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Practicing

11 Episodes

41 minutes | Jul 28, 2022
Donald Vinh: Building an Answer
In this third pandemic summer, it’s difficult to say anything about Covid that hasn’t been said before. More than two years into this transformative event, we’ve pretty much heard it all. But that doesn’t mean we’ve reached a state of peaceful coexistence with the virus, or an acceptance of pandemic life.  In spite of all that’s unfolded since news of a novel respiratory virus emerged out of Wuhan, China in late 2019, the infection has continued to surprise us and catch us off guard. Even at this late stage, with many effective vaccines and therapies and a near global consensus from authorities that it’s time to roll back measures and learn to “live with the virus”, we continue to struggle with new variants, massive numbers of infections and, in spite of the many effective means of prevention and treatment at our disposal, illness and death.  While many of you have probably had Covid, or at the very least know someone who has, we are by no means done with this pandemic.  I’ve been hesitant to dedicate an episode to Covid and uncertain of the point of expending yet more energy on what is certainly the most talked about subject of the last two years. But faced with the virus’s persistent and ever-changing impact on our lives, and having so many unanswered and nagging questions about our response to it, I decided it needed to be done.  I chose Donald Vinh, an infectious disease clinician and researcher, as my guest for this conversation. Don is an experienced medical communicator, and a measured, rigorous voice on Covid. I came to know of him because of his vocal and unflinching but always factual assessments of our local response to Covid here in Quebec. He’s also actively engaged in research on Covid, and contributed to an international study on severe Covid that was published in the prestigious journal Science in 2020 and was named one of 2020’s 10 remarkable scientific discoveries by the equally prestigious journal Nature. So, he seemed like the ideal person to have on for a deep dive on Covid.  Donald Vinh is an Infectious Disease specialist and Medical Microbiologist at the McGill University Health Centre. He is Director of the Centre of Excellence for Genetic Research in Infection and Immunity, and Fonds de recherche du Québec Santé Senior Scholar with a translational research program on human immunodeficiencies and genetic susceptibility to infectious diseases at the Research Institute of the McGill University Health Centre.  His frequent media appearances have earned him a reputation as a trusted voice on infectious diseases, such as Covid-19, monkeypox, and the rare diseases he studies. He has been interviewed on many occasions by such outlets as CBC, BBC, and NPR.  Don and I talked about what his research has to teach us about Covid and how it shifts the paradigm for understanding infectious diseases, his evolution as a medical and scientific communicator, and the benefits and pitfalls of Covid Twitter.  ***Links: Don's selected publicationsNature's 10 Remarkable Discoveries 2020Inborn errors of type I IFN immunity in patients with life-threatening COVID-19, Science***Recorded July 19, 2022Music: Mr Smith  Art: Jeff Landman
49 minutes | Jun 1, 2022
Will Feldman: Thinking Ethically
While many physicians are called to the profession from a young age or commit to it early in life because of onerous pre-requisites and medical school admission requirements, others find their way to the bedside through more meandering routes. When the leap into medicine spans such a great distance, when the change of direction from a person’s past pursuits into the profession is so abrupt, I automatically become curious. What happened in this person’s life, or in their mind, to send them from one domain, one particular way of thinking about the world or going about their days, into the very different and idiosyncratic world of medical training and practice?   As a doctoral candidate writing a thesis on the ethics of war, Will Feldman felt a need to take his ethical reasoning and moral questions outside of the theoretical realm and into the real world. That’s what brought him to a neurology ward as an observer and, a decade later, to his work as a critical care physician, clinical ethicist, and health services researcher.   