The summer I turned thirteen my family moved to Berlin from Canada. Although we were an essentially secular Jewish family, I had a basic Jewish education and quite a developed awareness of the history of World War II and the Holocaust. Like many young readers, I had been captivated by “The Diary of Anne Frank”. I’d also been to museums and seen plays, movies, and read many stories about the period and the plight of Europe’s Jews under the Nazis.

So although I was well aware of Germany’s brutal history, I wasn’t prepared for its omnipresence in everyday life in Berlin. Subtle, almost banal traces of the Nazi past were everywhere: in discreet memorial plaques on buildings, in the names of subway stops, or even on the ground beneath one’s feet, where the names of deported Nazi victims were engraved on special brass cobblestones in the sidewalks in front of the victims’ former homes.

But for Harvard anatomist Sabine Hildebrandt, growing up in postwar Germany meant being surrounded by a lack of evidence of her country’s dark past. Absent Jewish neighbors, abandoned synagogues, and uncomfortable silences: that was her experience. From the silence a curiosity emerged, a need to know that was the impetus for her ongoing quest to excavate the past, to understand it and to memorialize it. And that’s what she does in her book, “The Anatomy of Murder: Ethical Transgressions and Anatomical Science during the Third Reich”, the first systematic study of anatomy under National Socialism.

Sabine Hildebrandt is an associate professor of pediatrics at Boston Children’s Hospital, and a lecturer on Global Health and Social Medicine at Harvard Medical School. She also teaches anatomy and history of anatomy at Harvard.

I knew I wanted to speak to Sabine when I saw her name mentioned in not one, but two stories in the New York Times related to German anatomy’s Nazi past; one about the notorious Pernkopf anatomical atlas, and the other related to her work as a member of the Historical Commission on the University of Strasbourg, which was taken over by the Nazis during the war and was the site of some harrowing abuses. I’ve linked to both articles below.

Speaking to Sabine was interesting on many levels. The history she has systematically laid out in her work is horrific, but unquestionably fascinating and valuable in its own right. But what is so special about her work, I think, is the way it prompts us to reflect on medicine’s relationship to power, and the discipline’s intrinsic potential not only for good, but also for evil.

On that note, a brief warning. My conversation with Sabine includes the discussion and description of medical violence and outright crimes in a context of tremendous brutality and disregard for human life. So please listen with caution and care.

***

Links:
Sabine's bio
New York Times article on Pernkopf Atlas
New York Times article on Strasbourg University

***
Recorded October 12, 2022
Music: Mr Smith
Art: Jeff Landman

Hosted on Acast. See acast.com/privacy for more information.

One of the reasons I never tire of making this podcast is that each conversation brings with it a sense of surprise, an encounter with the unexpected. When I heard about Q Hammouri and the advocacy group they founded, Pride Ortho, I was eager to hear about their efforts to break the taboo of queerness in the straight, male-dominated field of orthopedics and to hear Q’s own story. Although we were able to speak at length about that advocacy work and the field of orthopedics, our conversation took us in many other directions, about the nature of identity, the fundamentals of medical thinking, and the ways something as simple as looking and seeing can transform our relationship to the world.

Q Hammouri is a pediatric orthopedist and spine surgeon. They are also an artist, immigrant, proud American, Buddhist, Muslim, Arab, and non-binary. They obtained their medical degree at the University of Jordan and immigrated to the US to pursue further medical training. They received their orthopaedic training at Yale, then completed a fellowship in spine surgery at New York University and a fellowship in pediatric orthopaedics at Columbia University. In 2013, they joined Northwell health to found the Pediatric Orthopaedic Department at Staten Island University Hospital, where they practiced until recently, performing the first pediatric spinal surgeries in the New York City borough of Staten Island. Q is the founding president of Pride Ortho, an LGBTQ+ advocacy group in orthopedics, and sits on the Diversity task forces of Pediatric Orthopaedic Society of North America and Scoliosis Research Society. In 2021, they were chosen as an Atlantic Health fellow for Health Equity for their work on LGBTQ access and advocacy.

What struck me most about Q’s observations and experience is the way their identity, their many identities in fact, are woven into their professional self, and the way they are as a physician and surgeon. I couldn’t help but see a connection between their attention to detail, their focus on observation as a surgeon and as a visual artist, and their sensitivity to their own appearance, to the ways their patients may feel perceived, seen or not seen, because of their medical condition, their sexual and gender identity, or both. Far from making them a less focused or engaged professional, Q’s different pursuits reinforce their sense of purpose and their grounding in what remains – even in our high tech, hyperspecialized age – medicine’s essence: tending to the suffering of other human beings.


***
Links:
Pride Ortho
Q's art: Earl of Bushwick
The Whitest Specialty, by Usha Lee McFarling, Stat News, December 13, 2021

***
Recorded October 18, 2022
Music: Mr Smith
Art: Jeff Landman

Hosted on Acast. See acast.com/privacy for more information.

So many forces that seem to be about other aspects of human life – economics, geography, identity, politics – are in fact also intimately connected to health. That connection isn’t just incidental, it’s fundamental: once you begin to see it, it’s everywhere, and it comes through in concrete, important ways, ways that impact human wellbeing.

Transportation - how we choose to get around - is one such aspect of daily life. We usually talk about it as traffic patterns, transit fares, bus schedules, and commute times. For some, it’s a fascinating subject, for others, it’s simply background noise: there, but hardly worth remarking upon.

