The Modern Medicine Podcast

Dennis interviews Nikunj Vyas about Xocova/ensitrelvir, an oral antiviral approved in May for COVID-19 post-exposure prophylaxis (ages 12+) within 72 hours of exposure; SCORPIO PEP showed a 67% reduction in developing COVID by day 10, with lower viral RNA and numerically lower symptom scores among breakthrough cases, generally mild side effects (headache, diarrhea, cough) and some CYP3A interaction cautions without ritonavir boosting. Dennis then gives “medium dives” on Ozempic and NAION blindness reports (mixed evidence, rare risk, and stopping diabetes therapy can be worse) and the Galleri multi-cancer blood test (high NPV, ~50% sensitivity skewed to later-stage cancers, PPV ~66–77% with false positives). In “In the News,” a possible pneumonic plague case in Russia, a meta-analysis linking cannabis use to higher violence risk, early cardiovascular disease markers in some adults under 30, a study associating glucosamine with faster Alzheimer’s progression, and early flu activity prompting vaccination. The non-medicine segment features producer David’s brother Adam Yas, who will sing the national anthem at a Patriots game, discussing favorite anthem renditions. They close with Boston sports talk focused on Drake Maye and the Red Sox.

Topics

02:19 Meet Nikunj Vyas

02:50 Patriots Fandom Origins

03:54 What Is Xocova

04:56 How It Prevents COVID

06:43 Study Results And Symptoms

09:17 Who Should Use It

13:06 Long COVID Questions

14:00 Side Effects Interactions

16:45 Bledsoe Memories Wrap

20:13 Guest Takeaways Access

22:38 Post Interview Recap

23:49 Medium Dives Intro

24:31 Ozempic Blindness Breakdown

32:56 Galleri Blood Test Tease

33:40 Galleri Test Explained

35:12 NPV Hype vs Reality

36:25 Sensitivity and False Security

37:40 Positive Predictive Value

40:23 Cost and Follow-Up Risks

42:17 In the News Plague Scare

45:56 Cannabis and Violence Data

49:20 Young Adults Heart Disease

51:40 Supplements and Alzheimer Risk

54:10 Flu Shot Timing and Tamiflu

56:05 National Anthem Guest Segment

58:36 Whitney Lip Sync Debate

59:58 Anthem Soundcheck Prep

01:01:13 Flyover Timing And In Ears

01:03:50 Stage Nerves And Crowd Size

01:05:32 Iconic Anthem Performances

01:06:53 Jerseys Tribute And Plugs

01:09:48 Boston Sports Minute Intro

01:10:23 Drake Maye Bounce Back

01:14:39 Red Sox Roster Fixes

01:17:54 Wrap Up And Sign Off

Dennis opens the September Modern Medicine Podcast with guest Ellen Lubensky, founder of the Mental Health Choice Project, a nonprofit seeking 501(c)(3) status that advocates for informed consent and patient choice around psychiatric medications, better clinician/therapist awareness of medication withdrawal (including benzodiazepines), and improved 988 crisis-line training to avoid “catastrophizing” callers who can be kept safe. Lubensky urges therapy as a first resort when possible, second/third opinions, and bringing a trusted person to rushed appointments; she shares her own benzodiazepine-withdrawal experience and says many patients lie to taper safely. In “In the News,” Dennis and producer Dave discuss markets allowing bets on drug-trial outcomes and fraud risk, a crackdown on compounded GLP-1s amid insurance coverage loss, promising Merck/Moderna personalized mRNA melanoma vaccines, a study suggesting at least 25% of sampled NFL players had CTE, research warning NAD+/B3 anti-aging derivatives may aid cancer cells, a Massachusetts ballot question on legal cannabis, and the Lindsay Clancy trial and challenges of an insanity defense.

