The Clinical Problem Solvers

The Clinical Problem Solvers

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The Clinical Problem Solvers episodes

  • Episode 309 – Antiracism in Medicine Series – Episode 23 – Anti-Blackness, Anti-Fatness, and Food Shaming
    https://clinicalproblemsolving.com/wp-content/uploads/2023/11/CPSolvers-Episode-23_-Anti-Fat-Bias-FINAL-Post-Auphonics.mp3

    CPSolvers: Anti-Racism in Medicine Series

    Episode 23 – Anti-Blackness, Anti-Fatness, and Food Shaming

    Show Notes by Humza A. Siddiqui

    October 31, 2023

     

    Summary: This episode highlights the culture of food shaming and anti-fatness as it relates to anti-Blackness. During this episode, we hear from Da’Shaun L. Harrison, a community organizer and trans theorist, and Dr. Psyche A. Williams-Forson, an author and chair of the Department of American Studies at the University of Maryland. Together, our guests offer context around the history of anti-Blackness and how it is deeply intertwined with the culture around eating in America as well as the way anti-fatness manifests. Further, they expand on this to discuss how it relates to policing and the court systems in the U.S. This discussion is hosted by Sudarshan Krishnamurthy and Ashley Cooper. The show notes for this episode were written by Humza A. Siddiqui.

     

    Episode Learning Objectives

    After listening to this episode, learners will be able to

    1. Explain how anti-fatness and food shaming culture in the U.S. is rooted in anti-Blackness.
    2. Describe the intersection of policing and the court systems with anti-fatness and food shaming.
    3. Identify ways to navigate clinical interactions with patients while respecting them and affirming their experiences with food and fatness.

     

    Credits

    • Written and produced by: Sudarshan Krishnamurthy, Ashley Cooper, Team
    • Hosts: Sudarshan Krishnamurthy and Ashley Cooper
    • Infographic: Creative Edge Design
    • Audio Edits: Ashley Cooper and Noah Nakajima
    • Show Notes: Humza A. Siddiqui
    • Guests: Dr. Psyche A. Williams-Forson, Da’Shaun L. Harrison

     

    Time Stamps

    00:00 Opening

    00:45 Introductions

    03:07 Guest Introduction 1

    04:46 Guest Introduction 2

    08:15 On the Intersection of Black, Fat, and Trans Communities and the Medical-Industrial Complex

    13:35 History and the Racial Underpinnings of Food Shaming in the U.S. Landscape

    21:48 Policing, the Court Systems, Anti-Blackness, and Anti-fatness 

    46:45: Language Matters: The War On Obesity

    1:02:09 On Caring For Black, Fat, and Trans Patients

    1:15:37 Fatness is Not Killing People and Other Pearls

    1:21:25 Closing Remarks

     

    Speaker biographies (Abbreviated)

    • Dr. Psyche Williams-Forson is a Professor and Chair of the Department of American Studies at the University of Maryland College Park. She is the author of two award winning books:  Eating While Black: Food Shaming and Race in America (James Beard Foundation) and Building Houses Out of Chicken Legs: Black Women, Food, and Power (American Folklore Society); as well as the co-edited Taking Food Public: Redefining Foodways in a Changing Food World. Her work can also be found in several other publications and on podcasts and documentaries. Dr. Williams-Forson received her BA from the University of Virginia and her MA and PhD in American Studies from the University of Maryland.

    • Da’Shaun Harrison is a trans theorist and Southern-born and bred abolitionist in Atlanta, Georgia. They are the author of Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness, which won the 2022 Lambda Literary Award for Transgender Nonfiction and several other media/literary honors. As an editor, movement media and narrative strategist, and storyteller, Harrison uses their extensive history as a community organizer—which began in 2014 during their first year at Morehouse College—to frame their political thought and cultural criticism. Through the lens of what Harrison calls “Black Fat Studies,” they lecture on blackness, fatness, gender, and their intersections. Harrison currently serves as Editor-at-Large at Scalawag Magazine, is a co-host of the podcast “Unsolicited: Fatties Talk Back,” and one third of the video podcast “In The Middle.” Between the years 2019 and 2021, Harrison served as Associate Editor—and later as Managing Editor—of Wear Your Voice Magazine.

     

    Episode Takeaways

    • Origin Stories – For Dr. Psyche A. Williams-Forson and Da’Shaun L. Harrison, the work that they do is deeply informed by the history of chattel slavery in the United States, through which eugenicists, white anthropologists, and racial realists created entire disorders to medicalize and bastardize enslaved folks who were interested in freedom. Natal alienation is, in part, the under-structure of the wider Medical-Industrial Complex and the gratuitous violence that fat, Black, trans folks experience. All of this contributes uniquely to social death.

