Host Pat Skerrett talks with emergency physician turned diversity consultant Uché Blackstock. Her First Opinion essay, “Why Black doctors like me are leaving faculty positions in academic medical centers,” published in January 2020, was a call to arms for many Black physicians. We also talked about a “green book” for prospective medical students, #DNRTulane, the strong current of medicine that runs through her family, and more.

Episode 6: Uché Blackstock on diversity in medicine and a ‘life-altering’ decision

Host Pat Skerrett talks with Kara Zivin, a physician, research scientist, and professor of psychiatry and of obstetrics and gynecology. She wrote a moving and informative First Opinion, "Meghan Markle gave voice to the despair I once felt during pregnancy," soon after Oprah Winfrey's interview with the Duchess of Sussex.  In their conversation, Kara talks about her own struggles, as well as the balancing act between protecting one's privacy and advocating for changes in policy and stigma.

A caution to listeners: This episode includes discussions of suicide during pregnancy.

Episode 7: Kara Zivin on seeing her own struggle reflected in Meghan Markle's testimony

Pat speaks with two addiction doctors who have seen delirium first-hand, and wrote last week's First Opinion, "Excited delirium: valid clinical diagnosis or medicalized racism? Organized medicine needs to take a stand." Though the term was first used back in 1985, little evidence exists that the diagnosis of excited delirium is a valid one.  Brody and Jordan break down the difference between delirium and "excited" delirium, contextualizing the racist systems of medicine and policing that created it.

Episode 10: Jennifer Brody and Ayana Jordan on "excited delirium"

Pat speaks with Baghdad-trained physician Lubab al-Quraishi about her disappointment with the medical licensing system in the United States. She worked for a decade as a pathologist in Iraq, but ended up working at Popeyes in the US because she could not afford the studying time or financial costs of the exams needed to transfer her license.  The conversation is based off al-Quraishi's recent First Opinion, "Foreign-trained doctors like me were asked to help fight Covid-19. Now we’re being tossed aside."

Episode 11: Lubab al-Quraishi on how the US mistreats foreign physicians

This week, Pat is joined by Chelsea Clinton, who recently wrote a First Opinion on the health dangers of fracking with two of her colleagues at Columbia University's Mailman School of Public Health, Terry McGovern, and Micaela Martinez.  The conversation covered global public health crises such as fracking, oxygen shortages, and the pandemic.

Episode 15: Chelsea Clinton on public health crises like fracking, oxygen shortages

This week, two First Opinion contributors join Pat to talk about the toll that medicine can take on a professional's mental health, and how the pandemic has only exacerbated those consequences.  Corey Feist co-wrote his essay with his wife Jennifer Breen Feist, the sister of Lorna Breen, who died by suicide last year after contracting Covid-19.  Wendy Dean is a psychiatrist who wrote an iconic First Opinion in 2018 about the moral injury that physicians experience.  Corey and Wendy joined Pat for a discussion on how to heal the healers.

Episode 18: An advocate & a psychiatrist on physician suicide

This week is a special two-part episode focusing on last week’s controversial — some say inflammatory — decision to approve aducanumab, a new Alzheimer’s drug. In these episodes, I talk with two Alzheimer’s experts with vastly different viewpoints on the news. First up: Dennis J. Selkoe, a physician and scientist whose research is at the core of how Aduhelm works.

Episode 19, Part 1: An original believer on the aducanumab decision

Why do more women die in and after childbirth in the U.S. than any other industrialized nation? In this week's episode of the "First Opinion Podcast," physician Alissa Erogbogbo argues that the only way the country can change the maternal mortality rates is through addressing the inherent biases and inequities of traditional health care.

Episode 23: An OB-GYN on the maternal mortality crisis in the U.S.

Research on excess body weight and obesity has long been predicated on the fundamental assumption that weight is gained based on a 'calories in, calories out' equation. If you consume more calories than you expend, you gain weight, right?  Science reporter Gary Taubes and reader-turned-friend Nick Gulino are among a growing faction that says it might not be so simple. As Gulino himself has experienced, this conventional paradigm often leads to a culture of fat-shaming and blame for heavy individuals.

