The Clinical Problem Solvers: Recent Episodes
The Clinical Problem Solvers
The Clinical Problem Solvers is a multi-modal venture that works to disseminate and democratize the stories and science of diagnostic reasoning Twitter: @CPSolvers Website: clinicalproblemsolving.com
https://clinicalproblemsolving.com/wp-content/uploads/2025/02/One-and-a-half-Syndrome-Podcast-final.mp3Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Aye presents a case of double vision to Vale.
Aye Chan Moe Thant ( @AyeThant94 )
Aye is a physician from Myanmar and now working as a clinical research team member at the Department of Neurology, Washington University in Saint Louis. Throughout her career in Myanmar, she worked closely and received training from her mentor neurologist, one of only three neurologists available for the whole upper Myanmar of 23 million population. Witnessing the challenges faced by the patients from underserved areas, she is dedicated to advancing health equity, research, and global neurology. Aye is also very passionate about medical education and has been deeply involved in Clinical Problem Solvers mainly in neurology with the mentor Dr. Aaron Berkowitz. She is going to apply for neurology residency and very excited about the journey ahead!
Valeria Roldan
@valeroldan23
Valeria Roldan was born and raised in Lima, Peru. She recently graduated medical school at Universidad Peruana Cayetano Heredia and is excited to pursue a career in Neurology. She is passionate about LGBTQ+ health, particularly advocating for trans rights, as well as medical education. She would describe herself as an optimist and outside of medicine you probably will find her running or talking about pop culture over a glass of wine.
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https://clinicalproblemsolving.com/wp-content/uploads/2025/02/IDLove-Episode-2-Final-Post-Auphonic.mp3
Frameworks discussed in the episode
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https://clinicalproblemsolving.com/wp-content/uploads/2025/02/SLS-2-6-2025-RTP.mp3Episode description: Valeria presents a very unique neurological finding amidst a case of cachexia to the SLS team.
Featuring: Valeria RoldanJasdeep BajwaElena StorzMukund RaguramSchemasWeight loss Abdominal distensionChronic diarrheaJoint pain thought trainIron deficiencyDownload CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2025/02/RLR-2-cases-of-fatigue-1.mp3Title – The same start, but a different ending
Episode description
RR discusses 2 cases of fatigue
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https://clinicalproblemsolving.com/wp-content/uploads/2025/01/CUS-1-2025.wavMark presented a case to Debora and Noah in the year’s first episode.
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Description:
Kaylin, Sharmin, and Cheryl are joined by Dr. Arghavan Salles. They discuss career transitions/pivots, challenging workplace experiences, social/digital media use, and thoughts on allyship and gender biases/stereotype threat as self-identified angry women.
Bio:
Dr. Salles is a minimally invasive and bariatric surgeon. She completed medical school and residency in general surgery at Stanford prior to completing her fellowship in minimally invasive surgery at Washington University in St. Louis. She stayed on faculty at Washington University for three years prior to moving back to Stanford in 2019. During the pandemic, Dr. Salles has served as a disaster relief physician, caring for patients with COVID in the ICU. Dr. Salles obtained a PhD in education from Stanford University during her residency training, and her research focuses on gender equity, implicit bias, diversity, inclusion, and physician well-being. Her R01 grant from the NIH focuses on sexual harassment. She is a sought-after speaker and has given over 100 national and international invited talks related to gender equity, physician well-being, and weight bias. She currently serves as the Special Advisor for DEI Programs at the Stanford University Department of Medicine where she is a Clinical Associate Professor.
Articles:
https://www.usatoday.com/story/opinion/voices/2018/10/24/angry-women-voting-discrimination-column/1696287002/
https://shows.acast.com/the-house-of-pod-a-medical-podcast/episodes/epsiode-235-masculinity
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https://clinicalproblemsolving.com/wp-content/uploads/2025/01/CPS-PCCM-VMR-Final-Version.mp3In this Pulmonary & Critical Care episode, Dr. Meghan Nothem presents an unusual case of acute encephalopathy and unresponsiveness to Dr. Paul A. Bergl. Stay tuned to found out the final diagnosis!
Session facilitator: Dr. Hui Ting Ruan
Case discussant:
Dr. Paul A. Bergl is an intensivist at Gundersen Lutheran Medical Center in La Crosse, WI and clinical adjunct assistant professor with the University of Wisconsin. He completed medical school at the University of Wisconsin-Madison, internal medicine residency at the University of Chicago, and critical care fellowship at the Medical College of Wisconsin.
Dr. Bergl is a decorated educator with over a dozen major teaching awards and honors from medical students, residents, and fellows. His foremost passions in medical eduation are critical thinking and diagnostic reasoning. His other scholarly work has focused on diagnostic error, point-of-care ultrasonography and echocardiography, and bedside teaching and rounding.
Case presenter: Dr. Meghan Nothem
Dr. Nothem is a third year Pulmonary & Critical Care Medicine fellow at The Medical College of Wisconsin in Milwaukee, Wisconsin where she also completed her Internal Medicine residency and served as Chief Resident. Prior to returning to her home city for post-graduate training, she earned her Bachelor of Science in Biology at University of Wisconsin-Madison and her medical degree at Rocky Vista University College of Osteopathic Medicine in Parker, Colorado. Dr. Nothem will be joining a Pulmonary and Critical Care Medicine practice in Milwaukee upon completion of her fellowship in summer of 2025.
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https://clinicalproblemsolving.com/wp-content/uploads/2025/01/audio1588233744-2.mp3Title – A Sudden Problem – but where is it?
Episode description
RR discuss a fascinating case of abrupt onset abdominal pain
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https://clinicalproblemsolving.com/wp-content/uploads/2025/01/2025.01.02-Neurology-Podcast.mp3Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Dr. Sebastian Green presents a case of generalized weakness to Aye.
Neurology DDx Schema
Aye Chan Moe Thant ( @AyeThant94 )
Aye is a physician from Myanmar and now working as a clinical research team member at the Department of Neurology, Washington University in Saint Louis. Throughout her career in Myanmar, she worked closely and received training from her mentor neurologist, one of only three neurologists available for the whole upper Myanmar of 23 million population. Witnessing the challenges faced by the patients from underserved areas, she is dedicated to advancing health equity, research, and global neurology. Aye is also very passionate about medical education and has been deeply involved in Clinical Problem Solvers mainly in neurology with the mentor Dr. Aaron Berkowitz. She is going to apply for neurology residency and very excited about the journey ahead!
Dr. Sebastian Green ( @sebfgreen )
Dr. Sebastian Green is a neurology resident at the University of California, Los Angeles (UCLA). He was born and raised in London, England. He has degrees in Medicine from the University of Bristol and Neuroscience from the University of Oxford. He has published on neuroimaging, memory, sleep, epilepsy, and more. He is passionate about medical education in neurology, and using EEG to answer big questions about the brain.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/12/SLS-12_26_RTP.mp3Episode description: Welcome our new SLS team member, Seyma! The SLS team get together from four time zones across the world to discuss a challenging case of altered mental status.
Featuring: Kirtan PatoliaAnna FretzPriyanka AthavaleSeyma Yildirim SchemasAltered Mental StatusInfection 1.0
Infection 2.0
CNS lymphocytosisDownload CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/12/CUS-8.mp3In this episode, Mukund presents a fantastic case to Jasdeep and Ibrahim.
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In this episode of WDx, Sharmin, Yaz, and Kaylin are joined by Dr. Laila Woc-Colburn. Tune in to hear Dr. Woc expertly discuss a case of a young woman with a worsening headache, followed by a roundtable discussion about what drew her to infectious diseases and her passions in medicine and life.
Bio:
Laila Woc-Colburn, MD is an associate professor in the Division of Infectious Diseases at Emory University School of Medicine. A graduate of Universidad Francisco Marroquín in Guatemala, she completed her internal medicine residency at Advocate Illinois Masonic Medical Center in Chicago and her fellowship in infectious diseases and HIV medicine at Case Western University in Cleveland. Dr. Woc-Colburn also holds a Diploma in Tropical Medicine and Hygiene.
