendencies, and a series of life choices—but Jason had something much worse. It all gave me pause. I was now twenty-four, just barely older than Jason when the committee took residence. Would I soon begin hearing voices as well? I supposed that beginning the long and arduous road of medical education while having an infant at home with a lonely wife in a new place more than a thousand miles from our family counted as enough of a stressful event to trigger whatever may lay dormant in my brain." Kyle Bradford Jones is a family physician and can be reached on Twitter @kbjones11. He shares his story and discusses his book, Fallible: A Memoir of a Young Physician's Struggle with Mental Illness. (https://amzn.to/30oJezU)

"Could COVID-19 be an opportunity that brings the plight of health care professionals finally to the forefront? Protect us so we can protect you. Do your part and stay home. Flatten the curve to give health care professionals a chance. Donate PPE. Donate food. And yet through this war, we, health care professionals, along with the entirety of humanity, are united against a common, invisible enemy. We are all human; we all seek to be healthy and happy, all deserving of love and connection. Are we able to remind ourselves that health care professionals have never been so united before? That humanity has never been so united? Can all the health care professionals, no, all of humanity bear the weight of the world together? We can; we must. For our sake. For humanity's sake." Ni-Cheng Liang is a pulmonary physician and founder, the Mindful Healthcare Collective. She shares her story and discusses her KevinMD article, "Undergoing an appendectomy in a pandemic." (https://www.kevinmd.com/blog/2020/04/undergoing-an-appendectomy-in-a-pandemic.html)

"We are grateful to be avoiding the need to use draconian measures for resource allocation. We have been afforded the blessing of lead-time here in Los Angeles and have the chance to learn from other parts of the world, as well as other areas within the United States. We are preparing our personal protective equipment, re-organizing team structures and hospital workflow, taking new precautionary measures, and expanding the skillset of providers to maximize manpower. In case resource utilization reaches capacity, frameworks are in place to guide decisions in the most ethical and morally appropriate manner possible, and such frameworks remain available in future disaster scenarios. While we as health care providers address COVID-19 from the frontlines, there are still many ways the public at large can contribute to the battle against this pandemic that we all face, though the storm seems to slowly be calming." Alexander Connelly is an internal medicine physician. He shares his story and discusses his KevinMD article, "A Los Angeles response to the pandemic." (https://www.kevinmd.com/blog/2020/04/a-los-angeles-response-to-the-pandemic.html)

"We are in the midst of the COVID-19 pandemic, but it's already very clear that the infection prevention community in the U.S. has never faced such an enormous challenge. We have learned many things that will make us better prepared for the long term. We are far too reliant on single-use disposable products. Having a large supply of cloth surgical gowns and isolation gowns that can be laundered is essential. I'll comment on disposable face masks below. Less reliance on disposables will also be better for the environment." Michael Edmond is an infectious disease physician who blogs at Controversies in Hospital Infection Prevention. He shares his story and discusses his KevinMD article, "Infection preventionists are true heroes, and other things we've learned so far." (https://www.kevinmd.com/blog/2020/03/infection-preventionists-are-true-heroes-and-other-things-weve-learned-so-far.html)

"People remember stories in your speech. The rest fades away. I learned that pearl of wisdom from studying great literature and telling personal stories, and now teach it to students of speech. Who can forget the stories of The Iliad and The Odyssey having once read the books or heard of these tales of Homer? And when I want to tell a story of a hero, I think of the story detailed in another chapter of the life of my heroic policeman father who rescued hostages and gave wise advice about medical school that has served me well throughout life, that is, Homework; Courage; Never Give Up! Again, people remember stories. They forget statistics, graphs, and most information on slides. Stories that generate emotion have the equivalent of Velcro stickiness to your long-term memory storage." Donald J. Palmisano is a surgeon, an attorney and past president, American Medical Association. He is the author of A Leader's Guide to Giving a Memorable Speech: How to Deliver a Message and Captivate an Audience. (https://amzn.to/2VZu1DW) He shares his story and discusses his KevinMD article, "People remember stories in your speech. The rest fades away." (https://www.kevinmd.com/blog/2020/05/people-remember-stories-in-your-speech-the-rest-fades-away.html)

"Being a parent in the middle of a pandemic is not easy. Sheltering in place with canceled daycare, school, and college, while also being a doctor or other healthcare worker, working in high-risk, high-intensity situations, presents many challenges. It also presents many opportunities. It is possible to choose thoughts about being a physician and a parent during the COVID-19 situation that can help it feel more like an opportunity and less like a struggle." Jessie Mahoney is a pediatrician and can be reached at Pause & Presence Coaching. She shares her story and discusses her KevinMD article, "How parenting in a pandemic is an unexpected opportunity." (https://www.kevinmd.com/blog/2020/04/how-parenting-in-a-pandemic-is-an-unexpected-opportunity.html)