William B. Feldman completed his doctorate in Political Theory from Oxford University before entering medical school at the University of California San Francisco. He subsequently completed his internship and residency in Internal Medicine at Brigham and Women’s Hospital in Boston, along with a Master’s of Public Health at Harvard University and a Fellowship in Pulmonary and Critical Care at Brigham and Women’s.  He is now Associate Physician in theDivision of Pulmonary and Critical Care Medicine at Brigham and Women's Hospital and Faculty in the Program On Regulation, Therapeutics And Law (PORTAL) and Co-Chair of that hospital’s Ethics Committee and Associate Director of its Ethics Service.  Will’s credentials and background may seem quite distant from the daily reality of critical care medicine or pulmonology clinic, and yet our conversation revealed how he has woven together the many strands of his academic and professional development into a coherent and meaningful whole. Speaking to Will also illustrates something I’ve always felt to be true: that diverse approaches, backgrounds and intellectual traditions only serve to deepen medicine’s impact and relevance.  ***Links:Will's profile and twitterInformed consent paper Crisis standards of care paperOTC inhaler paper and tweet threadInhaler patents paper and tweet thread CBC article on effort to regulate Canadian drug prices***Recorded May 20, 2022Music: Mr Smith  Art: Jeff Landman
56 minutes | Apr 21, 2022
Peggy Kleinplatz: Glowing in the Dark
I never would have guessed that I’d think this about a book on sex, but Peggy Kleinplatz and Dana Ménard’s “Magnificent Sex” is a revelatory book. I was intrigued about Peggy, a clinical psychologist, sex therapist and researcher, when I saw her work mentioned in a fascinating New York Times article, “The Joys (and Challenges) of Sex After 70”. That article opened my eyes to the importance of intimacy and sexual relationships beyond the so-called prime years of adolescence and early adulthood, and also to how narrow and exclusionary our cultural views on sex can be. That narrow-mindedness struck me as representative of how our broader conceptions of health and wellness are culturally constructed as well, and defined around a very limited set of human states and experiences: youth, able-bodiedness, heterosexual coupledom, gender identity, neurotypicality, and others.  “Magnificent Sex” summarizes years of research around what Peggy and her team refer to as optimal sexual experiences, and in so doing it shows how solutions to common problems in human sexuality lie where we might least expect to find them – not in conventional notions of physical performance, bodily functioning, or attractiveness - but rather in experiences of marginalization and challenge that demand creativity, courage, and vulnerability and which culminate not only in fantastic sex, but in a form of religious, transcendent experience. If that all sounds wild, that’s because it is! But by the same token reading Peggy and her team’s work and hearing her speak makes it clear that her findings are very real. ***Links:Optimal Sexual Experiences Research Team at the University of Ottawa (includes Peggy's bio and publications)Peggy's book: "Magnificent Sex: Lessons from Extraordinary Lovers" (with A. Dana Ménard, PhD)"The Joys (and Challenges) of Sex After 70" (New York Times)***Recorded March 22, 2022Music: Mr Smith  Art: Jeff Landman
45 minutes | Mar 24, 2022
Nicolas Cadet: Confronting Racism
Although some have known it for decades, the Covid pandemic and the Black Lives Matter movement have brought the fact that systemic racism pervades our healthcare system into mainstream conversation. And just as racism influences healthcare outcomes and service delivery, it impacts the experiences and opportunities of healthcare workers.  Yet where I sit in Quebec, our Premier, François Legault, has never acknowledged the existence of systemic racism, even after Joyce Echaquan, a First Nations woman, died at the hands of openly racist hospital staff in September 2020, an event that marked the public and became something like Quebec’s own George Floyd moment. That’s what comes to mind for me when my next guest says that we can’t fix a problem without first recognizing that it exists.  While I feel I understand the reality of systemic racism, I have to reckon with the fact that I only know a handful of black physicians, and know very little of their journey in medicine, their experiences, or their ideas.  