Her clinical interests encompass tropical diseases in immunosuppressed individuals, including those with HIV, as well as mycotic diseases, orthopedic infections, and medical education. She is passionate about teaching the next generation of healthcare professionals about infectious diseases and is dedicated to empowering women and BIPOC individuals in medicine.
https://clinicalproblemsolving.com/wp-content/uploads/2024/12/WDx-12.12-AUPH.m4aDownload CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/12/CPSolvers_Derm_Final.mp3In this dermatology episode, Dr. Eamonn Maher presents a case of eruptive nodules to Dr. Steven Chen.
Session facilitator: Dr. Maddy Conte
Case Discussant: Dr. Steven Chen
Case Presenter: Dr. Eamonn Maher
Evolution of Skin Lesions: Link here
Skin Biopsies: Link here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/12/audio1338996199-1.mp3Title – Photophobia and diarrhea
Episode description
RR discuss a fascinating case of fever, photophobia and diarrhea
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https://clinicalproblemsolving.com/wp-content/uploads/2024/11/Schema_ACS_FINAL.mp3Maddy, Youssef and Andrew share their approach to acute coronary syndrome as they discuss a case presented by Sharmin.
Acute Coronary Syndrome Framework
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https://clinicalproblemsolving.com/wp-content/uploads/2024/11/11.21.2024-Headche-and-seizure-RTP.mp3Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Bayan presents a case of headache and seizure to Aye.
Neurology DDx Schema
Aye Chan Moe Thant ( @AyeThant94 )
Aye is a physician from Myanmar and now working as a clinical research team member at the Department of Neurology, Washington University in Saint Louis. Throughout her career in Myanmar, she worked closely and received training from her mentor neurologist, one of only three neurologists available for the whole upper Myanmar of 23 million population. Witnessing the challenges faced by the patients from underserved areas, she is dedicated to advancing health equity, research, and global neurology. Aye is also very passionate about medical education and has been deeply involved in Clinical Problem Solvers mainly in neurology with the mentor Dr. Aaron Berkowitz. She is going to apply for neurology residency and very excited about the journey ahead!
Bayan Al Zoabu
Bayan is a senior medical student from Syria with a passion for neurology and a drive to make a difference in healthcare. From founding a screening initiative for congenital conditions in children to working with other students and residents to create the NeurAnki flashcard deck to help neurology residents prep for board exams, Bayan is all about supporting others. As a passionate advocate for ethics, she is the co-leader of the journal club team in the neuro-ethics group. Outside medicine and in her free time, Bayan loves to relax with a cup of tea and a book.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/11/11-14-2024-SLS-RTP_2.mp3Episode description: Jas presents a fascinating case of chest pain, dyspnea, and lower extremity edema that ends up in a very different place than any of us expected. Welcome to our new teammate Elena!
Featuring: Mukund RaguramJasdeep BajwaValeria RoldanElena StorzSchemasChest painDyspnea PyramidLower extremity edemaHypertensionAKI overviewNephrotic syndromeGlomerulonephritisAnemia thought trainHemolytic anemiaDownload CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/11/CUS-6.wavLea and Şeyma discuss this fascinating non-productive cough, fever and dyspnea case presented by Elena.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/11/audio1821958457-1.mp3Title – Dr. Centor joins RR for a case of diarrhea
Episode description
Robert Centor, Reza and Rabih discuss a case of diarrhea
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https://clinicalproblemsolving.com/wp-content/uploads/2024/10/WDx-10.31-RTP.mp3Kaylin, Sharmin, Cheryl, and Jane discuss two cases of volume overload. Kaylin reviews the pathophysiology behind constrictive pericarditis and restrictive cardiomyopathy, normal pericardial and thoracic anatomy and pressure changes with respiration, and the difference in treatments between the two disease processes.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/10/RafaM_RheumatologyPCCM_Final.mp3This joint rheumatology and pulmonary critical care medicine session is a collaboration between CPSolvers and The University of Colorado. This session, like all Rafa Medina Subspecialty sessions, is in honor of Dr. Rafael Medina. Dr. Melissa Griffith and Dr. Geoff Connors discuss a case of myositis presented by Dr. Sarah Haeger and Dr. Evan Zehr
Session facilitator: Maddy Conte
Case Discussants: Geoff Connors is an associate professor in Pulmonary and Critical Care at the University of Colorado. He is the Associate Dean for Graduate Medical Education and is the former program director of the Internal Medicine Program at University of Colorado. Melissa Griffith is an Assistant Professor of Rheumatology at the University of Colorado.
Case Presenters: Sarah Haeger was a chief medical resident at the University of Colorado and is currently a nephrology fellow at the University of Washington. Evan Zehr was a chief medical resident at the University of Colorado and is currently a fellow in Pulmonary and Critical Care medicine at Vanderbilt.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/10/NephroticSyndrome-FINAL.mp3Maddy, Youssef and Andrew share their approach to nephrotic syndrome as they discuss a case presented by Sharmin.
Nephrotic Syndrome Framework
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https://clinicalproblemsolving.com/wp-content/uploads/2024/10/RTPNeuroepisodeOct2024.mp3Episode title: Episode 359 Neurology VMR – altered mental status
Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Vale presents a case of altered mental status to Aye.
Neurology DDx Schema
Aye Chan Moe Thant
Aye graduated from University of Medicine, Mandalay, Myanmar, and has been working with her mentor neurologist, one of only three neurologists covering the Upper Myanmar region of 23 million population. Through her experiences witnessing the challenges faced by patients in underserved areas and hearing their stories, Aye is dedicated to advancing health equity, global health initiatives, and various aspects of neurology, both in clinical practice and medical education. She is going to apply for a neurology residency program this year. Outside of work, she spends time playing piano, jogging along trails, and listening to music.
Valeria Roldan
@valeroldan23
Valeria Roldan was born and raised in Lima, Peru. She recently graduated medical school at Universidad Peruana Cayetano Heredia and is excited to pursue a career in Neurology. She is passionate about LGBTQ+ health, particularly advocating for trans rights, as well as medical education. She would describe herself as an optimist and outside of medicine you probably will find her running or talking about pop culture over a glass of wine.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/10/ID-Love_Final.mp3Frameworks discussed in the episode:
Shock
Fever in The ICU
Fever in The ICU 2.0
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https://clinicalproblemsolving.com/wp-content/uploads/2024/10/10-2024-SLS-RTP.mp3Episode description: Kirtan presents a fascinating case of altered mental status that ends in an unexpected way!
Featuring: Kirtan PatoliaAnna FretzPriyanka AthavaleSchemasAltered Mental StatusHyponatremiaPancytopeniaDownload CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/10/RLR-111-1-1.mp3Title – All about the exam
Episode description
Reza and Rabih discuss a fascinating case of a swollen foot
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https://clinicalproblemsolving.com/wp-content/uploads/2024/09/CUS-5-Final-final.mp3Alex and Andrew discuss a fascinating case of Hypoglycemia presented by Aimme.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/09/CPSolvers-SGIM-2024-Episode-FINAL-91924-12.19PM.mp3CPSolvers: Anti-Racism in Medicine Series
Episode 25 – Live from SGIM 2024: Best of Antiracism Research at the Society of General Internal Medicine’s 2024 Annual Meeting
Show Notes by Ashley M. Cooper
September 19, 2024
Summary: This episode highlights a selection of antiracism research presentations at a live recording of the podcast at the 2024 SGIM Annual Meeting. This year’s episode, our fourth conducted at SGIM, is focused on the importance of qualitative research and the role it plays in antiracism research, community-based work, and scholarship. During this episode, we hear from Dr. S. Michelle Ogunwole, MD, PhD, an internist and social epidemiologist who specializes in the care of women with chronic medical conditions and racial disparities in maternal health outcomes, and Dr. Caroline Sloan, MD, a general internist whose research focuses on how financial considerations are imbued into medical decision-making. This episode is hosted by Ashley Cooper and Sudarshan (Sud) Krishnamurthy. The show notes for this episode were written by Ashley M. Cooper.
