This one is a biggie! Join us as we chat with Drs. Roger Harris and Oli Flower, the gurus behind the SMACC and CODA conferences. The topic is, naturally enough, the past and future of the medical conference.

Tim Caulfield (professor, best selling author, Netflix presenter and Order of Canada recipient) joins us for a spirited discussion of so much that matters to so many: COVID, vaccines, masks, science, tribalism and public debate. Informative provocative and (surprisingly?) upbeat.

Further Reading: 

On the harm of misinformation: https://cca-reports.ca/reports/the-socioeconomic-impacts-of-health-and-science-misinformation/

Debunking sudden death https://www.thestar.com/news/canada/2022/11/07/why-wont-a-debunked-conspiracy-theory-about-doctors-harmed-by-the-covid-vaccine-go-away.html

And a recent study that is relevant: https://www.nature.com/articles/s41467-022-35653-z

Dr Sandy Widder is a Trauma Surgeon, Intensivist and overall amazing human being. She works as an associate professor in the departments of critical care and surgery at the University of Alberta, and is the Assistant Zone Director on Integrated Quality Management for the Edmonton zone in Alberta, Canada. She is passionate about Quality Improvement/Patient Safety and somehow finds time for Health administration in her busy schedule. We were lucky to get her on our podcast! 

Join us as she talks about what the general intensivist needs to know about the trauma patient. 

Further reading:

Doctor Jarrod Mosier is a bit of a polymath, and we were delighted he could squeeze us into his busy life. His day jobs include Intensive Care Medicine and Emergency medicine in Tucson, where he is a professor (at the other UofA: Arizona).He is an expert in all aspects of airway management, ranging from the physiologically difficult airway, through the importance of first pass success, including how to optimize for intubation, the roles of ultrasound and extracorporeal support, and all the way to safe extubation. This was the focus of our wide-ranging entertaining conversation. When away from work Jarrod throws a mean football, dotes on his two kids, and loves getting up into the mountains to snap superb nature photographs.

Further reading:

1. Mosier JM, Sakles JC, Law JA, Brown CA 3rd, Brindley PG. Tracheal Intubation in the Critically Ill. Where We Came from and Where We Should Go. Am J Respir Crit Care Med. 2020;201(7):775-788. doi:10.1164/rccm.201908-1636CI

2. Mosier JM. Physiologically difficult airway in critically ill patients: winning the race between haemoglobin desaturation and tracheal intubation. Br J Anaesth. 2020;125(1):e1-e4. doi:10.1016/j.bja.2019.12.001

As health care providers, we are often called on to manage patients with chronic pain. In the acute setting, how do we manage them well? Join us on this podcast with Dr Saifee Rashiq, as we unravel chronic pain secrets well beyond opioids and other medications.

Dr. Saifee Rashiq is an Anesthesiologist and Pain Medicine Specialist at the University of Alberta in Edmonton and a Professor in its Faculty of Medicine and Dentistry. He studied medicine at University of Nottingham, anesthesia training at the University of Alberta, fellowship in Pain Medicine in Seattle, and a Master’s Degree in Clinical Epidemiology from the Harvard School of Public Health.

His clinical practice combines anesthesia and treating chronic pain patients in a Multidisciplinary Pain Clinic, where his clinical interest is in medically and psychosocially complex patients and non-organic pain syndromes.

He is a loving husband and father of 3 and cycles to work when the weather is fine.

Note that this was an earlier recording and the sound quality is not what we are hoping to achieve. 

Further Reading:

1. Beyond nociception: the imprecision hypothesis of chronic pain. G. Lorimer Moseleya, Johan W. S. Vlaeyen. Painjournalonline January 2015, Vol 156, Nr 1. http://dx.doi.org/10.1016/j.pain.0000000000000014

2. Injuries of the Nervous System: On Railway and Other Injuries of the Nervous System. London, Walton and Moberly 17-23.4349,1866.

3. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain. The SPACE Randomized Clinical Trial. Erin E. Krebs, MD, MPH; Amy Gravely, MA; Sean Nugent, BA; Agnes C. Jensen, MPH; Beth DeRonne, PharmD; Elizabeth S. Goldsmith, MD, MS; Kurt Kroenke, MD; Matthew J. Bair; Siamak Noorbaloochi, PhD. JAMA. 2018;319(9):872-882. doi:10.1001/jama.2018.0899

In brief, “it’s okay to not feel okay” and “to do well we ought to feel well”. The problem is that many of us don’t feel okay, hence this candid, caring and common-sense podcast. We timed it to coincide with what is- statistically at least- the most depressing day of the year, namely the third Monday of January. Otherwise known as “Blue Monday” it’s a day to take a moment, to reach out, to acknowledge that the job can be tough, and to be reminded that we need to care for the carers. There is nobody better than Dr. Shelly Dev to highlight the importance of burnout, wellness and medical culture. Thank you for your time and for the work you do. Take care of yourself.

Dr. Dev has been a Staff Intensivist at Sunnybrook Health Sciences Centre in Toronto since 2006, after completing her Internal Medicine residency and Critical Care Fellowship at The University of Toronto, followed by a Fellowship in Multimedia Education at the New England Journal of Medicine.  She is a Clinician Educator and Associate Professor of Medicine, Director of Education in the Department of Critical Care Medicine at Sunnybrook and lead for Mentorship and Wellness in the Interdepartmental Division of Critical Care Medicine at the University of Toronto. She is an award-winning medical educator of undergraduate, postgraduate and continuing medical education audiences.