A few months ago I read an exciting announcement from McGill University’s Faculty of Medicine about a new Black Candidate Pathway for medical school admissions and a bursary sponsored by the Cadet Family Foundation, and spearheaded by Nicolas Cadet, a graduate of McGill’s medical school, an ophthalmologist, and the first black oculoplastic surgeon in Canada.  After that, Nicolas and I connected over social media. As we exchanged messages and spoke, I saw that he was a passionate, charismatic, ambitious physician and activist, who was deeply committed to improving healthcare both in Montreal’s black community and in his father’s native Haiti, and to tackling the ways systemic racism and marginalization keep young black people out of the healthcare professions.  My conversation with Nicolas allowed me to hear directly from him about the ways he’s experienced racism and discrimination in his training and practice, his ambitions for transforming healthcare, and the moral core that guides him as a physician and person. Nicolas Cadet is an ophthalmologist and oculoplastic surgeon, or eyelid surgeon, practicing in Montreal. He completed medical school at McGill University, his ophthalmology residency at Université of Montréal, and his fellowship in aesthetic and reconstructive oculofacial plastic surgery as well as orbital and lacrimal surgery at McMaster University in Hamilton, Ontario. He is also a philanthropist and social entrepreneur, and the founder of the Cadet Foundation, Oculoplastics Without Limits, and the Alliance of Black Healthcare Professionals of Quebec.  Hearing and learning from Nicolas was a privilege, and felt like the building of a small bridge between our two realities. Links:-Nicolas's website-McGill University interview with Nicolas-Trabian Shorters website and "On Being" interview -Physician–patient racial concordance and disparities in birthing mortality for newborns, PNAS 2020 Intro essay sources:-After Echaquan Report, Legault Repeats There Is No Systemic Racism in Quebec, Montreal Gazette Recorded February 10, 2022Music: Mr Smith  Art: Jeff Landman
37 minutes | Feb 24, 2022
Erica Kaye: Sharing Stories
Sam speaks to pediatric hematologist-oncologist and palliative care physician Erica Kaye about her writing on infertility and misogyny in medicine. Erica talks about her own experience with infertility, how she came to write about it, and her ideas on how storytelling and dialogue can transform medical culture.  Erica's New England Journal of Medicine essays;-One in Four -- The Importance of Comprehensive Fertility Benefits for the Medical Workforce-Misogyny in MedicineErica's bioAs mentioned by Erica: Women in Medicine: Evidence That More Evidence is Insufficient in Effecting Improvements, by Janet BickelAmerican Medical Women's AssociationRecorded December 15, 2021Music: Mr Smith  https://freemusicarchive.org/music/mr-smithArt: Jeff Landman
38 minutes | Jan 27, 2022
Wendy Dean: Showing Up
Sam speaks to psychiatrist Wendy Dean about her pioneering work on moral injury and the crisis in the healthcare workforce. *** Show notes:2018 Stat News article on moral injury: https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/Follow-up Stat News article: https://www.statnews.com/2019/07/26/moral-injury-burnout-medicine-lessons-learned/Moral Injury of Healthcare: fixmoralinjury.orgMoral Matters podcast: https://podcasts.apple.com/us/podcast/moral-matters/id1529907905Wendy's website: wendydeanmd.comSources for intro monologue:https://www.nursingtimes.net/news/workforce/rcn-survey-suggests-half-of-nursing-staff-thinking-about-quitting-04-01-2022/https://www.cbc.ca/news/health/covid-19-doctor-burnout-oma-1.6146465https://www.theguardian.com/us-news/2021/apr/08/us-health-workers-deaths-covid-lost-on-the-frontlinehttps://www.who.int/news/item/20-10-2021-health-and-care-worker-deaths-during-covid-19https://www.who.int/news/item/07-04-2020-who-and-partners-call-for-urgent-investment-in-nurses ***Recorded January 11, 2022Music: Mr Smith  https://freemusicarchive.org/music/mr-smithArt: Jeff Landman
34 minutes | Jan 6, 2022
KC Bolton: Serving Others