Topics

02:02 Meet Ellen Lubensky

03:12 Mental Health Choice Mission

04:58 988 Crisis Line Reform

06:30 Informed Consent Explained

08:10 Benzos Risks and Withdrawal

09:59 Therapy Before Medication

12:47 Chemical Imbalance Myth

17:15 Overprescribing and Market Expansion

21:21 AI Second Opinions Debate

29:17 In the News Segment Begins

29:38 Betting on Clinical Trials

32:51 Compounded GLP-1 Crackdown

36:50 mRNA Cancer Vaccine Breakthrough

40:22 NFL CTE Study and Safety

46:17 Anti-Aging Supplements Warning

47:47 Supplement Safety Reality Check

48:40 Massachusetts Weed Ballot Debate

50:29 Health Risks and Messaging

52:52 Medical Marijuana Skepticism

53:53 Lindsay Clancy Trial Discussion

56:10 Insanity Defense and Empathy

59:14 Doc Off the Clock Banter

01:00:31 Family Group Chat Drama

01:04:05 Tim Curry Favorites

01:07:54 Remembering Dolly Parton

01:09:47 Boston Sports Minute Begins

01:10:07 Patriots Season Predictions

01:13:36 Red Sox Playoff Outlook

01:16:40 Final Thanks and Sign Off

Dennis interviews urologist Dr. Michael Curran, founder of Greater Boston Urology, about prostate cancer screening. Curran explains prostate cancer is common and often symptomless, making PSA trends and rectal exams important, and critiques the 2012 USPSTF “D” rating for PSA screening. He outlines higher-risk groups (first-degree family history and African American men) who should start screening at 40, and suggests most men begin around 50, with follow-up intervals based on results. The discussion covers limitations of PSA, biopsy risks, newer tools such as supplemental blood/urine markers, prostate MRI, high-definition ultrasound, and transperineal biopsy, plus treatment options including active surveillance, focal therapies, robotic surgery, and newer radiation approaches. They also discuss no-scalpel vasectomy and safe monitoring for testosterone therapy. Later segments cover competitive eating risks, mixed evidence for creatine in depression, Utah’s AI prescription refills, rectal bleeding as a colorectal cancer red flag, rising alpha-gal syndrome, summer “would you rather,” and Boston sports updates on the Celtics, Red Sox, and Patriots.

Topics

01:56 Meet Dr Curran

04:04 Why Prostate Cancer Matters

07:39 PSA Screening Controversy

14:59 Who Should Screen When

19:00 Reading PSA Trends

23:04 Modern Biopsy Options

26:52 Treatment Paths Today

29:58 Vasectomy Quick Guide

31:39 Safe Testosterone Therapy

34:48 First PSA Expectations

36:46 Post Interview Wrap

38:03 PSA Screening Debate

39:12 Competitive Eating Risks

41:24 Hot Pepper Pain Tolerance

42:52 Creatine and Depression

47:17 AI Prescription Refills

51:39 Rectal Bleeding Warning

54:33 Tick Bites and Meat Allergy

57:46 Disney Ride Scare

01:02:26 Summer Would You Rather

01:03:07 Drone Shows vs Fireworks

01:04:01 Firework Mishap Story

01:05:29 Dog Bite or Human

01:06:09 Central AC or Pool

01:07:03 Dog Poo vs Gum

01:08:47 Poison Ivy vs Sunburn

01:10:08 Celtics Jaylen Brown Trade

01:15:40 Red Sox Second Half Outlook

01:19:26 Patriots QB Rankings Talk

01:22:09 Family Anthem News

01:23:28 Wrap Up and Farewell

Dr. Wayne Altman joins Dennis to discuss the Massachusetts primary care crisis—poor access, retiring clinicians, burnout, rising costs, and spillover into ED and specialty care—and Altman’s JAMA-proposed solution: a “primary care common fund” treating primary care like a utility to deliver universal, no-cost primary care, bypass ERISA limits for self-funded plans, reduce administrative waste, and reallocate existing healthcare dollars with projected budget-neutral savings in 2–4 years; he urges listeners to contact state legislators. The episode also covers an FDA-approved post-exposure COVID preventive pill (XCOORA), concerns about “functional unblinding” in psychedelic trials, rising diagnosed mental health disorders, RFK Jr.’s push for more nutrition education in medical training, updated resistance training guidance, and evidence that stopping GLP-1 drugs may erase cardiovascular benefits, plus Boston sports talk and brief discussion of Star Wars and the World Cup in Foxborough.

