Out of Patients with Matthew Zachary

Jessica Federer built her career inside the rooms where science, money, and power collide. As the first female Chief Digital Officer at Bayer, she helped steer a 120,000 person global company through the rise of digital medicine while confronting a harder truth: women were excluded from U.S. clinical trials until 1993.

In this conversation, she explains how decades of “first in man” research shaped drug development, why women experience side effects at nearly 2x the rate of men, and how guidance on sex based differences did not arrive from the FDA until December 2025.  She shares what it means to sit on a Yale Institutional Review Board, why clinical trial stipends over $3,000 get taxed, and why she believes participants deserve tax credits instead. 

From GLP 1 profits to $40,000,000 women’s health funds that barely move the needle, this episode names the gaps and the opportunity hiding inside them.  

RELATED LINKS

Jessica Federer on LinkedIn

Jessica Federer on Instagram

Yale School of Public Health

Health of Women Investor Summit

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Dr Eugene Manley grew up in Detroit in the 1980s cycling through emergency rooms 20 to 30 times a year with asthma and anaphylaxis while hospital staff talked past his family and buried them in paperwork they could not decode. He responded by earning a BS in mechanical engineering an MS in biomedical engineering and a PhD in molecular biology cell biology and biochemistry. Along the way he tore his ACL training for a jiu jitsu black belt worked 86 straight days in a lab during his doctorate and learned how academic and clinical systems punish people who refuse to shrink.

In this episode Manley walks through a recent post surgery ordeal at Mount Sinai Queens where staff falsified records attempted an illegal discharge and nearly sent him home on the wrong blood thinner. He explains how medical racism shows up in charts staffing and decision making and why measurable equity fails without accountability. Listeners hear how his STEMM and Cancer Health Equity Foundation builds pipelines for underrepresented students challenges clinical trial design and teaches patients how to protect themselves when institutions lie.  

RELATED LINKS

Eugene Manley Jr

STEMM and Cancer Health Equity Foundation

Village Voice

LUNGevity Foundation

FEEDBACK

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Jenny Opalinski has spent more than a decade inside hospitals where people lose the ability to speak, breathe, swallow, and sometimes survive. A medical speech language pathologist by training, she worked in ICU, neuro rehab, and long term acute care settings, including a Level 1 trauma center, where she watched clinicians absorb 10 to 15 traumatic events in a single shift and then get told to move the crash cart faster next time.

That lived reality pushed her to co found The Wellness Shift, an advocacy and education platform focused on healthcare worker burnout, suicide, and assault. In this conversation, Opalinski walks through the moment that changed everything for her: standing in a hospital hallway listening to a family wail after a failed code, followed by a debrief that addressed logistics and ignored grief entirely.

She also explains how that work led to Humanity Rx, her podcast about the human cost of medicine, and Dragon’s Breath: Calming Tricks for Big Feelings, a children’s book that translates evidence based breathing and regulation strategies into language kids can actually use. The episode covers moral injury, time scarcity, false wellness, respiratory muscle training, and why empathy keeps getting treated as an optional expense instead of clinical infrastructure.

RELATED LINKS

Jenny Opalinski on LinkedIn

Humanity Rx Podcast

FEEDBACK

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Fitz Koehler is a fitness expert, race announcer, author, and breast cancer survivor whose career spans decades of helping people move, train, and live healthier lives. After earning a master’s degree in exercise and sport sciences, she built the Fitzness brand, launched the Morning Mile school fitness program, and became one of the country’s most recognizable voices at endurance events before cancer abruptly shifted the conversation.  

She spent 15 months enduring chemotherapy, surgery, and radiation after discovering breast cancer shortly after receiving a clean mammogram. She kept traveling, announcing races, and working through treatment while watching the body she had spent a lifetime building become weaker by the week. Instead of asking why cancer happened, she focused on the only things she believed remained under her control: movement, nutrition, sleep, and mental health.  

The conversation explores where personal agency ends and biology takes over. Koehler argues that exercise is not about chasing perfection or preventing every diagnosis. It is about building physical reserve before illness arrives and preserving strength, mobility, and independence during treatment. She rejects wellness snake oil, fad supplements, and miracle cures in favor of practical habits rooted in exercise science and lived experience.  