    • Soul Food – Food cultures are more complex, multilayered, and storied than Black stereotypes will lead even Black communities to believe. For this reason, labeling food in categories, and the moralizing that follows, can be extremely dangerous. A toxic cycle of disordered eating can emerge, and treatment for recovery can be rooted in anti-Blackness as physicians view the Black habitus as out of control, unruly, not in conformance with a wider racial project as described by Michael Omi and Howard Winant. The developing attitudes about food scarcity and deficit models, and mass media’s manufacturing consent, has to be challenged, especially because there is a deep and rich history of Black people as farmers, gardeners, and ranchers that belies what Chimamanda Ngozi Adichie calls the danger of a single story.

    • Afterlife of Slavery – We are living in what Saidiya Hartman calls the Afterlife of Slavery, in where skewed life chances, limited access to health and education, premature death, and surveillance, incarceration, and impoverishment are overdetermined by slavery’s racial calculus. Da’Shaun L. Harrison explains the role of fatness in all of this and offers examples across medicine, law, and sociology that demonstrate fatness and Blackness cannot be divorced from each other. Dr. Williams-Forson expands on this history with respect to Black women, whose bodies are fetishized, and Black children, whose bodies are adultified, respectively. All of this contributes to various mental health challenges that are consistent with surveillance in not only a wider police-state but also the patient-physician relationship.

    • The War on Obesity – We cannot make recommendations to our Black and Brown patients about diet and exercise without acknowledging that white supremacy is statistically more likely to kill Black and Brown patients than obesity. The conditions through which the United States’ socio-politico-economic apparatus is maintained, and the cultural mores that we encourage as a society, make it difficult for Black and Brown patients to eat a healthy diet or move their bodies freely.

    • Fatness is Not Killing Black People – Historically, what is killing Black people is a medical industry that is not primarily built to offer care and is otherwise disinterested in learning more about the experiences of Black bodies. Anti-obesity initiatives that aim to reduce weight and encourage healthy diet and exercise, while they may nudge choices on a population level and put pressure on corporations in their harmful advertising, may be reductive in their understanding of fatness as a function of obesity. Fat people can lead healthy lives, and we need to think about the structural issues that keep the populace from being healthy at all sizes. This demands teleological explanations and policy interventions. On one hand, we must not moralize food choices. On the other hand, we cannot let hyper-capitalism off the hook, especially those industries that target Black and Brown communities and seek to profit from the manufactured consent that lends itself to insecurities about weight loss or weight gain.



    Pearls

    • Respect cultural mores about diet and exercise. Acknowledge that Black and Brown patients understand their bodies at some level and what sustains them nutritionally. Be precise instead about the care we can offer beyond weight loss.

     

    • Fatness is not killing Black people. However, consider that Black patients are navigating disordered eating as a function of moralizing their food choices under white supremacy and a standard of care that was created by eugenicists, white anthropologists, and racial realists that inappropriately value the heterosexual, cis-gender, white European male habitus.

     

    References

     

    Cox, J. (2020). Fat girls in Black bodies: creating communities of our own. North Atlantic Books.

     

    Harrison, D. (2021). Belly of the Beast: the politics of anti-fatness as anti-blackness. North Atlantic Books.

     

    Taylor, S. R. (2018). The body is not an apology: the power of radical self-love (First Edition). Berrett-Koehler Publishers.

     

    Williams-Forson, P. A. (2022). Eating while Black: food shaming and race in America. The University of North Carolina Press.

     

    Possley, M., & Armstrong, K. (1999, January 11). Part 2: The flip side of a fair trial. Chicago Tribune. https://www.chicagotribune.com/investigations/chi-020103trial2-story.html

     

    Purkiss, A. (2017). “Beauty Secrets: Fight Fat”: Black Women’s Aesthetics, Exercise, and Fat Stigma, 1900–1930s. Journal of Women’s History, 29(2), 14–37. https://doi.org/10.1353/jowh.2017.0019

     

    Waxman, O.B. (2022). “The White Supremacist Origins of Exercise, and 6 Other Surprising Facts About the History of U.S. Physical Fitness.” Time Magazine. https://time.com/6242949/exercise-industry-white-supremacy/ 

     

    Harrison, D., Tovar, V. (2021, January 5). Fatphobia (& Foodphobia) is Anti-Blackness with Da’Shaun Harrison, Season 2, Episode 1. Rebel Eaters Club. https://podcasts.apple.com/us/podcast/fatphobia-foodphobia-is-anti-blackness-with-dashaun/id1495401238?i=1000504393373

     

    Harrison, D., Young, R. (2023, September 21). Destruction w/ Da’Shaun Harrison. Episode 6. Weight for it. https://podcasts.apple.com/us/podcast/destruction-w-dashaun-harrison/id1686599391?i=1000628697389

     

    Disclosures 

    The hosts and guests report no relevant financial disclosures.