Episode Learning Objectives
After listening to this episode, learners will be able to…
- Understand how they can better center patient experiences by engaging with, and conducting their own, qualitative research.
- Describe the positive impacts of qualitative methods on healthcare provision and/or policies in clinical settings.
- Identify the critical role that qualitative research plays in antiracism and health equity work.
Credits
- Written and produced by: Ashley Cooper, Sudarshan Krishnamurthy, Team
- Hosts: Ashley M. Cooper, Sudarshan Krishnamurthy
- Infographic: Canva
- Audio Edits: Ashley M. Cooper
- Show Notes: Ashley M. Cooper
- Guests: Dr. Michelle Ogunwole and Dr. Caroline Sloan
Disclosures
The hosts and guests report no relevant financial disclosures.
Citation
Ogunwole M, Sloan C, Cooper A, Krishnamurthy S, Calac A, Pitre A, Pierce G, Essien UR, Fields NF, Lopez-Carmen V, Nolen L, Onuoha C, Watkins A, Williams J, Tsai J, Khazanchi R. “Episode 25: Live from SGIM 2024: Best of Antiracism Research at the Society of General Internal Medicine’s 2024 Annual Meeting” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. September 19, 2023.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/09/CPSolvers-09-12-24-1.mp3In this Clinical Reasoning Rafael Medina Subspecialty episode, Dr. Kuchal Agadi presents a case to Dr. John Woller and Dr. Areeb Masood of a 67 year-old male with altered mental status.
Session facilitator: Hui Ting Ruan
The goal of this session is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.
Case discussant:
Dr. John Woller is an academic hospitalist working in the Johns Hopkins Hospital in the Division of Hospital Medicine. As a clinical coach and Associate Program Director for clinical reasoning and bedside medicine, John is enthusiastic about teaching medical students and Osler residents at the bedside.
And Dr. Areeb Masood, is a third-year internal medicine resident at Johns Hopkins Hospital in the Osler Internal Medicine Residency and Urban Health Track. He earned his undergraduate degree from The University of Texas at Austin and his medical degree from The University of Texas Rio Grande Valley School of Medicine. After completing his residency, he aims to practice a blend of hospital medicine and HIV primary care. @areebmasoodMD
Case presenter:
Dr. Kuchal Agadi, is first year Resident at a community hospital in Chicago. Kuchal is passionate about medical education. Apart from medicine she is a fitness enthusiast, and enjoys a good workout routine with Kettle bells.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/09/RLR-FOR-MAIN-PODCAST.mp3Title – The Wrong Context
Episode description
Reza and Rabih discuss a fascinating case of jaundice
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https://clinicalproblemsolving.com/wp-content/uploads/2024/08/RTPeditedAugust2024neuropodcast.mp3Episode title: Episode 351 Neurology VMR – headache and double vision
Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Aye presents a case of bilateral lower limb weakness to Valeria.
Neurology DDx Schema
Aye Chan Moe Thant
Aye graduated from University of Medicine, Mandalay, Myanmar, and has been working with her mentor neurologist, one of only three neurologists covering the Upper Myanmar region of 23 million population. Through her experiences witnessing the challenges faced by patients in underserved areas and hearing their stories, Aye is dedicated to advancing health equity, global health initiatives, and various aspects of neurology, both in clinical practice and medical education. She is going to apply for a neurology residency program this year. Outside of work, she spends time playing piano, jogging along trails, and listening to music.
Valeria Roldan
@valeroldan23
Valeria Roldan was born and raised in Lima, Peru. She recently graduated medical school at Universidad Peruana Cayetano Heredia and is excited to pursue a career in Neurology. She is passionate about LGBTQ+ health, particularly advocating for trans rights, as well as medical education. She would describe herself as an optimist and outside of medicine you probably will find her running or talking about pop culture over a glass of wine.
Download CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/08/SLS-8-2024-RTP.mp3Episode description: Mukund presents a case of nausea, vomiting and syncope with many twists and turns to Valeria and Jas.
Featuring: Mukund RaguramJasdeep BajwaValeria RoldanSchemasSyncopeNausea and vomiting thought trainImage negative abdominal painDownload CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/08/CUS-4.mp3Débora, Tansu, and Jack discuss a case presented by Samy.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/08/8.8-Wdx-RTP.mp3To celebrate the new academic year, Kaylin and Sharmin sit down with Dr. Alice Mao to share a few memorable stories from their intern year. They reflect on tough days, lessons learned, power moves, and the importance of community. We hope these stories and reflections make you laugh, feel connected, and inspire you to take gentle care of yourself. Welcome to the profession—we are so excited to have you.Dr. Alice Mao is an internal medicine and geriatric medicine physician who is passionate about social equity, community empowerment, and innovations in primary care. She was born in China and grew up in Canada and the US. She completed medical school at UCSF, internal medicine residency at the University of Washington, and geriatric medicine fellowship at Stanford. She is currently a primary care provider at On Lok Program of All-Inclusive Care for the Elderly where she gets to take care of help vulnerable seniors stay home for as long as possible. Outside of medicine, she enjoys spending time with family and friends, giving her cat cheek scratches, and resurrecting her childhood dreams of learning how to freestyle dance. Download CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/08/audio1778632667-1.mp3Episode description
Reza and Rabih discuss a fascinating case centered around the liver.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/07/ID-Episode-72224-8.25AM.mp3In this Infectious Disease Rafael Medina Subspecialty episode, Dr. Milee Nelson presents a case to Dr. John Huang & Dr. Varun Phadke of a man presenting with a rash and shortness of breath.
Session facilitator: Youssef Saklawi
The goal of this series is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.
Case Discussants: Dr. Varun Phadke is an infectious disease specialist at Emory.
Dr. John Huang is an infectious disease fellow at Emory.
Case Presenter: Dr. Milee Nelson is an internal medicine resident at Emory.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/07/RetiformPurpura_Final.mp3Sharmin, Jack, Maddy, and Youssef share their approach to retiform purpura as they discuss a case presented by Andrew Sanchez.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/07/CUS-3-Final-1.mp3Débora and Noah host Ravi discussing a case of silent jaundice presented by our dear Prof. Rez!
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https://clinicalproblemsolving.com/wp-content/uploads/2024/07/RLR-1.mp3Title – Anemia and odynophagia
Episode description
Reza and Rabih discuss these 2 findings and how they merge towards a clear answer.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/06/6.27.24-WDx-RTP-1.mp3Sharmin, Kaylin, and Jane interview Anu Gorukanti, MD and Laura Holford, RN MSN, the co-founders of Introspective Spaces. They discuss their journeys in healthcare and what motivated them to build an inclusive space to foster connection, cultivate contemplative practice, and empower women in healthcare through introspective and reflection.
Anu Gorukanti, MD is a public health advocate and pediatric hospitalist at a county hospital in Los Angeles, CA who is passionate about health equity and racial justice. She went to undergraduate and medical school at Saint Louis University and completed her residency at Stanford University. She is passionate about social justice and the role that reflection and contemplation play as building blocks for revolution (as inspired by many theologians, spiritual leaders, and activists before her). She strongly believes that understanding who you are, what you value, and where your values come from can lead to a meaningful and authentic life. In her perspective, social change should always honor and incorporate both the individual and systems-based approach.
Laura Holford, RN MSN, is an oncology certified nurse and public health nurse committed to working to reduce nursing burnout and moral distress, and the reassembly of responsibility and accountability in healthcare. Liberation theology led her to train as a masters prepared nurse at University of San Francisco. She works as a community health nurse in Sacramento, CA She has a background as a campus minister & was lay community pastor of an Christian Interfaith church and she enjoys nothing more than accompanying people on their healing, reflective, and spiritual paths. Like many mystics before her, she believes that contemplation and action cannot be separated and finds herself naturally helping others’ build reflective, imaginative, and spiritual practices to ground their action and work in the world.