Episode 33: A reporter and a reader on rethinking how we gain weight

Abortion access is being threatened across the country: Texas has come close to banning abortion as the Supreme Court prepares to take up a challenge to Roe v. Wade. While this has put much of the medical community on the defensive, many are looking ahead toward expanding access to medication abortion and having clinicians "step aside." This conversation is based on a First Opinion by physician Jennifer Karlin titled, "For abortion care, physicians may need to step aside to support patients."

Episode 35: A family physician on making medical abortion more accessible

Americans have a tendency to fixate on what's commonly thought of of as "a good death" — a peaceful, quiet passing that looks like falling asleep. But physician Joel B. Zivot and medical philosopher Ira Bedzow are cautious about how this preoccupation can shield people from the reality of death. When they read a recent report in JAMA on using medication to eliminate the "death rattle" — a soft moan or gargling sound sometimes made by people when death is near — they knew they needed to write about the dangers of curating death for the witnesses rather than focusing on those who are dying. This culture extends to state executions, in which people often injected with paralytics when they put to death. That makes these deaths easier for the witnesses, but not for those being executed.

Episode 37: A physician and philosopher on the dangers of 'curating' natural deaths and executions

Diseases like smallpox, measles, and dysentery killed two-thirds of the 1 million people who died in the Civil War. “Chronic diarrhea” and the stigma of smallpox scars plagued soldiers and others for decades afterward. And while Americans no longer depend on digging ditches for latrines, we’re still struggling with faith in national public health measures, racial disparities in health care, and more. Medical historian Jonathan S. Jones discusses the epidemics of the Civil War and the lessons learned and forgotten.

Revisiting: A medical historian on the deadly epidemics of the Civil War

It can be hard to fathom that anyone other than you might own your information. But they do. Everything from what's in your electronic medical record to the average jogging speed recorded on an app may be someone else's property. For a profit, the magic is in the aggregate. On an individual scale, it's valuable information that paints a full picture of health for individuals and their health care providers. Juhan Sonin and Annie Lakey Becker explain why it's important to fight for patient ownership of health data across the country and the world.

Episode 41: Who owns your health data — and why you should care

Two years into the pandemic and in the midst of the latest hospital staffing crisis, nurses have finally gotten the country’s attention when it comes to burnout and attrition within the country’s most trusted profession. And it’s an important shift, because nursing is in trouble.
This week, nurse and researcher Jane Muir describes some of the issues that are nudging more and more nurses to trade staff positions for jobs as travel nurses, or to leave nursing entirely, and offers ways to retain staff nurses. She says hospital systems need to put cash toward the nurses who make those systems so profitable.

First Opinion Podcast is technically on a break!  We'll have one more episode next month before we're back to our weekly schedule in March.

Episode 44: Burnout at the bedside is causing a crisis in nursing

Clinicians walk a tightrope when trying to help their patients with chronic pain. They want to be able to ease a patient's suffering with medication, but must be mindful of the risks of addiction. There are some non-medication treatments for pain, but they're often hard to access or not covered by insurance.  Finding the balance can be challenging and emotionally taxing. And in the wake of the opioid crisis, many clinicians tend to err on the side of caution and under-treat pain. This week, two physicians discuss how to treat chronic pain adequately and ethically.

Episode 53: How should doctors treat pain in the wake of the opioid crisis?

For two decades, nurses have been considered the most trustworthy professionals in the country, above physicians. Yet the rigid hierarchy within hospitals and health systems places physicians at the top, creating a fraught power dynamic and a double standard when it comes to discipline. This week, nurses and educators Michelle Collins and Cherie Burke discuss this double standard as it relates to the recent cases of a former nurse and another former physician.