Topics

01:44 Meet Dr Altman

03:02 Primary Care Crisis

06:44 ED Overflow Stories

10:34 Primary Care Value

12:07 Utility Model Proposal

17:35 Funding Without Taxes

20:49 Not Single Payer

25:38 Clinician Support

27:21 Advice For Med Student

29:33 Boston Sports Minute

30:38 Knicks Spurs Breakdown

34:19 Red Sox Frustrations

38:19 Patriots AJ Brown

39:59 Legislation Call To Action

40:55 In The News Tease

41:11 New COVID Prevention Pill

43:18 Psychedelic Trials Unblinded

47:21 Mental Health Surge Explained

50:04 Nutrition in Medical School

54:39 Strength Training Myths

57:35 GLP-1 Benefits Fade Off Drug

59:37 Star Wars Mando Debate

01:03:32 World Cup Comes to Boston

01:06:51 Wrap Up and Farewell

The guest is licensed mental health counselor Celeste Viciere, founder/medical director of the Shifting the Way You Think Wellness Center in Stoughton, Massachusetts, discussing holistic mental wellness that integrates therapy with body-based modalities (yin yoga, sound healing, workshops) to address nervo

us system dysregulation, stress-related physical symptoms, mindfulness, and self-compassion; the center is also developing an insurance-covered partial hospitalization program with prescribing support and plans virtual classes via Mindbody and ClassPass, with details at stwyt.com. In news, they cover a cruise-linked hantavirus outbreak with quarantines and three deaths, emphasizing low pandemic risk; RFK Jr.’s plan to curb antidepressant prescribing and mixed evidence versus patient-reported benefit; FDA approval of a new motion sickness drug; criminal charges after an IV infusion spa potassium dosing death; debate over a doctor delaying an incurable cancer diagnosis so a patient could enjoy a cruise; a Florida surgeon indicted after removing the wrong organ; and widespread clinician use of AI tools like OpenEvidence. They briefly discuss underwhelming UFO file releases and Boston sports struggles for the Celtics, Bruins, and Red Sox.

More on Celeste: https://stwyt.com/

Topics

00:56 Meet Celeste Viciere

02:10 Holistic Mind Body Care

03:02 Somatic Classes Explained

05:14 Stress Hits the Body

10:09 When Patients Push Back

12:22 Trauma Mindfulness Basics

15:45 Small Steps and Services

18:16 Mental Health Myths

21:35 How to Get Started

23:01 After the Interview Debrief

24:34 In the News Hantavirus

27:48 RFK and Antidepressants

32:12 New Motion Sickness Drug

33:17 Motion Sickness Stories

34:22 Infusion Spa Tragedy

36:27 Medical Director Liability

39:27 Cancer News Delayed

42:50 Wrong Organ Surgery

46:31 Doctors Using AI

50:37 UFO Files Reaction

54:23 Boston Sports Minute

Dennis welcomes Dr. Jeffrey Long, radiation oncologist, founder of the Near Death Experience Research Foundation, and author of “Evidence of the Afterlife,” to discuss near-death experiences (NDEs). Long describes how he began researching NDEs after reading a JAMA article during residency and says he has reviewed over 4,000 accounts, concluding NDEs are real and not explainable by physical brain function. He outlines common NDE elements (out-of-body perception, tunnel, light, “heavenly” realm, life review, encounters with deceased loved ones/pets, choice to return) and reports major aftereffects such as decreased fear of death, increased belief in an afterlife, compassion, and life changes. They discuss evidence against hypoxia, medication effects, and hallucination explanations, including NDEs under anesthesia and in blind individuals, plus cross-cultural and young-child similarity. The episode also covers news on GLP-1 drugs and substance use, a Lyme vaccine, AI safety concerns, easing licensure for foreign-trained doctors, nursing home antipsychotic use, plus cover-song favorites and brief Boston sports talk.