Find out more at the links below:
https://www.introspectivespaces.com/
https://introspectivespaces.substack.com/
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https://clinicalproblemsolving.com/wp-content/uploads/2024/06/Nephro-VMR-June24-final.mp3In this Nephrology Rafael Medina Subspecialty episode, Dr. Maddie Abrams presents a case to Dr. Jai Radhakrishnan of a 28 year old woman presenting with headache and blurry vision.
Session facilitator: Şeyma Yıldırım
The goal of this session is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.
Case discussant: Dr. Jai Radhakrishnan is Professor of Medicine at Columbia University Medical Center in New York. He is the Director of Clinical Services of the Nephrology Division and co-director of the hypertension center of Columbia University. @jradnephro
Case presenter: Dr. Maddie Abrams is an Internal Medicine PGY-2 & an aspiring cardiologist at ColumbiaMed at NewYork-Presbyterian Hospital. She graduated from Zucker School of Medicine in 2022. @Maddie_Abrams
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https://clinicalproblemsolving.com/wp-content/uploads/2024/06/RLR-01.mp3Title – A Brain Mass
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Reza, Aaron and Rabih discuss a case of a patient with a brain mass
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https://clinicalproblemsolving.com/wp-content/uploads/2024/05/5.31.24-SLS-RTP.mp3Episode description:SLS team members Mukund, Jasdeep and Valeria discuss a case of a second-trimester primigravida with new headache.Featuring: Mukund RaguramJasdeep BajwaValeria RoldanSchemasSecondary HeadacheCSF Lymphocytic PleocytosisDownload CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/05/CUS-2-Final-1.mp3In this episode, the team from The CPSolvers Academy participated in a fantastic discussion. Nidhi presented a case to Mark, Noah, & Yazmin.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/05/5.16.24-WDx-RTP.mp3In this episode of WDx, Dr Nidhi Patel joins Jane, Kaylin, and Sharmin and presents a case of a 23 yr old woman with worsening dyspnea and orthopnea.
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Nidhi is a current CPSolvers Academy member and a PGY2 in internal medicine at Emory University. She grew up in South Florida and went to University of Miami for undergrad and for medical school. Clinically she is interested in prevention of atherosclerotic disease, cardiac imaging and women’s health in cardiology! In her free time, she loves to catch a morning sunrise, and loves being outdoors to try adventurous activities including white water rafting, kayaking, and fast roller coasters.
This case was recently presented by Nidhi on a VMR with Rabih and Reza. Check it out here!
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https://clinicalproblemsolving.com/wp-content/uploads/2024/05/SubspecialtyEpiosdeRheum_FINAL.mp3In this rheumatology Rafael Medina Subspecialty episode, Dr. Appledene Osbourne presents a case of polyarticular joint pain to Dr. Lianne Gensler.
Session facilitator: Maddy Conte
The goal of this series is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.
Case Discussant: Dr. Lianne Gensler is a rheumatologist and serves as director of the UCSF Ankylosing Spondylitis Clinic, which is dedicated to care for this inflammatory disease. Gensler’s primary research interest is the disease progression of axial spondyloarthritis (a category that includes ankylosing spondylitis).
Case Presenter: Dr. Appledene Osbourne is a current rheumatology fellow at UCSF.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/05/Sequence-01.mp3Title Progressive back pain
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Reza and Rabih discuss a case of a patient with back pain
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https://clinicalproblemsolving.com/wp-content/uploads/2024/05/SchemaEpisode_SplenicInfarct-FINAL.mp3Maddy, Jack, and Sharmin share their approach to focal splenic lesions and splenic infarcts as they discuss a case presented by Youssef.
Frameworks Discussed in Case:
Focal Splenic Lesion
Splenic Infarct
Splenic Infarct vs Abscess
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https://clinicalproblemsolving.com/wp-content/uploads/2024/04/editedneuropodcastRTPapril2024.mp3Episode 331: Neurology VMR – Headaches and loss of sensation in the left leg
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Hans presents a case of headaches and loss of sensation in the left leg to Andrew and Maria.
Neurology DDx Schema
Hans Kaus
Hans Kaus received his MD from Ross University School of Medicine. He completed his undergraduate education in Pharmacy at the University of Tübingen, Germany. Driven by a deep desire to understand patient concerns, Hans wanted to go beyond pharmaceutical care. While in medical school, the virtual morning reports, Clinical Problem Solvers, unleashed his passion for solving complex patient cases. The blend of medicine and pharmacy will markedly benefit patients. In his spare time, Hans enjoys embarking on long bicycle rides.
Andrew Sanchez
@ASanchez_PS
Andrew Sanchez is an exiting PGY-3 in internal medicine at Yale New Haven Hospital: he will soon be starting a career in academic hospital medicine at Beth Israel Deaconess Medical Center, Boston. Meeting hospitalized patients and working with them to achieve diagnostic clarity is his primary clinical passion. His interest in diagnosing the undifferentiated patient is the driving force behind deep interest in learning and teaching diagnostic reasoning. On X/Twitter – which he considers the centerpiece of his teaching portfolio – he is known for creating and sharing schemas for both common and uncommon clinical dilemmas, which are frequently accompanied by “Tweetorial” commentary, as well as diagnostic case challenges.
María Jimena Alemán
@MariaMjaleman
María Jimena Alemán was born and raised in Guatemala. After suffering from long-standing neurophobia, she has embraced her love for neurology and will soon be starting her neurology residency at the University of California San Francisco. She looks forward to dedicating her life to improving neurological care and education around the globe. Maria loves art and culture and is currently obsessed with textiles and flowers
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https://clinicalproblemsolving.com/wp-content/uploads/2024/04/SLS-4_18_2024-JasValeMukund-RTP.mp3Our new members of the Spaced Learning Series team, Jasdeep and Mukund, join Valeria to discuss a case of progressive rash.
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Valeria Roldan
Jasdeep Bajwa
Mukund Raguram
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Fever and Rash
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https://clinicalproblemsolving.com/wp-content/uploads/2024/04/SLS-4_18_2024-AnnaPriyankaKirtan-RTP.mp3The Spaced Learning Series discuss a fascinating new case of a patient found down.
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Anna Fretz
Priyanka Athavale
Kirtan Patolia
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Hyperkalemia
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https://clinicalproblemsolving.com/wp-content/uploads/2024/04/ClinicalUnknownRec1.mp3Débora and Noah bring back the Clinical Unknown Series!
To kick off the first episode, we host Alec and Austin, who discuss a case presented by Laure. Embark on this diagnostic journey with us!
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https://clinicalproblemsolving.com/wp-content/uploads/2024/04/04.04.24-WDx-RTP.mp3In honor of Women’s History month in the United States, Sharmin, Kaylin, and Jane discuss the Matilda Effect, the current state of gender inequality, and reflect on some of the many incredible women scientists that came before us and helped pave the way for a better future.
For more on the topics discussed, check out:
Women Scientists Were Written Out of History. It’s Margaret Rossiter’s Lifelong Mission to Fix ThatWhat Rosalind Franklin truly contributed to the discovery of DNA’s structureWomen are credited less in science than menThe Diversity–Innovation Paradox in ScienceHer work paved the way for blockbuster obesity drugs. Now, she’s fighting for recognitionCelebrating 10 women medical pioneersCuriosity by Dr Faith FitzgeraldDownload CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2024/03/RLR-for-main.mp3Episode description
Reza and Rabih discuss a case of a patient with whole body pain
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https://clinicalproblemsolving.com/wp-content/uploads/2024/03/32124-Schema-Episode-.mp3In this clinical reasoning Rafael Medina Subspecialty episode, Dr. Mark Heslin presents a case to Dr. Tony Breuof a man presenting with facial swelling.
Session facilitator: Youssef Saklawi
The goal of this series is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.
Case Discussant: Anthony C. Breu, MD is the Director of Resident Education at the Veterans Affairs Boston Healthcare System and an Assistant Professor of Medicine at Harvard Medical School. He is also core faculty at the Center for Bioethics at Harvard Medical School. He completed his undergraduate degree in biomedical ethics at Brown University, where he also received his medical degree.