"Many physicians are looking for alternative sources of income and are looking for ways to diversify their investment portfolio from the volatility of the stock market. Some have heard of real estate syndications, but what exactly is a syndication? For those who have not heard of it, real estate syndications can be an attractive investment vehicle for busy professionals who do not have the time or experience to actively manage real estate. As an investor in a syndication, you can put your capital to work for you, leveraging the benefits of investing in real estate that can provide passive income independent of your time." Cherry Chen is an internal medicine physician and founder, The Real Estate Physician. She shares her story and discusses her KevinMD article, "Real estate syndication 101: a physician's guide." (https://www.kevinmd.com/blog/2019/04/real-estate-syndication-101-a-physicians-guide.html)

"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)

"The unparalleled and pervasive nature of the evolving COVID-19 pandemic has touched all of us in some way. There is limited, albeit growing, research on the mental health effects of disasters. A recent review article pointed out the potentially negative consequences of prolonged quarantine, while other research from Wuhan, China, highlighted the impact of COVID-19, particularly amongst healthcare personnel. Psychiatrists and mental health professionals will play a critical role in the aftermath of the pandemic, but this requires a shift in perception of who a psychiatrist is and what they have to offer." Chinenye Onyemaechi is a psychiatrist. She shares her story and discusses the KevinMD article that she co-wrote, "Redefining the role of psychiatrists in the time of COVID-19." (https://www.kevinmd.com/blog/2020/04/redefining-the-role-of-psychiatrists-in-the-time-of-covid-19.html)

"Recent articles have accused some physicians of hoarding medications for themselves during our international medical crisis. Authors such as these should be ashamed of their coverage and wasted ability on sensationalism when they could be spending their time informing the public about the dangers of COVID-19 and the actions communities, hospitals, physicians, businesses, and public servants are taking on a daily basis to protect our great nation and the world from the perils of this invisible enemy. As a physician, I urge my colleagues to keep fighting to help restore order and health in our nation and to remember the promise we made in our Hippocratic Oath: 'So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. There is hope we will defeat this invisible enemy and return to the normal way of American life: travel, commerce, vacation, celebrations, and sports. I ask that we help each other and not spread fear and disinformation during this period. Many people are in need, so reach out to your local hospital or medical school and ask how you can help by donating food or funds to help medical students, physician trainees, and other health care workers. This is a time of national unity and to rise as one and to share resources with each other, help the elderly, and listen to the advice of medical experts." Shady Henien is an interventional cardiology fellow and CEO, Physician Promise. (https://www.physicianpromise.com/) He shares his story, explores the cardiology-coronavirus connection, and discusses KevinMD article, "This is a time for national unity, not sensationalism." (https://www.kevinmd.com/blog/2020/03/this-is-a-time-for-national-unity-not-sensationalism.html)

"This pandemic presents a unique opportunity for senior anesthesiologists to see the benefit of accommodating the health care needs of our workforce. Just as I tried to avoid the teratogenic effects of certain cases when pregnant, we should consider the most effective ways to protect senior anesthesiologists from a life-threatening infection. When the pandemic has passed, anesthesiologists of all ages can take into account times when each of us is more susceptible than others. I hope that we will work to accommodate the age dynamics of our profession and protect each other. For now, while we still have a full roster of healthy anesthesiologists, an effort should be made to spare older colleagues who are at higher risk. After all, this is at the heart of what we do as physicians: care for and protect those who are in need." Becky Wong is an anesthesiologist and can be reached on Twitter @BeckyWongMD. She shares her story and discusses her KevinMD article, "Spare older anesthesiologists COVID-19 coronavirus risk." (https://www.kevinmd.com/blog/2020/03/spare-older-anesthesiologists-covid-19-coronavirus-risk.html)

"Being present is a wonderful thing. It relieves stress caused by focusing on failures of the past and worries of the future. Both realms are unreachable, largely unchangeable. But at the same time, they both entice and tease our minds such that we often find ourselves everywhere, but at the moment as we focus on changing what has already passed or what may (or may not) come to be. Living as our children model so well, at the moment, has an immediate influence on our health and wellness. Tuning out the constant barrage of news about coronavirus and tuning into what is before you will bring calm, serenity, and a sense that all is okay. It will allow you to enjoy the moment, the small pleasures our senses offer us, things that pass us by when we are lost somewhere else on the time continuum. The touch of an elder, the smell of a blossoming fruit tree, the way the wind feels against our cheek – open up to the present, and it is all there for you. Just ask the two year olds." Anthony Fleg is a family physician who blogs at Writing to Heal. He shares his story and discusses his KevinMD article, "Take a gratitude perspective on coronavirus" (https://www.kevinmd.com/blog/2020/05/take-a-gratitude-perspective-on-coronavirus.html) and "The superpower of being present." (https://www.kevinmd.com/blog/2020/05/the-superpower-of-being-present.html)