In addition to nearly 300 lectures given to national and international audiences about healthcare worker mental health, burnout, resilience and medical culture, Dr. Dev has written and spoken extensively on these topics in the wider media.

But, if asked, she would say her most significant accomplishment to date is continuing to convince 14-year-old Nathan and 12-year-old Jack that it is beyond cool to be seen with your mother in public.

This podcast was a little different and, hence, so are the show notes. What follows is the books mentioned during the recording. The list is neither comprehensive nor to suggest we’re especially literate: we’re not.

Instead, we’re merely encouraging people to explore books about the wider world of medicine and to bolster your courage when you come to write your own! Feel free to share your favorites, especially those that we missed, via our Twitter or Instagram accounts.

Matt Morgan

Critical 2019 (history of ICU, personal reflection)

One Medicine, 2023 (popular science, comparative physiology)

James Maskalyk

Life on the Ground Floor, 2017 (emergency medicine in both developed and developing world, personal reflection)

Kevin Fong

Extreme Medicine, 2014 (popular science, physiology)

Rachel Clarke

Your Life in My Hands, 2017 (life as a junior doctor, personal reflection)

David Nott

War Doctor, 2019 (surgery in developing world and war zones), personal reflection)

Aoife Abbey

Seven Signs of Life, 2019 (ICU physician, personal reflections)

Henry Marsh

Do no harm, 2014 (neurosurgeon, personal reflections

Admissions, 2017

Adam Kay

This is Going to Hurt 2017 (obstetrics, personal reflections, diary)

Undoctored (2022)

Kathryn Mannix

With the End in Mind 2017 (end of life, palliative care, insights)

Michael Bliss

The Discovery of Insulin 1982 (medical history)

William Osler: a life in medicine, 1999

Harvey Cushing, 2005

Rose George

The Big Necessity, 2008 (the story of human waste)

Nine Pints, 2019 (blood and transfusion)

Mary Roach

Stiff: the curious life of human cadavers, 2021 (self explanatory)

Caitlan Doughty

Smoke gets in your eyes, 2015 (working in the funeral and cremation business)

Sam Keens

The tale of the dueling neurosurgeons, 2014 (popular science, neuroanatomy)

The Icepick Surgeon, 2021 (the awful things done in the name of medical science)

Roy Porter

Medicine, a history of healing, 1997 (medical history)

The greatest benefit to mankind, 1999

And one we didn’t mention but should have

Wendy Moore

The Knife Man, 2005 (biography of John Hunter and the history of surgery and Victorian medicine)

Join us as we discuss Neuroprognostication after Cardiac Arrest with Clinician-Scientist, Dr Gord Boyd. Dr Boyd has dual certification in Neurology and Critical Care Medicine and is a Clinician Scientist at Queens University, Kingston, Canada. He works at the Kingston General Hospital as an Intensivist and heads a research program aimed at understanding the relationship between cerebral perfusion, delirium, and long-term neurological outcomes for ICU survivors.

He received his undergraduate degree (Psychology) from Lakehead University in his hometown of Thunder Bay, Ontario. That was followed by his PhD in Neuroscience from the University of Alberta, where he studied the role of growth factors in peripheral nerve regeneration. In 2001 he moved to Kingston to do a post-doctoral fellowship in the Queen’s Department of Anatomy and Cell biology, examining the potential of glial cell transplantation to treat spinal cord injury. He stayed in Kingston to do his undergraduate degree in Medicine, which was followed by his residency in Neurology and fellowship in Adult Critical Care. He is an active musician and plays the drums in an all-physician band.

In this episode we discuss the importance of admitting uncertainty when it comes to neuroprognostication following cardiac arrest, allowing enough time to pass, some of the best and worst tests for clinical prognostication, usefulness of biomarkers, EEG, seizure treatment and the risk of persistent neurovegetative states.

Further Reading:

1. Nakstad ER, Stær-Jensen H, Wimmer H, et al. Late awakening, prognostic factors and long-term outcome in out-of-hospital cardiac arrest - results of the prospective Norwegian Cardio-Respiratory Arrest Study (NORCAST). Resuscitation. 2020;149:170-179. doi:10.1016/j.resuscitation.2019.12.031 https://pubmed.ncbi.nlm.nih.gov/31926258/

2. Nolan JP, Sandroni C, Böttiger BW, et al. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Intensive Care Med. 2021;47(4):369-421. doi:10.1007/s00134-021-06368-4 https://pubmed.ncbi.nlm.nih.gov/33765189/

3. Sandroni C, D'Arrigo S, Cacciola S, et al. Prediction of good neurological outcome in comatose survivors of cardiac arrest: a systematic review. Intensive Care Med. 2022;48(4):389-413. doi:10.1007/s00134-022-06618-z https://pubmed.ncbi.nlm.nih.gov/35244745/

4. Beuchat I, Novy J, Barbella G, Oddo M, Rossetti AO. EEG patterns associated with present cortical SSEP after cardiac arrest. Acta Neurol Scand. 2020;142(2):181-185. doi:10.1111/ane.13264 EEG patterns associated with present cortical SSEP after cardiac arrest - PubMed (nih.gov)