Case Presenter: Mark Heslin is a third-year internal medicine resident at the University of Pennsylvania. This summer, he will be starting his career as an academic hospitalist at Stanford. His clinical interests include medical education, clinical reasoning, diagnostic error, and the use of innovative technology to disseminate the teaching of clinical reasoning.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/03/SchemaEp_JointPain-RTP.mp3Sharmin, Jack, and Youssef discuss their approach to joint pain as they reason through a case presented by Maddy.
Monoarticular Arthritis Framework
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https://clinicalproblemsolving.com/wp-content/uploads/2024/03/RTPfinaleditedMarch2024Neuro-Audio.mp3Episode title: Episode 323: Neurology VMR – Visual hallucinations
Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Valeria presents a case of visual hallucinations to Greg and Umbish.
Neurology DDx Schema
Valeria Roldan
@valeroldan23
Valeria Roldan was born and raised in Lima, Peru. She recently graduated medical school at Universidad Peruana Cayetano Heredia and is excited to pursue a career in Neurology. She is passionate about LGBTQ+ health, particularly advocating for trans rights, as well as medical education. She would describe herself as an optimist and outside of medicine you probably will find her running or talking about pop culture over a glass of wine
Gregory I. Atafo
Dr. Atafo is a general physician currently practicing in Accra, Ghana. He attended undergrad at the University of Benin, Nigeria where he received his degree as a Doctor of Optometry. He then attended the University of Ghana for his medical degree. He is currently applying for residency in the United States and has interests in Neuroscience, Internal Medicine and Global health.
In his free time, Greg loves to play soccer, volunteer at medical outreach programs and is passionate about sharing medical knowledge across borders.
Umbish Dino
@UmbishD
Umbish Dino, born in New York but raised in Pakistan, embodies a blend of cultures that enrich her perspective both personally and professionally. Having lived and worked in both the United States and Pakistan, she’s set to bring her diverse experiences back to the U.S. as she embarks on her journey into the 2024 internal medicine residency match. Outside the hospital, she is a devoted mom to her four-year-old son, Rayyan, and two cats, Drogo and Luna. She is a talented singer, and a culinary enthusiast who finds joy in cooking. Her passion for clinical reasoning has drawn her to the CP Solvers Academy, where she engages with complex medical cases, reflecting her commitment to excellence in patient care and her zeal for continuous learning.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/03/Episode-24-ARM-CPS-w-post-prod.mp3CPSolvers: Anti-Racism in Medicine Series
Episode 24 – Leveraging Narrative Medicine to Cultivate Antiracist Praxis
Show Notes by Sudarshan Krishnamurthy
February 13, 2024
Summary: This episode highlights the ways in which we might leverage stories, at the individual and structural levels, to reimagine medicine with a liberatory practice. During this episode, we hear from Zahra Khan, an educator and editor who has written extensively on abolition in medicine, and Dr. Sayantani DasGupta, a physician-educator, prolific children’s book author and faculty at the Center for the Study of Ethnicity and Race and the Institute for Comparative Literature and Society at Columbia University. Together, our guests offer context around how the medical and carceral systems are deeply intertwined and go hand-in-hand. Further, they expand on this to discuss how we might use stories in the form of visionary and speculative fiction to reimagine new landscapes of health care. This discussion is hosted by Sudarshan Krishnamurthy and Ashley Cooper. The show notes for this episode were written by Sudarshan Krishnamurthy.
Episode Learning Objectives
After listening to this episode, learners will be able to:
- Illustrate the relationship between narrative medicine and healing relationships.
- Explain the significance of abolition medicine, and the role of the medical system in upholding and perpetuating carceral logics.
- Discuss how we might use narrative and stories to enact social change and reimagine medicine.
Credits
- Written and produced by: Sudarshan Krishnamurthy, Ashley Cooper, Team
- Hosts: Sudarshan Krishnamurthy and Ashley Cooper
- Infographic: Creative Edge Design
- Audio Edits: Ashley Cooper
- Show Notes: Sudarshan Krishnamurthy
- Guests: Dr. Sayantani DasGupta, Zahra Khan
Time Stamps
00:00 Opening
00:45 Introductions
01:03 Guest Introduction 1 – Zahra Khan
01:26 Guest Introduction 2 – Sayantani DasGupta
02:40 Background and Inspiration for Guests
13:45 Narrative Medicine in the Clinical Setting
23:45 Role of Narrative in Abolition Medicine
37:10 How does storytelling impact your clinical work and vice-versa?
42:00 Abolitionist reimaginings of Health
55:05 Democratizing Narrative Medicine
1:03:05 Closing Remarks and Clinical Pearls
Speaker biographies (Abbreviated)
- Zahra Khan is an educator and editor whose work emerges at the intersection of narrative, healing and disability justice, and liberation pedagogy. Her research, writing, and community engagement focuses on shifting consciousness in medical education toward abolitionist possibilities. Zahra enjoys facilitating spaces that cultivate critical consciousness, earnest reflection, and collective care. Her work has appeared in publications such as the Lancet, Journal of Medical Ethics, and AMA Journal of Ethics. She currently works with Project NIA, a nonprofit dedicated to ending youth incarceration, and teaches in the graduate program in Narrative Medicine at Columbia University and at CUNY School of Medicine.
- Sayantani DasGupta is a faculty member in the Master’s Program in Narrative Medicine, the Center for the Study of Ethnicity and Race and the Institute for Comparative Literature and Society, all at Columbia University. Originally trained in pediatrics and public health, her work has appeared in journals including The Lancet, JAMA, Pediatrics, The Hastings Center Report, Literature and Medicine, Teaching and Learning in Medicine, and The Journal of Medical Humanities. She is an associate editor of the journal Literature and Medicine, and her current interests are in issues of narrative humility in medical education and practice, racial justice and health, diaspora studies, and science fiction/health futurities. She is also a New York Times bestselling children’s author. Learn more about her work at www.sayantanidasgupta.com.
Episode Takeaways
- Origin Stories – Zahra encountered abolition for the first time at the ‘Beyond the Bars’ Conference, where she encountered students and community members from all backgrounds who were dedicated to ending mass incarceration. Here, she encountered Angela Davis, where she was encouraged to reimagine and build frameworks that center justice and do not reproduce oppression. She started in the Narrative Medicine program at Columbia around Sayantani, and wanted to focus on incarceration as a healthcare issue, and has since engaged in work that attempts to decarcerate health care. Sayantani became a physician since she thought it was a concrete tool for social justice. She came from an activist family, with her mother being one of the first South Asian feminist activists in the country. She grew up among stories of activist struggle and decolonial movements, and discovered a lot around the frameworks in medicine as she navigated her medical education. She discovered narrative medicine, and to her, it was about finding and retelling individual and structural stories in antiracist ways. Now, she teaches undergraduates and graduate students at the intersections of stories, social justice, and health. Part of her journey has been imagining how abolition and medicine go together, thinking through the carceral logics that have built medicine, and reimagining a new form of medicine with a liberatory practice.
- Role of Narrative Medicine in the Clinical Setting – Narrative Medicine is often called different things in different places; it is called health humanities in some places, to decenter the physician in the health care team, and Sayantani is a fan of this terminology. What the term gestures towards is the centering of the ‘story’ in healing relationships. However, it is important to think about individual stories within the broader historical and sociocultural context; for instance, you cannot highlight stories in individual physician-patient dyads, without discussing mechanisms of racialized, historical, or sociocultural power and other larger structural forces. Listening to individual stories within the context of their structural stories is important. Stories are not inherently just. It is important to be critical of stories, and we must train individuals to recognize stories that dehumanize groups of people and transform them into more just stories that humanize everyone.
- For instance, Toni Morrison’s “Home” depicts scenes of a community of Black women nursing a woman who has been the victim of medical racism and violence. It helps us understand Morrison’s critiques of anti-Black racism in medicine, and better understand care, restoration, and safety too. This helps people think about how people tend to each others’ well-being in their communities as well. It also helps illustrate the power of witnessing and mutual recognition, where there is a narrative exchange between patient and provider, with a validation of patients’ suffering. Apart from this, this also helps practitioners in improving their capacity to develop empathy for their patients, to be more curious about, and appreciate the complex context of those they care for.