"Recently, I realized that something needed to change in my family life. With three busy daughters at three different schools who participate in multiple activities along with my full-time job as an anesthesiologist, my life depended on accurate and concise communication. However, this was the third time in a week that a ball had been dropped between my husband and me. This time it resulted in my middle daughter, Laini, being left at practice, and the coach calling to figure out who was picking up this last straggler. It was enough to make me realize that something had to change. The previous day, I had run a code in the GI suite at the hospital where I work. Everything had gone smoothly with team members, all understanding each other perfectly. If I could communicate effectively with a team of five health care members, why couldn't I use these strategies to communicate with my own husband more effectively?" Maria Michaelis is a pediatric anesthesiologist. She shares her story and discusses her KevinMD article, "Closed-loop communications: Good for codes and for marriage." (https://www.kevinmd.com/blog/2020/03/closed-loop-communications-good-for-codes-and-for-marriage.html)

"All too often, physicians and other health care providers have tried to do the right things for our patients to ultimately have had our hand slapped. So pause for a second, get the questions answered, know what future implications are for today's actions. Make the right choice for your patient, and for yourself, especially if it means amending your contract before you start something that may limit your talent/potential as a health care provider. We are taught to feel powerless, which is why our burnout rate is so high. Words are disguised to mean another: patient volume/productivity disguised as patient access, EHR checkboxes that are clinically meaningless disguised as quality measures, your bedside manner, and ability to relate disguised as patient satisfaction surveys. And yet, as we see, despite being made to feel powerless, at the end of the day, we are the only ones with the ability to provide medical care when people need it. An anesthesia machine, scalpel, laboratory, and stethoscope are all useless without the person with it. So get out there and wear your warrior uniform and help your patients! But don't have it be a disguise for being made to wear shackles tomorrow." Vasanth Kainkaryam is an internal medicine-pediatrics physician. He shares his story, explores his direct primary care decision, and discusses KevinMD article, "Advice to employed physicians plunging into telemedicine." (https://www.kevinmd.com/blog/2020/03/advice-to-employed-physicians-plunging-into-telemedicine.html)

"Obesity is a topic that literally hits home for me. For the past two years, the website WalletHub has voted the McAllen-Edinburg-Mission TX metroplex as the 'fattest city in America.' As a health care provider, this is deeply disturbing because it puts my community at high risk for a wide variety of health problems, including but not limited to coronary artery disease, diabetes, stroke, and several cancers such as liver, kidney, breast, endometrial, prostate, and colon. Not surprisingly, we also rank third for the highest percentage of diabetic (type 2) adults. In a local news article published just after our unceremonious coronation, city officials were quoted as saying that WalletHub's findings were, '… extremely misleading about the actual activities and health and wellness and well-being of our community.' I've seen all of the strides that this area has taken to make exercise more accessible, with increasing healthy food options, gyms seemingly everywhere, and miles of paved paths for running and biking. Each city hosts a number of races yearly, including marathons. We even live an hour from South Padre Island, where there's a wide variety of water sports available to enjoy. Yet, the fact remains that our obesity rates still rank at the very top in the country. So, what's to blame for this health epidemic? The plate is full when it comes to contributors, but we are missing out on the main dish." Henry Herrera is a gastroenterologist. He shares his story and discusses his KevinMD article, "What's to blame for the obesity epidemic?" (https://www.kevinmd.com/blog/2020/03/whats-to-blame-for-the-obesity-epidemic.html)

"We are in the midst of a crisis in humanity. While we are still dealing with COVID pandemic and its deleterious health, economic and societal consequences, our troubling past of racism and inequality is rearing its ugly head. The senseless killings at the hands of police, the shameful subjugation of persons of color, the systemic prejudice of a person based upon gender, sexual orientation, or disability have placed us at a tipping point in society. We are vulnerable as a community, as a state, and as a nation. As I am writing this, I am disheartened, disillusioned, and spiritually broken. Our children are witnesses and possibly victims of this inequity. So we as persons of all ways of life and ethnicity must do right for our current generation of highly impressionable minds. As I pen this 'call to care,' I ask you all to consider the following important actions." Nicolo Geralde is a neonatologist. He shares his story and discusses his KevinMD articles, "We are in the midst of a crisis in humanity" (https://www.kevinmd.com/blog/2020/06/we-are-in-the-midst-of-a-crisis-in-humanity.html) and "A different perspective on PPE during the COVID-19 crisis." (https://www.kevinmd.com/blog/2020/04/a-different-perspective-on-ppe-during-the-covid-19-crisis.html)