Topics

00:53 Meet Dr Jeffrey Long

02:07 How NDE Research Began

04:16 Science Versus Materialism

08:24 Core NDE Elements

11:05 Aftereffects and Life Changes

14:56 Hyperlucid Memories

16:16 Why Not Hallucinations

16:51 Anesthesia Blindness and Culture

22:43 Time and Nonlinear Reality

24:59 Takeaway We Are More

27:33 Hosts Reflect After Interview

30:11 In the News Segment Begins

30:38 GLP1s and Addiction

32:25 Lyme Vaccine Update

35:15 AI Medical Safety Concerns

37:04 AI Misses Heart Pause

38:04 Chatbots and Mental Health Risks

38:56 Licensing Foreign Doctors

41:16 Antipsychotics in Nursing Homes

44:14 Greatest Cover Songs Debate

50:46 Boston Sports Minute Drama

55:25 Red Sox Early Season Check

57:55 Celtics and Bruins Outlook

59:27 Final Thanks and Sign Off

Dennis welcomes Dr. Jeffrey Long, radiation oncologist, founder of the Near Death Experience Research Foundation, and author of “Evidence of the Afterlife,” to discuss near-death experiences (NDEs). Long describes how he began researching NDEs after reading a JAMA article during residency and says he has reviewed over 4,000 accounts, concluding NDEs are real and not explainable by physical brain function. He outlines common NDE elements (out-of-body perception, tunnel, light, “heavenly” realm, life review, encounters with deceased loved ones/pets, choice to return) and reports major aftereffects such as decreased fear of death, increased belief in an afterlife, compassion, and life changes. They discuss evidence against hypoxia, medication effects, and hallucination explanations, including NDEs under anesthesia and in blind individuals, plus cross-cultural and young-child similarity. The episode also covers news on GLP-1 drugs and substance use, a Lyme vaccine, AI safety concerns, easing licensure for foreign-trained doctors, nursing home antipsychotic use, plus cover-song favorites and brief Boston sports talk.

Topics

00:53 Meet Dr Jeffrey Long

02:07 How NDE Research Began

04:16 Science Versus Materialism

08:24 Core NDE Elements

11:05 Aftereffects and Life Changes

14:56 Hyperlucid Memories

16:16 Why Not Hallucinations

16:51 Anesthesia Blindness and Culture

22:43 Time and Nonlinear Reality

24:59 Takeaway We Are More

27:33 Hosts Reflect After Interview

30:11 In the News Segment Begins

30:38 GLP1s and Addiction

32:25 Lyme Vaccine Update

35:15 AI Medical Safety Concerns

37:04 AI Misses Heart Pause

38:04 Chatbots and Mental Health Risks

38:56 Licensing Foreign Doctors

41:16 Antipsychotics in Nursing Homes

44:14 Greatest Cover Songs Debate

50:46 Boston Sports Minute Drama

55:25 Red Sox Early Season Check

57:55 Celtics and Bruins Outlook

59:27 Final Thanks and Sign Off

Dennis dedicates the episode to his late father Dennis J. Teehan Sr., who died of cancer, featuring his oncologist Dr. Erin DeRose from Beth Israel Needham Cancer Center. DeRose shares her path into oncology, her experience in community practice, and the “best of both worlds” model: intimate, accessible suburban care with strong links to Boston specialists, tumor boards, clinical trials, and second opinions. They discuss rising lung cancer in never-smokers, screening debates and risks of incidental findings, risk factors like secondhand smoke, occupational exposures, family history, and radon, and advances from targeted therapies (including EGFR) and immunotherapy, plus emerging approaches like CAR-T, bispecifics, and antibody-drug conjugates alongside concerns about cost and access. They critique direct-to-consumer cancer blood tests, discuss prognosis conversations, then cover news on rising US life expectancy, GLP-1 benefits versus insurer losses, AI in diagnosis, and ultra-processed carbs, ending with March Madness, St. Patrick’s Day, and Boston sports.