     

    Citation

    Harrison DL, Williams-Forson P, Cooper A, Krishnamurthy S, Siddiqui H, Calac A, Pitre A, Pierce G, Essien UR, Fields NF, Lopez-Carmen V, Nolen L, Onuoha C, Watkins A, Williams J, Tsai J, Ogunwole M, Khazanchi R. “Anti-Blackness, Anti-Fatness, and Food Shaming” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. November 7, 2023.

     

    Show Transcript

     

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    1 hr 18 min
  • Episode 308 – RLR – 105 Fever
    https://clinicalproblemsolving.com/wp-content/uploads/2023/11/RLR-Mainpodcast.mp3

    Episode description

    Reza and Rabih discuss a case of a young woman with a fever of 105

     

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    54 min
  • Episode 307: Rafael Medina Subspecialty Series – Fever and Chills
    https://clinicalproblemsolving.com/wp-content/uploads/2023/10/Episode-307.mp3

    In this Infectious Disease Rafael Medina Subspecialty Episode, Dr. Navila Sharif presents a case to Dr. Natasha Spottiswoode of a patient presenting for fevers and chills.

     

    Session facilitator: Youssef Saklawi

    The goal of this series is to provide greater access to subspecialty, primary care, and internal medicine-adjacent specialty education for learners worldwide. For those interested in participating as a case presenter or discussant (or to nominate an educator or attending), the nomination form is available here. 

     

    Case Discussant: Natasha Spottiswoode, MD, PHD

    Natasha is a fellow in the Division of Infectious Diseases at the University of California, San Francisco. Her interests include the use of combined host-pathogen metagenomics to diagnose and treat critically ill patients, and the development of better treatments for patients with rare infectious syndromes. She also loves climbing, trail running and backcountry skiing.

     

     

    Case Presenter: Navila Sharif, MD

    Navila is a second year internal medicine resident at Emory University in Atlanta, GA. She is passionate about health equity and advocacy, and is interested in general hospital medicine and gastroenterology, with a keen interest in transplant hepatology. Outside of work, she enjoys exploring coffee shops, binging reality TV, and any hike with the promise of a view.

    To join us live on Virtual Morning Report (VMR), sign up HERE. 

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    45 min
  • Episode 306: Schema Episode – Severe Acute Liver Injury
    https://clinicalproblemsolving.com/wp-content/uploads/2023/10/SchemaEp10.19.23_RTP.mp3

    Sharmin, Jack, and Maddy discuss their approaches to severe acute liver injury, abdominal pain, and hyperferritinemia as they talk through a case presented by Ann-Marie. 

    Frameworks: 

    Severe Acute Liver Injury

    Abdominal Pain

    To join us live on Virtual Morning Report (VMR), sign up HERE. 

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    44 min
  • Episode 305: Neurology VMR – Shallow Breathing
    https://clinicalproblemsolving.com/wp-content/uploads/2023/10/EditedEPISODEOctober-12-Neuro-VMR-_09.26_-Audio.mp3

    Episode 305: Neurology VMR – Shallow breathing

    Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Vaness presents a case of shallow breathing to Maria and Sridhara.

    Neurology DDx Schema

     

    Vanessa Roque

     

    Vanessa, a proud Filipino through and through, has dedicated herself to medicine. She has been serving her countrymen since earning her medical degree. Practicing in areas of limited resources, she has sharpened her clinical eye allowing her to realize her passion for neurology where localizing lesions is as intellectually stimulating and satisfying as a daily crossword puzzle. Her interests include cognitive neurology, vascular neurology, and neurocritical care. A true “jill of all trades”, she is always down for a new adventure. She has explored dance and theater, film and photography, various musical instruments, different languages, and swimming. At home, you are most likely to find her in the kitchen preparing your new favorite meal

     

    Maria Jimena Aleman

    @MariaMjaleman

    María Jimena Alemán was born and raised in Guatemala where she currently works in community and rural health care. After suffering from long standing neurophobia, she has embraced her love for neurology and will pursue a career in this field. She looks forward to dedicating her life to breaking barriers for Latin women in medical fields and improving medical care in her country. Maria is one of the creators of a medical education podcast in Spanish called Intratecal. Her life probably has a soundtrack of a mix between Shakira and Ella Fitzgerald. Outside of medicine, she enjoys modern art, 21st century literature, and having hour-long conversations over a nice hot cup of coffee or tequila.