"With my passion for writing and connecting digitally with others in health care and the general public, this 'downtime' has allowed for an expansion of these interests. I've begun recording on my podcast, a multidisciplinary conversation between women who thrive in fields that traditionally they haven't thought to be able to (or shouldn't). I've spent more time than I ever could have imagined with my son – a wonderful by-product of the distancing measures. And I've found that I love to make my friends – and even strangers – find their laughter during this dark time. My family and friends will often attest to this, how I get joy from getting a smile, a smirk, or even a head shake (I can see you trying not to laugh under there though). As I've grown as a clinician, I've become more comfortable with infusing humor – appropriately – with my patients, and I know that a shared laugh even as they are going through a time that isn't the best in their lives is appreciated." Nancy Yen Shipley is an orthopedic surgeon and can be reached at her self-titled site, NancyMD, and on Twitter @_nancymd and Instagram @_nancymd. She shares her story and discusses her KevinMD article, "How a physician finds laughter during this dark time." (https://www.kevinmd.com/blog/2020/04/how-a-physician-finds-laughter-during-this-dark-time.html) We also discuss her #1 tip for women physicians interested in traditionally male-dominated fields, and her new podcast, The 6% with NancyMD. (https://www.nancymd.com/podcast/)

"I had been trained to be this way. No panic, just a calm journeyman's approach to any affliction, like a mathematician working an equation. Years of preparation, acquiring a skill set, building up my vault, had readied me to stand in the lounge like a zebra. And so, I stared at my hands to see if I was actually here, to see who I was. Maybe I was hoping to see something different. Anything, really. A tremble, a shake. But I saw nothing. Just my hands. Steady. Solid. Quiet. The clock clicked, 8:21. It was one of those old-school clocks, like you'd see on the wall back in grade school. I had zoned out looking at a similar clock at my son's last parent-teacher conference. The second hand was rigid and jerky, making a big move forward, then a small move back. Big forward, small back. Everything fits together, like the pieces of a giant puzzle. The picture becomes clear only when the dark colors blend with the bright. The picture is revealed because of the unity of pieces. I felt the seconds ticking, moving forward from 8:21. Even though it didn't look like it, deep down, the last thirty minutes had kicked my ass. From the outside I was calm, but somewhere inside, the hideous reality of death and suffering screamed and rattled in my well-guarded cage." Shannon Sovndal is an emergency physician and author of Fragile: Beauty in Chaos, Grace in Tragedy, and the Hope That Lives in Between. (https://amzn.to/30SyL1C) He shares his story and discusses his KevinMD article, "Calm in the face of the hideous reality of death." (https://www.kevinmd.com/blog/2020/05/calm-in-the-face-of-the-hideous-reality-of-death.html)

How do racial issues affect patients' physical and mental health, and how do we address them during regular visits? For those without the lived experience of the black community, how can we learn and educate ourselves? How are the current protests different from those in the past? In order for us to make enduring changes that arise from the protests, what needs to happen? C. Nicole Swiner is a family physician and can be reached at Docswiner and on Twitter @docswiner. She shares her story and her perspective on the country's racial climate and how it affects both doctors and patients.

"Physicians have struggled and sacrificed to develop the clinical judgment and skill needed to provide competent clinical care. They have undergone over a decade of schooling and training, taken on excessive student loan debt, worked backbreaking hours for low pay during residency, and risked their lives during the process. Yet when they have completed their training, they often times have to pay excessive malpractice premiums, having to answer to bureaucrats, administrators, insurance companies, politicians, and lawyers. Many times they get the short end of the stick, and are completely expendable by the system. Their incomes are tied to a job, boss, corporate, and regulatory entities that do not have their best interests in mind. More frequently, these entities are failing physicians. Look at what happened with COVID-19, and ask yourself, "What if that source of income was eliminated by no fault of your own?" What is needed is a paradigm shift, and breaking out of traditional modes of linear thinking that our profession is so accustomed to. Now, more than ever, it's not just about having a single high-income wage. Too many physicians are living paycheck-to-paycheck, have large liabilities, little-to-no savings, and families to support. Today's physicians must be able to use asset and income diversification to mitigate economic risks." Christopher H. Loo is a physician and author of How I Quit My Lucrative Medical Career and Achieved Financial Freedom Using Real Estate. (https://amzn.to/37MiPPB) He shares his story and discusses his KevinMD article, "How COVID-19 is forcing physicians to rethink the concept of job security." (https://www.kevinmd.com/blog/2020/05/how-covid-19-is-forcing-physicians-to-rethink-the-concept-of-job-security.html) This episode is brought to you by Money Insights. Please visit Moneyinsights.net/KevinMD (https://moneyinsights.net/KevinMD/) for a unique financial strategy to help physicians across the country grow and protect their wealth.

"Sitting in front of my laptop with both of us on the screen, I can maintain decent eye contact even if I look something up or type something into the medical record. The patient sees me as paying more attention than when I couldn't effectively both maintain eye contact and look at the screen while talking to him or her (because I'm not that good at typing). Without the ability to do a physical exam, I have more time to listen and ask questions, and my patient is speaking to me from their home environment without the distractions of getting to my office, sitting in the waiting room and perhaps waiting in a sterile exam room longer than they should have. We are now perhaps a little more at ease as we begin our encounter. Without the trappings of the medical office, we are face to face, and our surroundings are less obvious and less able to distract us. We feel more on an equal playing field, each one of us in our own environment. At the same time, if the patient chooses to, they can show me a glimpse of theirs. Just the other day, a tough-looking ex-convict showed me his new cat, a surprising side of him that deepened my understanding of his new life and new level of responsibility and respectability." Hans Duvefelt, also known as "A Country Doctor," is a family physician who blogs at A Country Doctor Writes: and is the author of A Country Doctor Writes: CONDITIONS: Diseases and Other Life Circumstances. (https://amzn.to/30Kl0BT) He shares his story and why he writes, explores how the pandemic change primary care, and discusses his KevinMD article, "Will telemedicine make us better diagnosticians?" (https://www.kevinmd.com/blog/2020/05/will-telemedicine-make-us-better-diagnosticians.html) This episode is brought to you by Money Insights. Please visit Moneyinsights.net/KevinMD (https://moneyinsights.net/KevinMD/) for a unique financial strategy to help physicians across the country grow and protect their wealth.