- Narrative in Abolition Medicine: Zahra explains that structural competency is a framework that Jonathan Metzl and Helena Hansen offer to understand structural factors and barriers to care that perpetuate worse health outcomes like housing, food, and water as upstream factors that lead to worse health. Sayantani and Zahra (along with Yoshiko Iwai) have written about policing to be another one of these upstream factors that affect health, and offer ‘abolition medicine’ as a framework. Medicine often has a role in caring for those impacted by police brutality, and it should also have a role in creating new visions for violence prevention and reenvisioning healthcare without relying on carceral logics. It involves understanding stories and their relationships to power and structural oppression. Narrative medicine can offer us an imaginative space to create change. “Practicing New Worlds”, a book by Andrea Ritchie, talks about visionary fiction to help us look towards abolitionist futures, and can even help us reimagine new possibilities for health care. Sayantani expands on this to discuss the class she teaches on the relevance of visionary medicine, speculative fiction, and imagining an antiracist health system. Abolition Medicine itself involves recognizing and dismantling the carceral logics baked into medicine, and looking outside of medicine to see how we might reimagine these structures to improve health.
- How does storytelling impact your clinical work, and how does clinical work impact storytelling? – As a pediatrician, Sayantani shares that physical health, corporeal health, intellectual health, and imaginative health can be thought of as a part of the same praxis. Childrens’ fiction has always been about imagination, and it creates paths forward and gives young people the ability to imagine acts of justice within the storyteller’s own stories.
- Abolitionist reimaginings of health – Zahra talks about the piece she wrote with Yoshiko and Sayantani, and talks about how they wrote this piece in the backdrop of the American Medical Association recognizing systemic racism as a public health crisis, and acknowledging that police violence has severe health consequences. They realized that if policing and prisons are systems that require abolitionist reimaginings, health care does too. Ruth Wilson Gilmore, an abolitionist scholar and geographer, uses the term ‘organized abandonment’ to describe what happens when communities lose protections from the state through systems and structures that are involved in disinvestment from communities, leading to these communities being more vulnerable to increased criminalization and police presence, and resulting in these communities lacking safe and just infrastructure in the form of housing options, lack of access to clean and safe water, transportation, etc. For instance, the presence of police and ICE officials in health care settings, along with the use of restraints, are examples of the ways policing has permeated medicine as well. And we have examples of mutual aid networks and organizations that worked to improve care in the setting of organized abandonment; some of these include the Black Panther Party providing free healthcare in communities, and the Puerto Rican activist organization ‘The Young Lords’ ensuring their community receives tuberculosis screenings. There are also more contemporary organizations doing this work; Zahra works with Mental Health First, organized by the Anti Police-Terror Project, a multiracial, intergenerational, mobile, crisis-intervention team led by mental health officials to provide life-affirming treatment and deescalation assistance, without having to rely on law enforcement. This offers a framework for abolitionist and non-carceral solutions that can be implemented around the world.
- Sayantani shares that the medical system and carceral system work hand-in-hand and it is not possible to decarcerate medicine or practice antiracism in medicine without acknowledging the carceral logics that permeate medicine and that the medical industrial complex is a part of the carceral system. This is a prerequisite to dismantling oppressive systems within medicine.
- Democratizing Narrative Medicine – Zahra says that one of the loudest aspects of narrative medicine that is most powerful is using ‘story’, staying with narratives, and close reading and listening of story. Democratizing narrative medicine is also a matter of breaking open institutions to make knowledge and information more accessible to the public. Zahra also expresses hope around the spread of narrative medicine to the mainstream, and thinks that it might help more people organize around the story. However, institutions are only one place where actions happen, and actions within the institution often remain within the institution. So, it is important to consider how we might use narrative to advance social justice outside of institutions and in the world. Sayantani adds that there is a reason that certain voices are kept away from the fore, and that there are structural forces that are doing so intentionally. For instance, book bans around the country exist because states recognize the radical power of ‘story’ and it is the reason that they attempt to suppress the spread of these stories. Stories are imaginative playgrounds for social change. She even adds that she prescribes reading in a clinical setting, both for the parent to the child and by the child themselves. It is also important to recognize that teachers and librarians that attempt to get banned stories in the hands of their students are also engaged in this work of democratizing narrative medicine.
Pearls
- Zahra says that there are so many resources that help us practice and imagine new futures now, and shares with listeners these resources. One of these include Interrupting Criminalization – Beyond Do No Harm is one network of U.S. based health practitioners, advocates, nurses, community members, educators, social workers, and others who are working across racial, gender, reproductive, migrant and disability justice, drug policy, sex worker, and anti-HIV criminalization movements. Another is an Interrupting Criminalization podcast called One Million Experiments, that shares projects that are happening all over the country that build transformative solutions to safety without relying on police and prisons. Another thing Zahra mentions is that we must all be cartographers in mapping out new possibilities of an antiracist health care that satisfies all of us. As Mariame Kaba says, this is an opportunity to shrink the space between our values and our actions, and this is a collaborative and collective project where she invites everyone to think about their role in advancing health and justice.
- Sayantani encourages listeners of this podcast not to feel overwhelmed. So many times, we take care of others’ needs better than our own, and there is a sense of exhaustion, frustration, and anger that many face from medical training. We must strive to change the violent carceral logics that medical training and education inculcates, and also remember that we do not have to do everything alone and that we are not alone in this work. Rather than viewing it as one more thing to do, it is easier to become learners again, where we view antiracism as a new philosophy of living, learning, and working, and just taking it one step at a time.
References
Dasgupta, S. (n.d.). GU4340: Visionary Medicine: Racial Justice, Health and Speculative Fictions. Science and Society – Columbia University. https://scienceandsociety.columbia.edu/content/gu4340-visionary-medicine-racial-justice-health-and-speculative-fictions-s-dasgupta
Iwai Y, Khan ZH, DasGupta S. Abolition medicine. Lancet. 2020 Jul 18;396(10245):158-159. doi: 10.1016/S0140-6736(20)31566-X. PMID: 32682471; PMCID: PMC7365639.
Narvaez, A. (1970, June 18). THE young lords seize x‐ray unit. The New York Times. https://www.nytimes.com/1970/06/18/archives/the-young-lords-seize-xray-unit-take-it-to-area-where-they-say-it.html
Interrupting criminalization: Research in action. Interrupting Criminalization | Research In Action. (n.d.). https://www.interruptingcriminalization.com/
Beyond the Bars Conference 2023: Seeding Justice. (n.d.). New York City. https://centerforjustice.columbia.edu/events/beyond-bars-conference-2023-seeding-justice
Metzl JM, Hansen H. Structural competency: theorizing a new medical engagement with stigma and inequality. Soc Sci Med. 2014 Feb;103:126-133. doi: 10.1016/j.socscimed.2013.06.032. PMID: 24507917; PMCID: PMC4269606.
Khan Z, Iwai Y, DasGupta S. Military metaphors and pandemic propaganda: unmasking the betrayal of ‘Healthcare Heroes’. Journal of Medical Ethics. 2021;47:643-644.
Khan ZH, Iwai Y, DasGupta S. Abolitionist Reimaginings of Health. AMA J Ethics. 2022 Mar 1;24(3):E239-246. doi: 10.1001/amajethics.2022.239. PMID: 35325526.
Ritchie, Andrea J. Gumbs, Alexis Pauline. Brown, Adrienne Maree. (2023). Practicing new worlds: Abolition and emergent strategies. Consortium Book Sales & Dist.
DuBois, W. E. B. (1920). The Comet. http://zacharyrawe.com/sem_6_the_comet_dubois.pdf
Nelson, A. (2013). Body and soul: The black panther party and the fight against medical discrimination. University of Minnesota Press.
Beyond do no harm – interrupting criminalization: Research in action. Interrupting Criminalization | Research In Action. (n.d.-a). https://www.interruptingcriminalization.com/beyond-do-no-harm
Disclosures
The hosts and guests report no relevant financial disclosures.