    Sridhara Yaddanapudi

    @syaddana_neuro

     

    Sridhara is a board-certified internist, neurologist, vascular neurologist, and hypertension specialist. Currently, he holds the position of Clinical Assistant Professor at Thomas Jefferson University Hospital and serves as the Director of Neurology for Jefferson New Jersey.

    As a medical professional, he is passionate about case-based learning, clinical reasoning, and teaching decision-making while avoiding the pitfalls of heuristics. His goal is to bridge the ever-growing gap between neurology and internal medicine, an area in which he has a keen interest.

     

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    54 min
  • Episode 304: Spaced Learning Series – The Journey of 3Hs: Hyperbilirubinemia, Hypoxia and Hemolysis
    https://clinicalproblemsolving.com/wp-content/uploads/2023/10/10.5.23-SLS-RTP_2.mp3

     

    Episode description: 

    The spaced learning series team discusses a case of a patient with hyperbilirubinemia secondary to acute alcoholic hepatitis, who then developed hypoxia and hemolysis.

    Featuring: Anna Fretz
    Priyanka Athavale
    Kirtan Patolia Schemas
    HyperbilirubinemiaHypoxemiaHemolysis 

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    36 min
  • Episode 303: WDx #25: “Do Small Things with a Big Heart” with María Jimena Alemán
    https://clinicalproblemsolving.com/wp-content/uploads/2023/09/9.21.23-WDx-RTP.mp3

    Sharmin & Kaylin are joined by María Jimena Alemán, CPSolvers co-director of internal operations & future neurologist with a passion for global health. They discuss how her upbringing has informed & shaped her passions & values, how she got involved with CPSolvers, the growth that comes from being a leader, the power of community & good mentor-mentee relationships. 

     

     

     María Jimena Alemán was born and raised in Guatemala where she currently works in community and rural health care. After suffering from long-standing neurophobia, she has embraced her love for neurology and will pursue a career in this field. She looks forward to dedicating her life to breaking barriers for Latin women in the medical field and improving neurology care around the world. She loves being a part of The Clinical Problem Solvers where she serves as the co-director of internal operations alongside Madellena Conte. Her life soundtrack is a mix between Shakira and Ms. Lauryn Hill. Outside of medicine, she enjoys contemporary art, crossword puzzles, and having hour-long conversations over a nice hot cup of coffee or tequila.

     

     

     

     Kaylin Nguyen is a non-invasive cardiologist with interests in medical education, women in medicine, and health disparities. She was born in Vietnam and grew up in Southern California. She completed medical school and Internal Medicine residency at UCSF. She then made her way down the peninsula to Palo Alto, where she completed cardiology fellowship at Stanford, serving as a chief fellow. She is super excited to be back in Los Angeles and to help care for the underserved community as a clinician-educator at Olive View-UCLA Medical Center. Outside of medicine, you can find her hiking with her dog, making (and eating) baked goods, and buying and neglecting plants*.

     

    *Her plants are alive & well. We promise.

     

    1 hr
  • Episode 302 – RLR – Anasarca
    https://clinicalproblemsolving.com/wp-content/uploads/2023/09/RLR-69_Anasarca-1.mp3

    Episode description

    Reza and Rabih discuss a curious case of Anasarca

     

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    57 min
  • Episode 301: Rafael Medina Subspecialty Series – Worsening diarrhea
    https://clinicalproblemsolving.com/wp-content/uploads/2023/09/GI-Subspecialty.mp3

    In this Gastroenterology Rafael Medina Subspecialty episode, Dr. Allyson Richardson presents a case to Dr. Ryan Flanagan of a 68 year old woman presenting with chronic diarrhea. 

    Session facilitator: Şeyma Yıldırım

    The goal of this session is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.

    Case discussant: Dr. Ryan Flanagan is a gastroenterologist and faculty member at the Brigham and Women’s Hospital and Instructor in Medicine at Harvard Medical School in Boston. He has a clinical focus on the inpatient GI consult service and is the Associate Program Director for the Gastroenterology Fellowship Program.

    Case presenter: Dr. Allyson Richardson is a second year Gastroenterology/Hepatology fellow at Brigham and Women’s Hospital. 

    Presented images from flexible sigmoidoscopy

         

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    45 min
  • Episode 300: Schema Episode – Cytopenias
    https://clinicalproblemsolving.com/wp-content/uploads/2023/08/RTP_SchemaEp_8.24.mp3

    Jack, AMK, and Maddy discuss their approaches to cytopenias and DVTs as they talk through a case presented by Sharmin.

    Frameworks:

    Pancytopenia

    Thrombocytopenia

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    48 min

About The Clinical Problem Solvers

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The Clinical Problem Solvers is a multi-modal venture that works to disseminate and democratize the stories and science of diagnostic reasoning

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