Physicians are finding out that their jobs aren't as secure as they thought. Many have taken salary acts, are furloughed, or worse, laid off completely. It comes as a financial shock to many doctors. In this episode, gastroenterologist and certified financial coach Brent Lacey shares his tips and advice on how physicians can navigate these uncertain financial times. Brent Lacey is a gastroenterologist and certified financial coach and can be reached at the Scope of Practice. He shares his story and discusses finance tips for physicians in the year 2020. This episode is brought to you by Money Insights. Please visit Moneyinsights.net/KevinMD (https://moneyinsights.net/KevinMD/) for a unique financial strategy to help physicians across the country grow and protect their wealth.

"We desperately want to be part of it. For most of us, this pandemic has tapped at a foundational, altruistic urge to do our part. Our friends and loved ones are on the frontlines, their faces creased by masks worn all day, their eyes bloodshot, their foreheads grooved by too-tight goggles. Our friends and loved ones risk their lives while we … don't. If you're anything like me, social isolation has felt like the opposite of heroism. It's felt like a jarring mix of survivor guilt, uselessness, and boredom." Mark G. Shrime is an otolaryngologist. He shares his story, global health perspective, and discusses his KevinMD article, "Let's not let our pride get in the way of heroism." (https://www.kevinmd.com/blog/2020/04/lets-not-let-our-pride-get-in-the-way-of-heroism.html)

"When the director of my general surgery program asked for a report on how the pandemic was affecting the residents, I queried my colleagues, promising anonymity to encourage candor. I received a wide variety of responses and reactions. Some are thriving; others are not. In the end, I cannot decide if things are going well or not. That may be because everything still feels uncertain and, at times, overwhelming. Parts of our health system are shining, and others need improvement. As residents, we're frightened; we're fearless; we're overworked; we want to work more. But we are all proud of our work, our colleagues, and our institution. Generations of doctors have lived and died without facing a catastrophic health event quite like this one. Our institution and our forebears have faced many. This is our time." Maggie Connolly is a general surgery resident. She shares her story and discusses her KevinMD article, "How are the residents doing during the pandemic?" (https://www.kevinmd.com/blog/2020/05/how-are-the-residents-doing-during-the-pandemic.html)

"Few physicians feel properly prepared to face the fear caused by this pandemic. I certainly did not. However, we continue to show up every day for our colleagues and our patients. We continue to focus on our jobs and the things that we can do to help. Let's not forget to find moments throughout the day to recognize that we are fearful and for good reason. Face the fear and then keep going, just as we have always done." Kristin Yates is an obstetrics-gynecology physician. She shares her story and discusses her KevinMD article, "Coping with fear as a physician during a pandemic." (https://www.kevinmd.com/blog/2020/04/coping-with-fear-as-a-physician-during-a-pandemic.html)

"Today, we got called on a patient in the ICU who recently had a new brain mass removed surgically. The specimen came back positive for an aggressive brain tumor known as glioblastoma multiforme. We discussed his diagnosis and prognosis with him at bedside alone, with his wife and daughter on speakerphone given visitor restrictions due to the current coronavirus pandemic. Unfortunately, this type of situation is rather familiar to us. We are used to breaking bad news, comforting patients during their times of need, and then shifting to our usual survival tactic of orchestrating a treatment plan. While many aspects of this exchange were similar, there were unique variables that grabbed my attention, given our current circumstances." Azam J. Farooqui is a hematology-oncology physician. He shares his story, global health perspective, and discusses his KevinMD article, "Breaking bad news to patients when they are alone." (https://www.kevinmd.com/blog/2020/03/breaking-bad-news-to-patients-when-they-are-alone.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

"The events over the last couple of weeks have affected me deeply. Of course, I'm concerned about a novel virus that is infecting and killing people. But, I'm more distraught over the reaction of the people, the response of the state and federal governments, the blatant disregard of science/epidemiology, and the warnings of our physicians on the front lines. Most of us will get this virus and be OK. But slowing it down is 100 percent vital. Why? Because our health care system has limited resources. We only have so many hospital beds in this country and, at last count, only 62,000 ventilators. If the forecasted numbers of infected Americans reach the projected peak in the millions, we will have no choice but to ration those resources. This means a physician will be tasked with choosing who gets a chance to live and who does not. This is the reality in other countries." Michelle C. Hure is a dermatopathologist. She shares her story and discusses her KevinMD article, "A pathologist's message to the public." (https://www.kevinmd.com/blog/2020/03/a-pathologists-message-to-the-public.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