Citation
Khan Z, DasGupta S, Krishnamurthy S, Cooper A, Siddiqui H, Calac A, Pitre A, Pierce G, Essien UR, Fields NF, Lopez-Carmen V, Nolen L, Onuoha C, Watkins A, Williams J, Tsai J, Ogunwole M, Khazanchi R. “Leveraging Narrative Medicine to Cultivate Antiracist Praxis.” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. February 13, 2024.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/02/SLS-2_29_24-RTP_2.mp3Episode description:SLS team members Priyanka, Kirtan and Anna discuss a case of progressive renal dysfunction in a patient with recent weight loss, peripheral eosinophilia and organomegalyFeaturing: Anna FretzKirtan PatoliaPriyanka AthavaleSchemas
AKI
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https://clinicalproblemsolving.com/wp-content/uploads/2024/02/2.15.14-Wdx-RTP.mp3Sharmin and Kaylin sit down with Dr. Denise Davis to discuss communication as a procedure, continuous and incremental improvement, and the interrelationship between social and health justice
Denise L. Davis is a general internist and Clinical Professor of Medicine at University of California San Francisco. She serves as Associate Director for Faculty Development for the SanFrancisco VA Center of Excellence in Primary Care Education. Dr.Davis teaches locally and nationally on a range of topics, including teaching and coaching students, trainees and physicians in communication skills that increase quality, safety and improve patient experience. She is on the Executive Committee of the Academy on Communication in Healthcare and serves as VP of Diversity, Equity and Inclusion. She is also a specialist for minority medical students at UCSF School of Medicine. Dr. Denise Davis is a recipient of many awards, includingthe prestigious Kaiser Foundation Award for Excellence in Teaching and she was elected to the UCSF Academy of Medical Educators in 2015.
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https://clinicalproblemsolving.com/wp-content/uploads/2024/02/RLR-Fatigue.mp3Episode description
Reza and Rabih discuss a case of a patient with profound fatigue
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https://clinicalproblemsolving.com/wp-content/uploads/2024/01/Rheuma-VMR-edited.mp3In this Rheumatology Rafael Medina Subspecialty episode, Dr. John Landefeld presents a case to Dr. Sarah Goglin of a 74 year old woman presenting with headache.
Session facilitator: Şeyma Yıldırım
The goal of this session is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.
Case discussant: Dr. Sarah Goglin is a rheumatologist and associate director at Zuckerberg San Francisco General Rheumatology clinic and at the UCSF Vasculitis Clinic. @SarahGoglinMD
Case presenter: Dr. John Landefeld is an internist and medical educator at Sacramento County Public Health & an assistant Clinical Professor at UC Davis Health. @johnlandefeld
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https://clinicalproblemsolving.com/wp-content/uploads/2024/01/RTP_EditedNeuroPodcastJanuary2024.mp3Episode title: Episode 317: Neurology VMR – Generalized weakness
Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Kirtan presents a case of generalized weakness to Vivek and Hannah.
Neurology DDx Schema
Kirtan Patolia
@KirtanPatolia
Kirtan Patolia is a second-year Internal Medicine resident from John H. Stroger Jr., Hospital of Cook County, Chicago. He relishes being the CPSolvers team member, as solving cases and generating differential diagnoses are his biggest passions. You will frequently find him sharing clinical cases on VMR. Outside of medicine, he likes to read fiction, particularly Agatha Christie and Nancy Drew novels. He also loves kite flying, especially using various techniques and maneuvers to fly the kites.
Vivek Paul
@vjpaul88
Vivek Paul is a medical graduate from Bharati Vidyapeeth University in Pune (India), now based in Chicago, Illinois. Having worked as a junior doctor in India after completing medical school, Vivek has more recently been involved in clinical research at Northwestern University Feinberg School of Medicine and is working towards a residency in Internal Medicine. He is also an avid musician with a Spotify account where he releases songs he has written through the years. When not working, Vivek can be found making loud and angry music, playing tennis, exploring local food joints, or on long walks with his dog, Melody.
Hannah Roberts
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https://clinicalproblemsolving.com/wp-content/uploads/2024/01/1.10.24-Reboot-dissecting-the-learning-process.mp3New Year, old episode! Rabih and Reza reveal all of the math and magic behind becoming better learners.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/12/SchemaEp_Diverticulitis_FINAL.mp3Ann-Marie, Sharmin, and Maddy discusses their approaches to diverticulitis complications as they talk through a case presented by Jack.
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Reza and Rabih discuss a case of a patient with flank pain and systemic features
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https://clinicalproblemsolving.com/wp-content/uploads/2023/12/SubspecialtyHepatology_12.7.23_FINAL.mp3In this Hepatology Rafael Medina Subspecialty episode, Dr. Christopher Coe presents a case to Dr. Arpan Patel of a woman presenting with fatigue and splenomegaly.
Session facilitator: Maddy Conte
The goal of this series is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.
Case Discussant: Dr. Arpan Patel is a hepatologist and researcher at UCLA. @ArpanPatelMD
Case Presenter: Dr. Christopher Coe is Chief GI fellow at UCLA. @CCoeMD
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https://clinicalproblemsolving.com/wp-content/uploads/2023/11/editedNeuroVMRnovember2023frequentstumbling.mp3Episode title: Episode 312: Neurology VMR – Frequent stumbling
Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Valeria presents a case of frequent stumbling to Nilayan and Subhangi.
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Valeria Roldan
Valeria is a medical student at Universidad Peruana Cayetano Heredia. She was born and lives in Lima, Perú. She hopes to pursue Neurology residency. Her interests include neuro-infectious diseases, transgender health and medical education. Her work with CPSolvers involves being a part of the Virtual Morning Report team and serving on the Spanish schemas team. Outside of Medicine she loves running, hiking, cooking pasta and spending time with her dogs.
Nilayan Sarkar
@nilayansarkar
Nilayan is a first year Internal Medicine Resident at Lady Hardinge Medical College in New Delhi, India. He has been an avid fan of the CPSolvers since his third year of medical school. Clinically, his interests include Point of Care Ultrasound (POCUS), Critical Care, Cardiology and Medical Reasoning. Outside of work, Nilayan enjoys quiet evening walks with his family, meditation, and nature jaunts. He hopes this episode brings you as much joy as it did to him and believes Dr. Aaron Berkowitz is the best thing that has ever happened to #beatingNeurophobia.