Sam speaks to his friend, KC Bolton, about his career of service, from his impulsive move to enlist in the US Coast Guard, where he became a decorated hero during Hurricane Katrina, to his time as a volunteer EMT in rural Vermont, and his medical training and new career as a community internist. ***Show notes:Distinguished Flying Cross Citation for KC Bolton: https://aoptero.org/medals/citation_bolton_kenyon_c_dfc.pdfRichmond Rescue: https://www.richmondrescue.org/Central Vermont Medical Center: https://www.cvmc.org/***Recorded June 29, 2021Music: Mr Smith  https://freemusicarchive.org/music/mr-smithArt: Jeff Landman
50 minutes | Dec 8, 2021
Stephen Liben: Reacting, Responding
Sam speaks to pediatric palliative care physician and medical educator Stephen Liben about his work with sick and dying children and their families,  how mindfulness changed his life and career, and more.   ***Show notes:www.stephenliben.com"MD Aware" course guide: https://link.springer.com/book/10.1007/978-3-030-22430-1McGill Programs in Whole Person Care: https://www.mcgill.ca/wholepersoncare/Article on course in Mindful Medical Practice at McGill: https://www.mcgill.ca/wholepersoncare/files/wholepersoncare/hutchinson-liben2020_article_mindfulmedicalpracticeaninnova.pdf***Recorded September 9, 2021Music: Mr Smith  https://freemusicarchive.org/music/mr-smithArt: Jeff Landman
38 minutes | Nov 10, 2021
Bindu Suresh: Being Both
Sam talks to pediatrician and writer Bindu Suresh about her medical and literary careers.  They explore themes of work, creativity, and selfhood. Bindu's novel is "26 Knots" (Invisible Publishing, 2019). ***Show notes:Bindu's website: https://www.bindusuresh.com/"No Visitors" by Bindu Suresh: https://www.cbc.ca/books/transmission/a-woman-must-make-a-life-changing-decision-for-her-covid-19-infected-ex-husband-in-this-story-by-bindu-suresh-1.5581050Montreal Gazette profile: https://montrealgazette.com/entertainment/local-arts/montrealer-bindu-suresh-took-a-knotted-path-to-her-striking-literary-debutCBC Books profile: https://www.cbc.ca/books/why-bindu-suresh-wanted-to-explore-the-meaning-of-love-romance-and-heartbreak-in-her-debut-novel-1.5201188CBC Books Writers to Watch 2019: https://www.cbc.ca/books/19-canadian-writers-to-watch-in-2019-1.5193090La Presse profile: https://www.lapresse.ca/arts/litterature/2021-03-28/26-noeuds/les-amours-compliquees.php***Recorded June 14, 2021Music: Mr Smith  https://freemusicarchive.org/music/mr-smithArt: Jeff Landman
49 minutes | Oct 14, 2021
Samir Shaheen-Hussain: Decolonizing Medicine
Sam talks to Pediatric Emergency physician Samir Shaheen-Hussain about medical colonialism, physician-enabled violence against Indigenous children, and his journey as an activist. Samir is the author of “Fighting for a Hand to Hold: Confronting Medical Colonialism Against Indigenous Children in Canada” (McGill-Queen’s University Press, 2020). ***Show Notes:CLARIFICATION: Samir mentions working in Oji-Cree communities during his experience in Sioux Lookout as a medical trainee. The Sioux Lookout First Nations Health Authority serves 33 First Nations, some of which are Oji-Cree. Pikangikum, which Samir mentions, is an Ojibwe First Nation. https://www.slfnha.com/about-2/communities/Book website: www.fightingforahandtohold.caLancet review: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01369-6/fulltext?rss=yesNew Scientist interview: https://www.lemonde.fr/international/article/2021/07/09/samir-shaheen-hussain-au-canada-le-colonialisme-a-tue-les-enfants-autochtones_6087723_3210.htmlLe Monde interview: https://www.lemonde.fr/international/article/2021/07/09/samir-shaheen-hussain-au-canada-le-colonialisme-a-tue-les-enfants-autochtones_6087723_3210.htmlNY Times article on unmarked residential school graves: https://www.nytimes.com/2021/06/26/world/canada/indigenous-residential-schools-grave.htmlTerminology:CEGEP = mandatory pre-university junior college in QuebecNunavik = homeland of the Inuit in present-day QuebecEeyou = what the Cree in present-day Quebec call themselvesMap of First Nations in Quebec: http://www.esaquebec.ca/communitiesSummary Report of the Quebec Viens Commission (to which Samir testified): https://www.cerp.gouv.qc.ca/fileadmin/Fichiers_clients/Rapport/Summary_report.pdfTruth & Reconciliation Commission of Canada: https://www.rcaanc-cirnac.gc.ca/eng/1450124405592/1529106060525***Recorded July 26, 2021Music: Mr Smith  https://freemusicarchive.org/music/mr-smithArt: Jeff Landman
2 minutes | Oct 4, 2021
Season 1 Teaser
Practicing is a new interview podcast by physician and host Sam Freeman, who asks the question: "What can medicine tell us about our world, our culture and our society?" 
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