56: The double standard of discipline between nurses and physicians

During his long career as a pediatric oncologist and cancer researcher, William Woods thought highly of the FDA's work evaluating and approving new cancer drugs. But his opinion of the agency changed when he was diagnosed with amyotrophic lateral sclerosis, or ALS, a progressive disease that damages nerves in the brain and spinal cord. This week on the "First Opinion Podcast," Woods talks about living with ALS, and watching what he sees as the glacial pace of approving an experimental ALS drug called AMX0035.

58: A doctor with ALS laments a slow pace for drug approval

When Ken Duckworth was a child, his family didn't talk about mental health, especially not his father's bipolar disorder. It was an untouchable topic, but Duckworth knew his father shouldn't be seen as a lost cause. Instead, his father and others like him might actually have critical expertise on how to navigate the world with mental illness — expertise they gained not through books and studying but through lived experience.

69: The real experts are people living with mental illness

After two years as host of the First Opinion Podcast and many more as the founding editor of STAT's expansive, authoritative First Opinion platform, Pat Skerrett put down his editing pen and microphone to start a new chapter: retirement. But before he left, he sat down with Torie Bosch, who has just joined STAT as our new First Opinion editor.  They chatted about hopes for the section, editorial pet peeves, and the vampire bats of Costa Rica.

70: Big changes for First Opinion

Alex Rosenblat is particularly careful when it comes to her digital privacy. She requests to fill out paper forms instead of digital ones; she documents and tracks what she signs. But even her diligence can't always save her. Rosenblat recently spent months retracing her digital steps after Phreesia, a company that collects demographic information, claimed to have her authorization to share her data — authorization she knew she hadn't consented to. This week, Rosenblat talks to host and editor Torie Bosch about tracking down her own information and the amorphous harm caused by invasions of privacy.

72: The coercion built into medical privacy consent forms

We've all had the experience of a clinician staring at screen while asking us sensitive questions to fill out our electronic health records. But that frustrating experience is made even worse by a new trend in health care. As Sanjay Basu wrote in a recent First Opinion, hospitals are using so-called "screen and refer" systems to identify people with social needs, like those who are experiencing domestic violence or hunger. The idea is that workers ask patients about their needs, then refer them to organizations such as food banks that can help. But according to Basu, a primary care provider, these well-intended efforts are instead dehumanizing and ineffective for patients, and burdensome for the organizations buried by referrals.

74: How 'screen and refer' systems fail to help patients

The high cost of cancer treatment in the U.S. is literally killing people. “Over a quarter of cancer patients delay medical care, go without care, or make changes in their cancer treatment because of cost,” Ezekiel J. Emanuel, an oncologist and co-director of the Health Care Transformation Institute at the University of Pennsylvania, wrote in a recent First Opinion essay.

But Emanuel says there’s a solution: Cancer patients shouldn’t have to pay any out-of-pocket costs for their treatment, especially in the first (and typically most expensive) year after diagnosis.

75: Ezekiel J. Emanuel explains why cancer patients shouldn’t pay out-of-pocket costs

When a loved one is living with serious substance use disorder and refuses to get help, sometimes it seems like the only solution is to force them into it. In many states, people can be “arrescued” — that is, forced under penalty of law into a treatment program that is nearly identical to being incarcerated, down to orange jumpsuits. But Sarah Wakeman, an addiction medicine physician, says that while she understands the love that makes people see involuntary treatment as a solution, it doesn’t actually work.

76: Why forced treatment can't fix substance use disorder

Drug shortages are a growing problem in the U.S., and a shortage of live-saving cancer drugs has reached crisis levels. Oncologist Kristen Rice explains that drug shortages have been happening for several years but have been getting progressively worse in the last few months. Oncologists are facing critical shortages of common, generic cancer medications and have even begun to ration care for certain patients who are able to delay treatment, according to Rice.

79: Cancer drug shortages should be causing more outrage

Physician and professor Jason Karlawish argues that new promising drugs like lecanemab, an anti-amyloid antibody expected to be approved by the FDA July 6, will introduce complicated issues into the field of Alzheimer's care. These medications require a great deal of testing and patient monitoring, trained physicians, and other resources in a system that is already stretched thin.