The discussion also confronts a harder truth. Koehler did everything “right” and still developed cancer. That tension becomes the center of the episode. Fitness cannot eliminate randomness, but it can influence how people experience treatment, recover from surgery, and reclaim their lives afterward. The conversation moves beyond motivation and into survivorship, exercise oncology, cancer rehabilitation, evidence-based nutrition, and the limits of individual control inside a healthcare system that often tells patients what they should do without showing them how to do it.  

Along the way, the conversation wanders through kickboxing, Cinnabon, Jean-Claude Van Damme, chocolate-covered Cheetos, Jerry Seinfeld playing during chemotherapy stretches, and why the simplest advice is often the hardest to follow. Beneath the humor sits a larger argument: preparing the body for hardship is not about living forever. It is about living better when life inevitably gets difficult.  

RELATED LINKS

Fitz Koehler⁠

Fitzness⁠

The Morning Mile⁠

You. Supercharged!⁠

My Noisy Cancer Comeback⁠

Your Healthy Cancer Comeback⁠

UF Health Cancer Center⁠

American College of Sports Medicine Exercise Is Medicine⁠

FEEDBACK

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Jeremy Heffner, MD, FACS is a board-certified trauma surgeon, former Chair of Surgery at Lima Memorial Health System, and cofounder of Surgery Unified, one of the largest physician-led communities in surgery. His perspective carries weight because he has spent decades inside operating rooms, hospital leadership, physician culture, and the growing collision between medicine and corporate healthcare. He grew up in a blue-collar Ohio family of firefighters, railroad workers, police officers, and tradespeople. Medicine represented something rare: a career that combined service, stability, and purpose. He pursued engineering, earned his medical degree, completed trauma surgery fellowship training at the University of Michigan, and entered a profession that taught physicians to sacrifice themselves for patients.

Then the rules changed.

This conversation traces the gap between the medicine physicians were trained to practice and the healthcare industry that emerged around them. Administrative burden expanded. Insurance companies gained influence over treatment decisions.  Prior authorization became routine. Hospital systems consolidated. Physicians retained responsibility for outcomes while losing authority over the conditions required to achieve them.

Heffner describes watching colleagues struggle with burnout, moral injury, PTSD, and growing frustration with a system that increasingly inserts business incentives between clinicians and patients. He explains why younger physicians are entering medicine with a level of visibility that previous generations never had. They see the paperwork, the denials, the loss of autonomy, and the personal cost before they ever finish training.

The discussion moves beyond physician dissatisfaction and into the broader consequences for patients. When insurers delay care, hospitals absorb costs, clinicians absorb stress, and patients absorb uncertainty. The financial incentives remain intact while trust erodes across every level of the healthcare system.

At its core, this episode examines what happens when a profession built around service finds itself operating inside an industry built around extraction. The result affects physicians, nurses, caregivers, and every patient forced to navigate the consequences.

RELATED LINKS

Jeremy Heffner⁠

Surgery Unified⁠

SurgeOn⁠

University of Michigan Department of Surgery⁠

KevinMD⁠

Suck It Up Buttercup⁠

FEEDBACK

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In 1971, the National Cancer Act transformed cancer into a national research priority. More than 50 years later, the next frontier is no longer defined solely by scientific discovery, but by how quickly knowledge, lived experience, and patient voices can reshape healthcare itself.

The concluding chapter of The Cancer Mavericks: A History of Survivorship explores how the cancer advocacy movement continues to evolve in an era of digital communities, social media, precision medicine, and grassroots activism. Building on the work of pioneers such as Mary Lasker, Rose Kushner, and the generations of survivors who followed, today’s advocates are expanding the movement beyond awareness to demand health equity, trusted information, patient-centered research, and meaningful representation in healthcare decision-making.

The episode examines how technology has transformed advocacy from local support groups into global communities capable of organizing in real time. Researchers, policymakers, nonprofit leaders, and survivors reflect on the growing influence of digital storytelling, online education, and peer-to-peer networks that connect patients across diagnoses, generations, and geographic boundaries. At the same time, they acknowledge new responsibilities: ensuring accurate medical information, combating misinformation, protecting trust, and keeping patients at the center of innovation.

The story also looks ahead to the next generation of advocates. Young leaders are applying lessons learned from decades of cancer activism while drawing inspiration from broader movements for social justice, public health, and community organizing. Their work reflects a simple but enduring truth: meaningful change rarely begins inside institutions. It begins when ordinary people refuse to accept that the system cannot improve.