"Most physicians have spent decades training for the day that they see their first patient or perform their first surgery. This extended time involved to become a physician does not leave a lot of spare time in college or medical school for most physicians to take any significant coursework in economics, finance, or investing. Yet, physicians have a tremendous amount of knowledge with regards to all aspects of health care, including patient evaluation and physiology, medical technology, and electronic health records. We recognize the relevant positives and negatives and the benefits and shortcomings of current medical technology and computer-based patient care platforms. Most physicians have keen insight into what is currently working for them and their patients, and what might be done to improve the status quo. This knowledge and insight is a major reason why startup companies with new technology, and venture capital investors, often look to partner with physicians and bring them on as investors and advisers. There is a growing desire and need for physicians to be more actively involved in venture capital funds and physician networks for this purpose." Chris Kager is a neurosurgeon. He shares his story and discusses his KevinMD article, "A physician in the venture capital world." (https://www.kevinmd.com/blog/2020/03/a-physician-in-the-venture-capital-world.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

"Each morning before the doctors came in for rounds; I'd paint feverishly whatever abstraction came to mind and what evolved from my situation. When I completed my pieces, I felt like I had not only gotten out my frustrations and worry, but also found a place of joy and gratitude. I would put each canvas outside my hospital room, and soon the unit began to catch on, even taking patients by my room to see whatever I had created that day. Now, I was sustaining my aliveness and inspiring others, which filled myself with unanticipated meaning and satisfaction. Ironically, the darker the circumstances became, the more joyous my paintings seem today. Every tree seems to be singing and dancing, although the tear-drops and lightning bolts are always streaked across the bold backgrounds. Once I discovered painting, my world changed. I had found a way to express things that were too painful, complicated, and overwhelming for words. Suddenly, when the uncertainty around me seemed frighteningly unmanageable, the strokes of my paintbrush could soothe me as I created a peaceful world that my soul longed to rest in as a place of peaceful solace. My passion could ignite instead of my anger and despair. And slowly, the good feelings overwhelmed the bad because I could control the positive world portrayed on my canvases with what my subconscious chose to create." Amy Oestreicher is the author of My Beautiful Detour: An Unthinkable Journey from Gutless to Grateful (https://amzn.to/2AHSwhH) and can be reached at her self-titled site, Amy Oestreicher. She shares her story and discusses her KevinMD article, "Art therapy and the intersection between chronic illness and mental health." (https://www.kevinmd.com/blog/2019/07/art-therapy-and-the-intersection-between-chronic-illness-and-mental-health.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

"Do all physicians and scientists not on the frontlines of this pandemic feel this, or is it unique to women? Women in medicine and science have long struggled with the sense of never having 'done enough' and have pushed themselves even harder to get the same recognition accorded our male colleagues. Does that make us more vulnerable to guilt, or are we holding ourselves to unreasonable expectations? We arranged to meet for a 'wellness session,' and as we shared our experiences, we realized one thing was common: We all felt guilt." Theresa Rohr-Kirchgraber is an internal medicine-pediatrics physician. She shares her story and discusses her KevinMD article that she co-authored, "The guilt of not being on the frontlines of the pandemic." (https://www.kevinmd.com/blog/2020/04/the-guilt-of-not-being-on-the-frontlines-of-the-pandemic.html) This episode is brought to you by Saykara (https://www.saykara.com/), the first voice-powered ambient virtual assistant.

Thank you for listening to the podcast. There were some audio difficulties during this interview, which I hope you can overlook. It certainly does not take away from Dr. Sheikh's message and her wonderful interview. "'It's a strange time to be having a baby,' my patient said as she sat alone in her labor room. The state order to shelter-in-place in California had left her family with few options as her husband had to stay home to take care of their toddler. She is one of many pregnant women who do not have the choice to even consider a home birth due to her congenital heart condition, which puts her at risk for sudden cardiac death. She understood that she was part of a 'high-risk' population, the ones with preexisting conditions that are more likely to have severe disease if they contract COVID-19. If she got sick, it would mean total isolation and separation from her baby and family for weeks. I sat with her a little longer. She smiled, but I could see the fear and uncertainty in her eyes — fear of giving birth alone and of what life would look like with a newborn in our new apocalyptic reality. Pre-pandemic, I would have sat closer to her and even held her hand to ensure her that she was not alone. But I sat six feet away and consoled her from a distance and simultaneously wondered if she could sense my own fear and apprehension. 'I'm sorry that your husband can't be here with you. These are unprecedented times for all of us, and we'll do the best we can to keep you and your baby safe.' We must be strong for our patients. As young physicians, we have seen our fair share of trauma, death, and despair. But most of us have never had to come face-to-face with our own mortality. Now, we have fear." Maria Sheikh is an obstetric anesthesiologist who blogs at The Epidural Doc and can be reached on Twitter @MariaSheikhMD. She shares her story and discusses her KevinMD article, "Giving birth during the COVID-19 pandemic: an obstetric anesthesiologist's perspective." (https://www.kevinmd.com/blog/2020/04/giving-birth-during-the-covid-19-pandemic-an-obstetric-anesthesiologists-perspective.html)