80: Is the medical system ready for Alzheimer's drugs that work?

Duchenne muscular dystrophy is a devastating disease and, until very recently, was one without much hope. When Hawken Miller was diagnosed at age 5, the physician told his parents to enjoy the time they had with him, as there wouldn't be much. Over 20 years later, Miller is a journalist and content strategist for CureDuchenne, an organization started by his mother when he was diagnosed, and new treatment is on the horizon. Last month, the FDA approved a new gene therapy from Sarepta Therapeutics that will provide hope for many patients and families. The new drug, however, has its limitations — it's only approved for children age 4-5, for example. Miller joined the podcast to discuss how this drug may change lives, what more needs to happen, and what his personal experience has been living with Duchenne.

81: One Duchenne patient's bittersweet hope for new treatment

"You can't pour from an empty cup" is what registered nurse Tara Rynders learned the hard way after two decades of work and one heartbreaking, life-threatening experience of being a critical care patient herself. Before that experience, she'd always found found that dance, play, and other types of movement helped her express and heal from the trauma she encountered and held in her body every day. After recovering from her experience as a patient, she brought that to several other nurses in a workshop.

82: How dance helped one nurse heal from trauma, and help others

Stephanie W. Edmonds and Ginny L. Ryan are both doctors. Edmonds, a registered nurse, has a Ph.D., while Ryan is a traditional M.D. But as part of a fight over “scope creep” in health care, many medical doctors might bristle at the idea of calling Edmonds “doctor.” In the last episode of the season, Edmonds and Ryan speak about the health care hierarchy, why calling health care workers by their first names might help patients, the tendency for physicians to mock "noctors," and much more.

83: Why physicians should let patients call them by their first names

From our colleagues at Globe Opinion comes a new podcast: Say More. Say More, hosted by Globe columnist Shirley Leung, is all about exploring our backyard for the cultural trends, scientific discoveries, and breakthrough startups that are shaping the nation.

Introducing: Say More, from Globe Opinion

Physicians Alison Block and Nikki Zite knew what they were getting into when they became abortion providers early in their medical training. Family planning has long been a politicized, divisive area of medicine. And even though they knew that Roe v. Wade — the 1973 Supreme Court case that protected abortion access across the country — was being threatened, it still hit them hard when that ruling was actually overturned in June 2022.

84: How two abortion providers grapple with their post-Roe reality

We're popping into your feed on a Sunday because we wanted to share an episode of The Nocturnists: Post-Roe America. You may have already heard the First Opinion Podcast interview with Ali Block, an abortion provider and executive producer of The Nocturnists, and Nikki Zite, an OB/GYN in Tennessee. (If you haven't listened yet, please do!)

On this episode of The Nocturnists, you'll hear more from Nikki, Ali, and other doctors trying to navigate reproductive health landscape after the end of Roe.

Introducing: The Nocturnists: Post-Roe America

After physically debilitating cancer treatment, Laurie Brunner encountered another medical hurdle: She had developed lymphedema that required surgery, but her BMI was over the cutoff. To receive the necessary treatment, she would have to lose weight. I spoke with Laurie and her physician Jody Dushay about how the ongoing shortages of GLP-1 medications are creating logistical and medical problems. Our conversation was based on Jody’s recent First Opinion essay, “How the Wegovy shortage is making life impossible for my patients — and for me.”

85: How the Wegovy shortage is hurting one patient's health

Since the early days of the pandemic, long Covid has haunted us: Even a mild acute infection might leave you with life-altering consequences. While research suggests long Covid rates are falling, it still affects millions. But what if long Covid isn’t the right way to think about what those people are going through? This week, Torie spoke with Steven Phillips and Michelle A. Williams, authors of a recent First Opinion essay titled, “Long Covid is a new name for an old syndrome.” They discuss the history of post-infectious disease syndrome, what rethinking long Covid might mean for research, and the ways the health care system fails chronically ill patients.

86: Why long Covid might predate the pandemic

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