And yet getting from one place to another is something we nearly all have to do, most often on a daily basis. I started riding a bicycle to get around my city about 15 years ago, and I’ve loved it ever since. I can’t get everywhere I need to go by bike, but it’s long been my preferred means of transportation. More recently, I’ve become interested in the greater benefits of cycling, the factors that influence people’s decisions to choose one mode of transportation over another, and how better transit makes for better lives, and even a better world.

At the same time, I’ve seen more and more news of rising rates of car crashes, pedestrian deaths, and cars becoming less safe instead of safer, over the past few years. That’s news I’ve found it difficult to ignore.

As I’ve learned more about these issues, the cascading implications of something as basic as how you get to work, drop your children off at school, or run your errands have revealed themselves to me. Of course there’s traffic and noise and air pollution, but there’s also your individual health, your risk of injury – of death even – the look of the built environment and your feeling of connection to it. I really believe - and there’s evidence to support this - that how you get around even impacts your mood.

To explore the health and safety dynamics surrounding urban transit, I was fortunate to be able to speak to Kay Teschke, Professor Emeritus of the University of British Columbia's School of Population and Public Health, and a leading academic in the field. After beginning a career focused on occupational exposure risks, Kay started a new research program in 2004 called “Cycling in Cities”. That research focused on the interaction between factors like the type of bike route available to riders, and the risk of injury or the decision to ride a bike. It has contributed scientific evidence for building routes that welcome cycling in North American cities, and Kay has been involved in provincial, national, and international policy making related to cycling. Even after her retirement, “Cycling in Cities” continues to be a thriving research initiative.

Talking to Kay helped me better understand the facts around cycling and urban transit, and to more clearly see how, as a society, the way we get around isn’t pure happenstance: it’s the result of deliberate decisions and clear choices – and we live with the consequences of those choices every day.

***
Links:

Kay's research and Twitter
Cycling in Cities and its successor, CHATR
"The Deadliest Road in America", by Marin Cogan, Vox

***
Recorded September 27, 2022
Music: Mr Smith
Art: Jeff Landman

Hosted on Acast. See acast.com/privacy for more information.

Mental health as a phrase is so broad and far-reaching as to drift into cliché, or elude meaning altogether.

The many facets and complexities that “mental health” encompasses each merit their own conversation: the role of diagnosis and medication; our approaches to care; addiction and substance abuse; the apparent increase in struggles among our youth; the impacts of the Covid pandemic; the changing workplace; the effect of technology; the role of economic inequality, systemic racism, homophobia and transphobia, and other forms of discrimination; mass incarceration, and the list goes on.

But there is no question that the theme of mental health, the wellbeing of our mind and spirit, our sense of belonging in the world, is an urgent one, which, it seems to me, has been garnering ever-greater degrees of attention in public discourse. I’ve wanted to figure out how to approach this vast topic and pick out avenues for further reflection and examination.

That’s why I jumped at the opportunity to speak to my next guest, someone who’s been immersed in mental health work for over twenty years, and has approached it from several angles.

Benjamin F. Miller is the former president of Well Being Trust and chair of the advisory board of Inseparable, two mental health organizations. Over the last two decades, he has worked to promote and prioritize mental health in policies, programs, and investments in his native United States.

Trained in clinical psychology at Spalding University, the University of Colorado and the University of Massachusetts, Ben started his career as a clinician and then spent 8 years as an Associate Professor in the Department of Family Medicine at the University of Colorado School of Medicine where he was the founding Director of the Eugene S. Farley, Jr. Health Policy Center. He subsequently joined Well Being Trust, a nonprofit dedicated to mental health, as Chief Strategy Officer and then, until recently, as President.

Ben has testified before state and federal government committees in the United States, is active as a keynote speaker, and has been featured in a wide range of major media outlets, including the New York Times, USA Today, CNN and NPR. He is also the author of “Mental,” a substack newsletter on topics related to mental health.

I’ll confess speaking to Ben left me with more questions than answers, given the enormity of the topic, but our exchange allowed me to focus my thoughts and his insights provided material for further contemplation. I hope it does something similar for you.

Just a warning that we do discuss topics of suicide, addiction, and other forms of distress during the episode. If you’re in need of help, please reach out to someone you trust or a healthcare provider. If you’re a healthcare worker, your employer or professional association may also provide support. And you can always call Talk Suicide Canada, 988 in the United States, or a suicide prevention or crisis hotline wherever you are.

***
Links:

Ben's newsletter
"The Mystifying Rise of Child Suicide," by Andrew Solomon, The New Yorker
"'It's Life or Death': The Mental Health Crisis Among US Teens," by Matt Richtel, The New York Times


***
Recorded August 1, 2022
Music: Mr Smith
Art: Jeff Landman

Hosted on Acast. See acast.com/privacy for more information.

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 publications
Nature's 10 Remarkable Discoveries 2020
Inborn errors of type I IFN immunity in patients with life-threatening COVID-19, Science

***
Recorded July 19, 2022
Music: Mr Smith
Art: Jeff Landman

Hosted on Acast. See acast.com/privacy for more information.

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 the Division 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 twitter
Informed consent paper
Crisis standards of care paper
OTC inhaler paper and tweet thread
Inhaler patents paper and tweet thread
CBC article on effort to regulate Canadian drug prices

***
Recorded May 20, 2022
Music: Mr Smith
Art: Jeff Landman

Hosted on Acast. See acast.com/privacy for more information.

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, 2022
Music: Mr Smith
Art: Jeff Landman

Hosted on Acast. See acast.com/privacy for more information.

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, 2022
Music: Mr Smith
Art: Jeff Landman

Hosted on Acast. See acast.com/privacy for more information.