"As a nearly graduated medical student, I have come to the conclusion that the focus of medical school is split between training and distinguishing medical students. Modern pedagogy has not found its way into the modern medical school classroom. Preclinical students spend mounds of time on impossible tasks, like memorizing First Aid for the USMLE Step 1, without learning concrete skills that can be applied to clerkships. As for clerkships, the quality of teaching is highly dependent on the attending's or resident's level of commitment to education. Oftentimes, we feel like flies on the wall rather than active participants in patient care." David Chen is a medical student. He shares his story and discusses his KevinMD article, "Why are medical students non-essential?" (https://www.kevinmd.com/blog/2020/05/why-are-medical-students-non-essential.html)

"Come with me on this journey, this very ancient journey. To experience the age-old story of a very modern foe. This foe is invisible; it is neither living nor dead. You cannot smell it, and you cannot taste it. While it is not alive, it can become alive, with a flick of the right kind of switch. While it is not dead, it can masquerade as the dead, until the perfect moment. This is the journey of the 2019 novel coronavirus." Frank Han is a cardiology fellow. He shares his story and discusses his KevinMD article, "A journey through time with a very modern foe." (https://www.kevinmd.com/blog/2020/05/a-journey-through-time-with-a-very-modern-foe.html)

"It is no secret that we started off combating COVID-19 with disadvantages. Lately, news is rampant with coverage of the paucity of ventilators, hospital beds, and N95 masks. But it is important not to forget the deficits in our workforce. Last year, the American Medical Association estimated that our nation faces a projected shortage of up to 122,000 doctors in the next decade. In the midst of this, 27,000 physicians are DACA recipients, and a myriad of international medical graduates suffer the disquiet of whether or not they will get timely visas or green cards. As I think of these doctors, some of whom are my own colleagues and are fellow minorities in medicine, I cannot help but consider the repercussions to public welfare if their status was rescinded." Natalie Moreno is a medical student and can be reached on Twitter @NatalieAMoreno1. She shares her story and discusses her KevinMD article, "Immigrant and minority physicians at the frontline of pandemics." (https://www.kevinmd.com/blog/2020/04/immigrant-and-minority-physicians-at-the-frontline-of-pandemics.html)

"The donation of hydroxychloroquine, in contrast to the accompanying donation of 1,000 ventilators, is unethical as either humanitarian aid or as a 'research study.' The United States has a moral responsibility for any human harm that results. We cannot simply send medications off to potentially vulnerable populations without regard for the lives that could be negatively affected. It is not enough to intend to do good and avoid harm; we must ensure it." Charles E. Binkley is a bioethicist and general surgeon. He shares his story and discusses his KevinMD articles, "It is unethical for the United States to send hydroxychloroquine to Brazil" (https://www.kevinmd.com/blog/2020/06/it-was-unethical-for-the-united-states-to-send-hydroxychloroquine-to-brazil.html) and "Mike Pence and the Mayo Clinic's moral failure." (https://www.kevinmd.com/blog/2020/05/mike-pence-and-the-mayo-clinics-moral-failure.html)

"Out of the blue, a new virus popped up, and ten weeks later, it is a pandemic. Within the last ten weeks, doctors have identified this new disease, figured out how it is transmitted, identified what body fluid we need to test to determine who has contracted the disease, developed a test for it, mass-produced that test, and distributed the tests all over the world. What an incredible response we have had from the medical community. I can't believe we could do all that so quickly. Hats off to the researchers who pulled off this incredible feat. Yet to hear it on the news, we haven't done anything to stop the spread of the coronavirus. Now we have been asked to use social distancing to help slow down the spread of this virus. Workers staying home from work is disrupting income all over the world. The entire travel industry has almost shut down. Cruise ships are suspending operations, professional and amateur sports have come to a halt, Broadway has shut down, even Las Vegas is putting away the red carpet. People are told to stay home. Businesses have shut down, including Disneyland. The economy has slowed to a standstill. This is even worse than the government shutdown. This pandemic highlights the need for an emergency fund." Cory Fawcett is a general surgeon and can be reached at Financial Success MD. He is the author of The Doctors Guide to Starting Your Practice Right, The Doctors Guide to Eliminating Debt, and The Doctors Guide to Smart Career Alternatives and Retirement. He shares his story and discusses his KevinMD article, "This pandemic highlights the need for an emergency fund" (https://www.kevinmd.com/blog/2020/04/this-pandemic-highlights-the-need-for-an-emergency-fund.html) and his book, The Doctors Guide to Navigating a Financial Crisis. (https://amzn.to/2YeO5DV)