Cancer survivorship has never been a finished story. Every generation inherits the progress achieved by those who came before while confronting challenges uniquely its own. The future of survivorship will be shaped not only by scientific breakthroughs, but by those willing to listen, organize, educate, and ensure that every patient’s voice helps define what comes next.

RELATED LINKS

• National Cancer Institute⁠
• Cancer Moonshot⁠
• Centers for Disease Control and Prevention | Division of Cancer Prevention and Control⁠
• HopeLab⁠
• Tigerlily Foundation⁠
• Stupid Cancer⁠

FEEDBACK

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In 1987, Mary P. Lovato, a member of Kewa Pueblo in New Mexico, was diagnosed with acute leukemia. To receive a bone marrow transplant, she had to travel more than 800 miles from home because specialized cancer care was unavailable through the Indian Health Service. When she returned, she discovered another obstacle: many in her community feared cancer so deeply that they avoided speaking about it altogether.

This episode examines how cancer survivorship exposed profound inequities in the American healthcare system. Long before health equity became a national priority, advocates from underserved communities were confronting disparities rooted in geography, poverty, racism, language, underfunded healthcare systems, and historical mistrust of medical institutions. Their work demonstrated that scientific advances alone cannot improve survival if patients cannot reach, afford, or trust the care available to them.

The story follows pioneers including Mary P. Lovato, who built the first national Native-led cancer support and education program for Indigenous communities, and Maimah Karmo, founder of the Tigerlily Foundation, whose breast cancer diagnosis inspired a movement to improve early detection, clinical trial participation, and representation for Black women. Their advocacy challenged longstanding barriers to culturally competent care while highlighting persistent inequities in access to screening, fertility preservation, navigation, and innovative treatments.

The episode also explores why diversity in clinical research matters. For decades, many cancer clinical trials disproportionately enrolled White patients, limiting both access to promising therapies and the scientific understanding of how treatments perform across different populations. Researchers, patient advocates, and community leaders responded by redesigning outreach, improving patient navigation, reducing logistical barriers, and insisting that affected communities help shape the research itself.

Cancer survivorship cannot be measured solely by scientific breakthroughs. It also depends on whether every patient has a meaningful opportunity to benefit from them. The pursuit of health equity remains one of the defining challenges and enduring responsibilities of modern oncology.

RELATED LINKS

• National Cancer Institute | Cancer Health Disparities⁠
• Indian Health Service⁠
• Tigerlily Foundation⁠
• National Cancer Institute | Cancer Clinical Trials⁠
• American Indian Cancer Foundation⁠
• Abramson Cancer Center | University of Pennsylvania⁠

FEEDBACK

Like this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to [email protected].

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In 2000, Katie Couric underwent a live colonoscopy on national television following the death of her husband, Jay Monahan, from colorectal cancer at age 42. The broadcast demystified a procedure many Americans feared, led to an estimated 20% increase in colonoscopy screenings, and became one of the clearest examples of how public storytelling can change healthcare behavior.

This episode examines how celebrities, journalists, filmmakers, and entertainers helped reshape the public conversation about cancer during a period when survivorship was becoming increasingly visible. As breakthroughs in targeted therapies, immunotherapy, and early detection allowed more people to live beyond cancer, public figures used their platforms to encourage screening, reduce stigma, and accelerate research. Their influence extended far beyond awareness campaigns, helping transform cancer from a private diagnosis into a national public health conversation.

Central to this story is Laura Ziskin, the Hollywood producer behind Pretty Woman and the Spider-Man films, whose metastatic breast cancer diagnosis inspired the creation of Stand Up To Cancer. Working alongside Couric and leaders from entertainment, journalism, and biomedical research, Ziskin championed a new funding model that required multidisciplinary scientific collaboration, helping accelerate discoveries that contributed to multiple FDA-approved cancer therapies. The episode also highlights the advocacy of actor Patrick Dempsey, whose family’s experience with ovarian cancer led to the creation of the Dempsey Center, expanding support for patients and caregivers beyond medical treatment.

The story also asks what celebrity advocacy often leaves unsaid. Financial toxicity, caregiver burden, chronic pain, mental health, and the long-term effects of treatment rarely receive the same attention as dramatic diagnoses or breakthrough cures. As cancer survivorship continues to evolve, the greatest challenge may not be convincing people to care about cancer, but helping them understand what it truly means to live with and beyond it.

RELATED LINKS

• Stand Up To Cancer⁠
• Katie Couric Media⁠
• Dempsey Center⁠
• American Association for Cancer Research⁠
• National Cancer Institute⁠
• Dana-Farber Cancer Institute | Adult Survivorship Program⁠

FEEDBACK

Like this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to [email protected].

