First Opinion Podcast

If there was one moment that led Kathleen Bachynski to a career studying the public health significance of sports injuries and violence, it was blowing out her knee in three places as a high school soccer player. And after years of documenting the many ways that football in particular can harm young players, she's got one rule: no full-body collision sports for kids. This week, she discusses the risks taken by youths in one of the country's most revered sports.

It can be hard to fathom that anyone other than you might own your information. But they do. Everything from what's in your electronic medical record to the average jogging speed recorded on an app may be someone else's property. For a profit, the magic is in the aggregate. On an individual scale, it's valuable information that paints a full picture of health for individuals and their health care providers. Juhan Sonin and Annie Lakey Becker explain why it's important to fight for patient ownership of health data across the country and the world.

Diseases like smallpox, measles, and dysentery killed two-thirds of the 1 million people who died in the Civil War. “Chronic diarrhea” and the stigma of smallpox scars plagued soldiers and others for decades afterward. And while Americans no longer depend on digging ditches for latrines, we’re still struggling with faith in national public health measures, racial disparities in health care, and more. Medical historian Jonathan S. Jones discusses the epidemics of the Civil War and the lessons learned and forgotten.

Resident physician Sudhakar Nuti was almost too burnt out to write about burnout. He spent months working to find the energy to start his recent First Opinion essay on how the pandemic has aggravated the already dire mental health situation for many medical trainees around the country, including himself. "I feel like I've gone from doctor to debris," he wrote. Nuti joins "First Opinion Podcast" to further discuss how burnout happens during residency, and how the profession might address its systemic problems with systemic solutions.

Ever since medicine adopted a race-based formula to assess kidney health in the mid-2000s, some experts have spoken out against it & the life-threatening impact it has on Black patients.  Patients like Glenda Roberts, who long self-identified as Black, and who has lived with kidney disease for most of her adult life. The "Black correction" in the eGFR made it look like her kidneys were doing better than they actually were, which delayed her being worked up for a kidney transplant. Roberts and kidney specialist Vanessa Grubbs spoke this week about the impact this equation has had on patients' lives and whether the profession has truly reckoned with it.

Natalie Ma knows a lot about antibiotics. She's familiar with the consequences of antibiotic resistance and the side effects of these essential drugs from her work at Felix Biotechnology, the biotherapeutics company she cofounded. So it was particularly daunting when what she thought was a run-of-the-mill urinary tract infection wasn't abated by the standard antibiotics.

The conversation stems from her First Opinion essay, "My company is developing new antibiotics. My resistant infection showed me we need them now." To hear more about antibiotic resistance, you can listen to episode #9 of the First Opinion Podcast with researchers David Hyun and Rachel Zetts on the far-reaching effects of these "superbugs."

Americans have a tendency to fixate on what's commonly thought of of as "a good death" — a peaceful, quiet passing that looks like falling asleep. But physician Joel B. Zivot and medical philosopher Ira Bedzow are cautious about how this preoccupation can shield people from the reality of death. When they read a recent report in JAMA on using medication to eliminate the "death rattle" — a soft moan or gargling sound sometimes made by people when death is near — they knew they needed to write about the dangers of curating death for the witnesses rather than focusing on those who are dying. This culture extends to state executions, in which people often injected with paralytics when they put to death. That makes these deaths easier for the witnesses, but not for those being executed.

When data shows that Asian Americans are faring better during the pandemic than other racial groups, physician and researcher Carlos Irwin A. Oronce knows that isn't the whole story. The first nurse to die from Covid-19 in Los Angeles was Filipinx, and more stories continue to emerge about the plight of Filipinx health care workers. Yet it's difficult to find any disaggregated data from within the Asian American racial group to back-up these stories, and Oronce says that needs to change.

Abortion access is being threatened across the country: Texas has come close to banning abortion as the Supreme Court prepares to take up a challenge to Roe v. Wade. While this has put much of the medical community on the defensive, many are looking ahead toward expanding access to medication abortion and having clinicians "step aside." This conversation is based on a First Opinion by physician Jennifer Karlin titled, "For abortion care, physicians may need to step aside to support patients."

Although billions of dollars have been poured into potential pharmaceutical cures for dementia, particularly Alzheimer's disease, none so far have been proven to slow or stop the disease from progressing. Yet even without an effective drug, incidence rates of dementia in the United States and several other countries have decreased since 1998. Why? Social changes like lower smoking rates and better education, along with better population-level health, have improved brain health.