"Here we are again, mourning the death of another black person at the hands of the people that are supposed to protect and defend our rights. Another casualty in the 400+ year struggle that we have had in this country to be granted the same right to liberty, the same access to success and the same ability to live without fear, that we were promised. And while this may seem dramatic and hyperbolic to some, I wonder how many people would like to trade places with black people in this country. It often feels like it is OK to hear our voices when it relates to music, sports, and other forms of entertainment, but when it comes to the tough issues that crush our communities, the fervor of the backlash, the push to discredit our concerns and the silence from our advocates that maintains the status quo is maddening." Brian C. Clark is a cardiologist and can be reached on Twitter @brianclarkmd. He shares his story and discusses his KevinMD article, "We should be collectively tired as a society." (https://www.kevinmd.com/blog/2020/06/we-should-be-collectively-tired-as-a-society.html)

"Some media outlets and public figures have heralded the ongoing pandemic as a great equalizer, referencing the pathogen's indiscriminate spread and disregard for national borders and tax brackets. The sobering mortality statistics, however, dispense any notion of an equal-opportunity crisis, revealing a familiar theme among public health challenges in America: significant racial disparities exist, and communities of color are disproportionately affected." Ritodhi Chatterjee is a medical student. He shares his story and discusses his KevinMD article, "COVID is not a great equalizer." (https://www.kevinmd.com/blog/2020/05/covid-is-not-a-great-equalizer.html)

"As medical trainees, we will shape the rapidly changing health care environment in this country. We are fiercely advocating for our disadvantaged patients, debating the price of life-saving medications, and carefully considering how the upcoming elections will shape the health care system in which we both provide and receive care. All the while, we handle our responsibilities and prepare to care for critically ill patients during a seemingly inevitable pandemic. These diverse issues bring to light a huge deficit in medical education — the lack of training on complex health systems." Daniel Arteaga is an internal medicine resident. Isobel Rosenthal is a psychiatry resident. Lauren Tronick is a medical student. They are founders of the podcast, Well Rounded. (https://podcasts.apple.com/podcast/well-rounded/id1498401733) They share their story and discuss Daniel and Isobel's KevinMD article, "Medical trainees need knowledge and education on health care systems and policy." (https://www.kevinmd.com/blog/2020/03/medical-trainees-need-knowledge-and-education-on-health-care-systems-and-policy.html)

Thank you for listening to the podcast. There were some audio difficulties during this interview, which I hope you can overlook. It certainly does not take away from Dr. Syed's message and her wonderful interview. "An essential part of daily living for many people is faith. No matter what faith you belong to, people practice their faith in different ways. Most people have faith intertwined with their daily routine in some form or another. Whether a person prays at that start of their day in solitude or in congregation, faith is a fundamental part of life for many people. There are so many challenges with how to observe their faiths and traditions in these unusual times. Most religious organizations have not been congregating in parts of the country with a large burden of COVID cases. Some faiths have shifted to virtual congregations. People are accustomed to praying and feasting with their loved ones. Although the human connection is being displaced in these times, and a shift is being placed on a virtual connection with the aid of technology, the gain that is resulted from the sacrifice is tremendous. With every social distancing encounter and sheltering in place, action comes the reward of a life saved. Uzma Syed is an infectious disease physician. She shares her story and discusses her KevinMD article, "During the pandemic, faith keeps us together." (https://www.kevinmd.com/blog/2020/04/during-the-pandemic-faith-keeps-us-together.html)

"In my lifetime, I have encountered those who have seemingly endured far greater states of human privation than I could ever imagine (though I try to eschew establishing comparative equivalencies [or non-equivalencies] among human suffering as much as possible because such an impossibly herculean task never ends well). And what I have come to realize is that the nexus of all of these extraordinary stories of tragic afflictions being overcome was the individual's remarkable propensity for gratitude and their mental aptitude to reorient, reframe, and reappraise all that was bad … into all that is good. Unlike biological antibodies that fight microbial marauders just by our very nature of existing until the illness passes, the acquisition of emotional antibodies is a far less passive process. We have to be proactive in our efforts to construct and build meaning around the negative impact of the trials around us, and integrate all that we ascertain into the person that we are … and the person that we become—our identity." Jay Wong is a medical student at the University of Michigan Medical School. He received his undergraduate degree in molecular, cellular, and developmental biology from Yale University. He can be reached at his self-titled site, Jay Wong, and on Twitter @JayWongMedicine, Instagram @JayWongMedicine, and Facebook. He shares his story and discusses his KevinMD article, "A vaccine alone will not be enough to recover from the impact of COVID-19: Emotional antibodies against it are needed as well." (https://www.kevinmd.com/blog/2020/05/a-vaccine-alone-will-not-be-enough-to-recover-from-the-impact-of-covid-19-emotional-antibodies-against-it-are-needed-as-well.html)