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In 2006, a landmark report titled Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults with Cancer confirmed what young survivors had been saying for years. While survival rates for children and older adults had steadily improved, adolescents and young adults had experienced decades of stalled progress. They had become cancer’s lost generation.

This episode explores how young adult survivors transformed their shared isolation into one of the most influential grassroots movements in cancer advocacy. Diagnosed during the years typically devoted to education, careers, relationships, and starting families, patients between the ages of 15 and 39 confronted challenges that extended far beyond treatment. Fertility preservation, sexual health, employment, financial toxicity, insurance, and long-term quality of life were rarely discussed in oncology clinics, leaving many to navigate survivorship alone.

The episode follows advocates including Tamika Felder, Lindsay Avner, Heidi Adams, Doug Ulman, and Dr. Archie Bleyer, whose research and advocacy fundamentally changed how medicine understands adolescent and young adult cancer. Through organizations including Planet Cancer, Fertile Hope, the Lance Armstrong Foundation, and later Stupid Cancer, survivors built online communities, educational resources, conferences, and national partnerships that challenged long-standing assumptions about cancer care. Their work helped establish fertility preservation as a standard discussion before treatment, expanded research dedicated to adolescent and young adult oncology, and elevated quality of life as a critical clinical outcome alongside survival.

The movement also demonstrated the power of lived experience to reshape medicine. Survivors became researchers, educators, nonprofit founders, and policy advocates, insisting that cancer care account not only for years of life saved, but for the lives patients hoped to build afterward.

What began as a search for peers evolved into a national movement that permanently transformed adolescent and young adult oncology. Today, dedicated research programs, clinical fellowships, survivorship resources, and patient advocacy organizations continue to build on the foundation these young cancer mavericks created.

RELATED LINKS

• National Cancer Institute | Adolescent and Young Adult (AYA) Cancer Program⁠
• Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults with Cancer⁠
• American Society of Clinical Oncology | Fertility Preservation Guidelines⁠
• Stupid Cancer⁠
• Livestrong Foundation⁠
• Journal of Adolescent and Young Adult Oncology⁠

FEEDBACK

Like this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to [email protected].

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In 2006, the Institute of Medicine published From Cancer Patient to Cancer Survivor: Lost in Transition, concluding that millions of Americans were surviving cancer only to find themselves navigating a healthcare system unprepared for life after treatment. The report challenged oncology to recognize that curing cancer was not the end of care, but the beginning of survivorship.

This episode explores how the growing cancer survivorship movement exposed the long-term consequences of cancer treatment that medicine had largely overlooked. As survival rates improved following the National Cancer Act of 1971, millions of survivors faced chronic fatigue, neuropathy, infertility, cognitive impairment, financial hardship, employment discrimination, anxiety, depression, and post-traumatic stress. These were not rare complications. They became defining features of survivorship for many patients.

Drawing on the work of oncologist Dr. Patricia Ganz, survivor advocate Ellen Stovall, and researchers, clinicians, and survivors across the country, the episode examines how survivorship research expanded beyond recurrence and mortality to include quality of life, psychosocial care, rehabilitation, and long-term follow-up. Their efforts helped establish survivorship care plans, multidisciplinary survivorship clinics, and a broader understanding that cancer affects every aspect of a person’s life long after treatment ends.

The episode also confronts persistent inequities in survivorship care. Insurance coverage often ends when treatment stops, supportive services remain inconsistent, financial toxicity continues to drive medical hardship, and racial, geographic, and socioeconomic disparities still influence who receives comprehensive follow-up care. For many survivors, finishing treatment simply marks the beginning of another struggle.

Modern oncology increasingly recognizes that surviving cancer is measured by more than years of life. It is also measured by quality of life, dignity, access to care, and the ability to rebuild a future after treatment. That evolution remains one of the most significant legacies of the cancer survivorship movement.

RELATED LINKS

• National Academy of Medicine | ⁠From Cancer Patient to Cancer Survivor: Lost in Transition⁠
• National Cancer Institute Office of Cancer Survivorship⁠
• American Society of Clinical Oncology | Survivorship Compendium⁠
• CancerCare⁠
• HopeWell Cancer Support⁠
• National Coalition for Cancer Survivorship⁠

FEEDBACK

Like this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to [email protected].

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