Topics

01:00 Episode Dedication

02:06 Dr. Erin DeRose Background

05:59 Needham Cancer Center

07:04 Best of Both Worlds

12:52 Lung Cancer Screening

17:21 Non Smoking Risk Factors

19:40 Targeted Therapy Breakthroughs

23:34 Future of Cancer Care

26:23 Access and Cost Questions

28:03 Blood Tests for Screening

30:59 Talking Prognosis Compassionately

34:43 Closing Thanks and Advocacy

35:14 Post Interview Reflections

35:44 Cancer Care Shoutout

36:42 Life Expectancy Rebound

40:18 GLP One Benefits Debate

41:09 Insurance Coverage Crunch

42:09 Ozempic Safety Reality

43:50 AI In The Clinic

46:25 Good Carbs Vs Bad

49:34 March Madness Talk

52:00 St Patricks Day Bits

53:33 Boston Sports Minute

57:44 Wrap Up And Thanks

Dennis welcomes fitness director Guy Caracciolo from Dedham Health and Athletic Complex to discuss New Year's fitness resolutions. They delve into the importance of gradually starting an exercise regimen, especially for those new to fitness, and highlight the 60-60 program designed to help individuals integrate exercise into their lives safely. The episode also examines recent health news, including the correlation between CRP levels and heart disease, the ineffectiveness of cannabis-based medicines for pain relief, and the financial hardship associated with surgical procedures. Additionally, the show covers the impact of daylight savings on health and the importance of kidney disease awareness. To close, Dennis and producer Dave engage in a spirited discussion about the upcoming AFC Championship game, snowstorm etiquette, and the role of ownership in the success of Boston sports franchises.

Topics

00:40 Introducing Fitness Expert Guy Caracciolo

02:25 Gym Anecdotes and Safety Tips

04:14 Guy Karachi's Fitness Journey

06:15 Overview of Dedham Health and Athletic Complex

09:09 The 60/60 Medical Wellness Program

11:06 Exercise Benefits and Barriers

27:04 Doctors and Exercise Prescriptions

31:48 In the News Segment

32:04 CRP Levels and Heart Disease

33:37 Daylight Savings Time and Health

35:58 Cannabis and Chronic Pain

38:52 Financial Hardship After Surgery

40:12 Chronic Kidney Disease Awareness

42:29 Patriots and Altitude Sickness

46:20 Snowstorm Etiquette

51:21 Boston Sports Minute

01:00:45 Conclusion and Sign-Off

The episode features a compelling discussion with Dr. Michael Hamrock, an expert in addiction medicine from Boston Medical Center, Brighton. Dr. Hamrock shares his insights on addiction, its impact on families, and effective treatment strategies. The conversation covers public health perspectives, the opioid crisis, the role of physicians in pain management, and mental health dual diagnoses. The episode also touches upon the challenge of helping loved ones with substance abuse issues and offers practical advice for families. Additionally, the hosts delve into current health news, such as the impact of commercialization of cannabis on teen mental health and new cancer detection tests. The episode concludes with a spirited debate on the worst Christmas songs, a reflection on the Patriots' recent game, and well-wishes for the holiday season.

Topics

12:02 The Impact of Addiction on Families

18:10 Challenges in Treating Substance Abuse

21:57 Cannabis and Mental Health

29:06 In the News: Cannabis and Psychosis

33:37 In the News: Early Cancer Detection

35:25 In the News: Pre-Diabetes and Cardiovascular Risk

38:53 In the News: Ozempic and Cardiovascular Benefits

40:12 The Impact of Losing Medication Coverage

40:37 The Cost and Challenges of Weight Loss Medications

42:28 Insurance Companies and the Healthcare Tug of War

43:10 Anxiety, Insomnia, and Immune Function

44:35 The Importance of Sleep and Exercise

47:34 Listener Mailbag: Measles Booster Shots

50:20 Non-Medical Topic: Worst Christmas Songs

54:39 Sports Talk: DK Metcalf Incident and Boston Sports

01:05:03 Wrapping Up: Holiday Wishes and Final Thoughts