PediPal

Welcome to Pediatrics. The first rule is, "Children are not just Little Adults." The second rule is also, "Children are not just Little Adults." But how does this trope fit into Pediatric Palliative Care? And is it possible that, instead, Adults are actually just Big Children??

In this episode, Sarah and Dan explore this idea with three different guests. Nimmy Simon (@palliativebear), a fellow who recently completed her pediatrics rotation, shares her reflections on the lessons learned. Sarah Keating, who had largely adult training but now works in pediatrics, shares the lessons she brought over and the culture differences she's seen. And Anand Sandesara, who proudly identifies as a pediatrician, talks about how this training enhances his work in adult palliative care. 

Our world tour continues with this next stop in Wellington, New Zealand.  Dan and Sarah interview paediatric palliative care specialist Amanda Evans (@amaevans), who teaches them a bit of New Zealand history, some Maori concepts of health and illness, and a lesson on just how cool Jacinda Ardern really is.

As Sarah and Dan continue their international tour in 2022, they find themselves surprisingly close to home in Phoenix, Arizona... by way of England, and by way of an inspiring story of community, advocacy, and ingenuity.

In this Episode your PediPal crew hears the story of the Cottor family and the founding of Ryan House, as well as the hopes for the future of pediatric hospice houses in the USA. And they learn some of the logistical challenges on the other side of their common "If I won the lottery..." fantasy.

PediPal is going international! In this inaugural episode of our new series, Dan and Sarah interview Dr. Spandana Rayala (@SpandanaRayala), a pediatric palliative care physician in Hyderabad, India.

Webster's dictionary defines "liminality" as... Just kidding. But not really.
In this episode, Dan and Sarah put on novice anthropologist hats and start to explore the role that ritual plays in Pediatric Palliative Care: in bereavement, in the day to day flow of the team, and in things as mundane as stapling your morning list. Social worker Caitlin Scanlon (@caitlin_scanlon) and music therapist Kristen O'Grady (@KOGrady_MTBC) join us to talk about the ways they participate in ritual, witness ritual, and think about the concept of liminality.

"So, what kind of work do you do?" When you're in pediatric palliative care, what answer do you give? And how do you respond to the inevitable follow-ups? "That's so sad," "You must be so special," "I could never do that..." We've all been there. So in this final episode of 2021, Dan and Sarah interview three peds palliative physicians—Allison Silverstein (@agsils), Jared Rubenstein (@DrJRubenstein), and Chris Adrian—about their responses to the dreaded cocktail party questions, as well as their insights on what these questions and answers teach us about very the nature palliative care and its practitioners.


Referenced in this episode:
Allison Silverstein and Jared Rubenstein - "Oh, That Must Be So Sad" (pdf on Google Drive)
Jared Rubenstein - "Oh That's So Sad" (video on youtube.com)
Christopher Adrian - "The Question" (article in NEJM)

Music therapy, art therapy, child life, and pediatric palliative care resonate with each other in a lot of important ways. In this episode, Dan and Sarah chat with.... Dan and Sarah?! Yep, that's music therapist Dan Stafford and art therapist and child life specialist Sarah Yazdian Rubin. The Dans and Sarahs discuss creativity and loss, the roles expressive therapies can play in pediatric palliative care, and just how similar our respective fields can be. 

If there's something long-acting that targets multiple receptors and has a variable equianalgesic dose ratio in your neighborhood, who you gonna call?
Eduardo Bruera (@edubru) and Kevin Madden (@madden_kevin), of MD Anderson Cancer Center!
Get ready for chills and thrills as they take Sarah and Dan on a haunted tour of that spooky old opioid, methadone, and bust some of the myths about dosing, QT prolongation, and more.

Was starting this podcast academic suicide for Sarah and Dan? That remains to be seen, but interviewing Joanne Wolfe (@WolfePPC) and Chris Feudtner was definitely a good choice!  In this episode, hear two of the founding figures of pediatric palliative care in the USA discuss the rocky roads they traveled, individually and together, to establish themselves in a specialty that they were creating as they went. What's changed the most since the early days? What prognostications do they have for the future? Is Dan angling for a musical gig on GeriPal? Listen to Episode 7 to find out!

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Chris Feudtner, MD, PhD, MPH, is the Division Chief of General Pediatrics, Attending Physician and Research Director of the Pediatric Advanced Care Team and Complex Care, Stephen D. Handler Endowed Chair and Director of the Department of Medical Ethics, and Director of the Academic General Pediatrics Fellowship Program at Children's Hospital of Philadelphia, as well as Professor of Pediatrics, Medical Ethics, and Health Policy at Perelman School of Medicine at the University of Pennsylvania. Chris is also the author of the recently published Light and Shadow: A Novel of Pediatric Internship.

Joanne Wolfe, MD, MPH, is a Professor of Pediatrics at Harvard Medical School, Attending Physician in Population Sciences at Dana-Farber Cancer Institute, and Director of Pediatric Palliative Care and Medical Director of the Pediatric Advanced Care Team at Boston Children's Hospital. 

Do you like my hat? No? How about this one?
In this episode, Sarah and Dan talk with three physicians who each wear two hats: palliative care and another specialty.
Wynne Morrison (Children's Hospital of Philadelphia) dons and doffs a PICU chapeau, Natasha Henner (Lurie Children's Hospital) wears a NICU cap, and Elisabeth Dellon (UNC Children's Hospital) is ready to switch from palliative to pulmonology and back at the drop of a... well, you get it.
So what's it like to practice two specialties concurrently? And is this millinery metaphor really a feather in our cap or could we have topped it? Hang on to your hats as we throw Episode 6 into the ring!