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"About suffering they were never wrong, / the old Masters: how well they understood / Its human position..." wrote W.H. Auden. For all that suffering seems to be central to our practice, how do we in pediatric palliative care actually stack up against Brueghel et al when it comes to understanding it, though? Dan and Sarah dig deep with guests Erica Salter, PhD, and Lauren Draper, MD to explore what suffering really means for children, families, and the clinicians who care for them.

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Even before heading homeward from the Annual Assembly, Dan and Sarah decided that we needed to do an episode about one of our favorite presentations, palliative home transports. So in this interview, Ashley Autrey from Children's Hospital New Orleans and Lindsay Ragsdale from Kentucky Children's Hospital bring it on home to you, our audience, sharing their wisdom and expertise about how to get some of our most complex and fragile patients out of the hospital, and what it means to honor death location preference.

This episode also features some exciting new AI integrations because... why not, right, I mean everything else has AI in it now, so... Will Sarah and Dan be replaced by robots? Have the robots learned anything about palliative care? Tune in to find out!


Materials
The Children's Hospital New Orleans home transport checklist, courtesy of Dr. Autrey

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Perinatal Palliative Care! Thanks to a healthy dose of serendipity, PediPal finally wades into the ever-changing waters of palliative care before, during, and after birth. Sarah and Dan talk with Brian Carter, Kelstan Ellis, and Jenni Linebarger about their collaborative, creative work at the Children's Mercy Kansas City Fetal Health Center and beyond. So come for the birth planning, stay for the unrivaled power of narrative, everyone's favorite pediatric bioethical Zone, hot-button political issues, and 18th-century etymologies!

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PediPal goes on the road! Dan brings his microphone to Phoenix, AZ, for the 2024 Annual Assembly of Hospice and Palliative Medicine, ambushing unsuspecting guests with that classic PediPal question, "What are your take-home points?" Sarah, unable to attend the conference, shares her take-homes from home.

Major thanks to AAHPM and all our enthusiastic participants: Tyler Badding, Gabe Daniels, Kelstan Ellis, Rachel Kentor, Jen Hwang, Matt McEvoy, Jennifer Salant, Alexis Santos, Meghna Singh, and Claire Slusarz, as well as #1 Fan Jared Rubenstein and #1 Fan Conrad Williams.

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Where do the fields of Palliative Care, Neurology, and PM&R overlap? Where can we learn more about how to approach the dreaded uncertainty of neurologic prognostication? In this episode! Overcoming some technical difficulties, Dan (kinda) and Sarah discuss the field of Pediatric Neuropalliative Care with Marina Ma and Lauren Treat.

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The episode we really wanted to call "2 Julie 2 Hauer."

Julie Hauer is back on PediPal! This time, she's here to discuss with Sarah and Dan what we do when we're beyond the guidelines, short on evidence, and way past the point of randomized control. What influences do culture and anecdote have on our prescribing? How much of pediatric palliative care is science and how much is art... and how much does the difference matter?

Julie's forthcoming book:
Childhood Onset Severe Neurological Impairment: Where Medical Complexity and Uncertainty Meet (Oxford University Press) 
[We'll update with a link when one becomes available!]

CPN NeuroJourney:
https://neurojourney.courageousparentsnetwork.org

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It's 2024! As PediPal enters its fourth year, we want to take a moment to look back on what we've learned over the last three years. So for the first time (and hopefully the last), we have no guests, just the reflections, opinions, and bad jokes of the two pedi pals ourselves.

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How and where do we draw the boundaries between ourselves and our patients and families? What other boundaries do we draw--or not draw so well--in pediatric palliative care? Here to discuss these questions and more are Stacy Remke, MSW, and Rev. Bentley Stewart.

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Death. Dying. Simple words, but often hard to say, and even harder to say to a child. In this episode, Sarah and Dan turn to some experts on saying difficult things to children, Certified Child Life Specialists Kelley Gavel and Nicole MackDiaz. Find out why Child Life is particularly adept at helping kids grapple with the toughest questions, and then stick around for a special guest who tries his best to stump Kelley and Nicole...

Books mentioned by our guests:
All About the Intensive Care Unit -  Alexandria Friesen
Lifetimes - Bryan Mellonie 
Ida Always - Caron Levis
The Memory Box: A Book About Grief - Joanna Rowland
When Families Grieve - Sesame Street (English and Spanish)

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Turn on, tune in, and drop your preconceptions, because in this episode, Sarah and Dan are your guides on a trip into the realm of psychedelics in pediatric palliative care. We join Dingle Spence, Chris Adrian, and Elisha Waldman to learn about how they came to do this work, how psilocybin is helping some bereaved parents on their journeys of grief, and what the future might hold for psychedelic therapies in pediatrics.