Subhangi Chandan
https://clinicalproblemsolving.com/meeting-join-live/
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https://clinicalproblemsolving.com/wp-content/uploads/2023/11/11.23.23-SLS_RTP.mp3Episode description:The spaced learning series team discusses a case of severe hypercalcemia, seizure, and vision loss.Featuring: Simone Vais
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https://clinicalproblemsolving.com/wp-content/uploads/2023/11/WDx-11.9.23-RTP.mp3Sharmin, Kaylin, and Jane are joined by Dr. Risheen Reejhsinghani, cardiologist extraordinaire, Clinical Associate Professor at Stanford, and Associate Program Director of the cardiology fellowship. They discuss her journey through medical training as an international medical graduate, how her love for cardiology developed, and how her career has evolved to allow her to combine her passions for medical education and mentoring into her daily work.Dr. Risheen Reejhsinghani is a Clinical Associate Professor in the Division of CardiovascularMedicine at Stanford. She was born in Mumbai, India, where she attended medical college, after spending her early school years in Sydney, Australia. Risheen moved to Boston for residency atSt. Elizabeth’s Medical Center and completed a cardiology fellowship at Baystate Medical Center, the western campus of Tufts University. She then completed an advanced echocardiography fellowship at the University of California, San Francisco.During fellowship, under combined cardiology and rheumatology mentorship, Risheen developed a clinical focus in cardio-rheumatology. This led to the creation of the StanfordCardio-Rheumatology Program, to provide specialized care to patients with cardiac pathology as a direct consequence of autoimmune disease. Risheen cares deeply about medical education and mentorship, and is an Associate Program Director for the CardiovascularMedicine Fellowship, where working closely with fellows is the absolute best part of her role. In the School of Medicine, she serves as an Associate Course Director for the pre-clerkshipPractice of Medicine Course, and is faculty co-lead for the cardiopulmonary block. Her scholarly work addresses curricular interventions and novel methods of teaching to improve education delivery, with the ultimate goal of increasing global access to education for medical trainees.Outside of medicine, Risheen enjoys writing and used to freelance for a newspaper in India.Along with her husband, she tries to travel as frequently as possible and loves learning about local cultures and traditions in the US and internationally. An ardent enthusiast of the alternative rock scene, Risheen has been an unwavering fan of the band Nirvana since well before she could read an EKG. Download CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2023/11/CPSolvers-Episode-23_-Anti-Fat-Bias-FINAL-Post-Auphonics.mp3CPSolvers: Anti-Racism in Medicine Series
Episode 23 – Anti-Blackness, Anti-Fatness, and Food Shaming
Show Notes by Humza A. Siddiqui
October 31, 2023
Summary: This episode highlights the culture of food shaming and anti-fatness as it relates to anti-Blackness. During this episode, we hear from Da’Shaun L. Harrison, a community organizer and trans theorist, and Dr. Psyche A. Williams-Forson, an author and chair of the Department of American Studies at the University of Maryland. Together, our guests offer context around the history of anti-Blackness and how it is deeply intertwined with the culture around eating in America as well as the way anti-fatness manifests. Further, they expand on this to discuss how it relates to policing and the court systems in the U.S. This discussion is hosted by Sudarshan Krishnamurthy and Ashley Cooper. The show notes for this episode were written by Humza A. Siddiqui.
Episode Learning Objectives
After listening to this episode, learners will be able to
- Explain how anti-fatness and food shaming culture in the U.S. is rooted in anti-Blackness.
- Describe the intersection of policing and the court systems with anti-fatness and food shaming.
- Identify ways to navigate clinical interactions with patients while respecting them and affirming their experiences with food and fatness.
Credits
- Written and produced by: Sudarshan Krishnamurthy, Ashley Cooper, Team
- Hosts: Sudarshan Krishnamurthy and Ashley Cooper
- Infographic: Creative Edge Design
- Audio Edits: Ashley Cooper and Noah Nakajima
- Show Notes: Humza A. Siddiqui
- Guests: Dr. Psyche A. Williams-Forson, Da’Shaun L. Harrison
Time Stamps
00:00 Opening
00:45 Introductions
03:07 Guest Introduction 1
04:46 Guest Introduction 2
08:15 On the Intersection of Black, Fat, and Trans Communities and the Medical-Industrial Complex
13:35 History and the Racial Underpinnings of Food Shaming in the U.S. Landscape
21:48 Policing, the Court Systems, Anti-Blackness, and Anti-fatness
46:45: Language Matters: The War On Obesity
1:02:09 On Caring For Black, Fat, and Trans Patients
1:15:37 Fatness is Not Killing People and Other Pearls
1:21:25 Closing Remarks
Speaker biographies (Abbreviated)
- Dr. Psyche Williams-Forson is a Professor and Chair of the Department of American Studies at the University of Maryland College Park. She is the author of two award winning books: Eating While Black: Food Shaming and Race in America (James Beard Foundation) and Building Houses Out of Chicken Legs: Black Women, Food, and Power (American Folklore Society); as well as the co-edited Taking Food Public: Redefining Foodways in a Changing Food World. Her work can also be found in several other publications and on podcasts and documentaries. Dr. Williams-Forson received her BA from the University of Virginia and her MA and PhD in American Studies from the University of Maryland.
- Da’Shaun Harrison is a trans theorist and Southern-born and bred abolitionist in Atlanta, Georgia. They are the author of Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness, which won the 2022 Lambda Literary Award for Transgender Nonfiction and several other media/literary honors. As an editor, movement media and narrative strategist, and storyteller, Harrison uses their extensive history as a community organizer—which began in 2014 during their first year at Morehouse College—to frame their political thought and cultural criticism. Through the lens of what Harrison calls “Black Fat Studies,” they lecture on blackness, fatness, gender, and their intersections. Harrison currently serves as Editor-at-Large at Scalawag Magazine, is a co-host of the podcast “Unsolicited: Fatties Talk Back,” and one third of the video podcast “In The Middle.” Between the years 2019 and 2021, Harrison served as Associate Editor—and later as Managing Editor—of Wear Your Voice Magazine.
Episode Takeaways
- Origin Stories – For Dr. Psyche A. Williams-Forson and Da’Shaun L. Harrison, the work that they do is deeply informed by the history of chattel slavery in the United States, through which eugenicists, white anthropologists, and racial realists created entire disorders to medicalize and bastardize enslaved folks who were interested in freedom. Natal alienation is, in part, the under-structure of the wider Medical-Industrial Complex and the gratuitous violence that fat, Black, trans folks experience. All of this contributes uniquely to social death.
- Soul Food – Food cultures are more complex, multilayered, and storied than Black stereotypes will lead even Black communities to believe. For this reason, labeling food in categories, and the moralizing that follows, can be extremely dangerous. A toxic cycle of disordered eating can emerge, and treatment for recovery can be rooted in anti-Blackness as physicians view the Black habitus as out of control, unruly, not in conformance with a wider racial project as described by Michael Omi and Howard Winant. The developing attitudes about food scarcity and deficit models, and mass media’s manufacturing consent, has to be challenged, especially because there is a deep and rich history of Black people as farmers, gardeners, and ranchers that belies what Chimamanda Ngozi Adichie calls the danger of a single story.
- Afterlife of Slavery – We are living in what Saidiya Hartman calls the Afterlife of Slavery, in where skewed life chances, limited access to health and education, premature death, and surveillance, incarceration, and impoverishment are overdetermined by slavery’s racial calculus. Da’Shaun L. Harrison explains the role of fatness in all of this and offers examples across medicine, law, and sociology that demonstrate fatness and Blackness cannot be divorced from each other. Dr. Williams-Forson expands on this history with respect to Black women, whose bodies are fetishized, and Black children, whose bodies are adultified, respectively. All of this contributes to various mental health challenges that are consistent with surveillance in not only a wider police-state but also the patient-physician relationship.
- The War on Obesity – We cannot make recommendations to our Black and Brown patients about diet and exercise without acknowledging that white supremacy is statistically more likely to kill Black and Brown patients than obesity. The conditions through which the United States’ socio-politico-economic apparatus is maintained, and the cultural mores that we encourage as a society, make it difficult for Black and Brown patients to eat a healthy diet or move their bodies freely.
- Fatness is Not Killing Black People – Historically, what is killing Black people is a medical industry that is not primarily built to offer care and is otherwise disinterested in learning more about the experiences of Black bodies. Anti-obesity initiatives that aim to reduce weight and encourage healthy diet and exercise, while they may nudge choices on a population level and put pressure on corporations in their harmful advertising, may be reductive in their understanding of fatness as a function of obesity. Fat people can lead healthy lives, and we need to think about the structural issues that keep the populace from being healthy at all sizes. This demands teleological explanations and policy interventions. On one hand, we must not moralize food choices. On the other hand, we cannot let hyper-capitalism off the hook, especially those industries that target Black and Brown communities and seek to profit from the manufactured consent that lends itself to insecurities about weight loss or weight gain.
Pearls
- Respect cultural mores about diet and exercise. Acknowledge that Black and Brown patients understand their bodies at some level and what sustains them nutritionally. Be precise instead about the care we can offer beyond weight loss.
- Fatness is not killing Black people. However, consider that Black patients are navigating disordered eating as a function of moralizing their food choices under white supremacy and a standard of care that was created by eugenicists, white anthropologists, and racial realists that inappropriately value the heterosexual, cis-gender, white European male habitus.
References
Cox, J. (2020). Fat girls in Black bodies: creating communities of our own. North Atlantic Books.
Harrison, D. (2021). Belly of the Beast: the politics of anti-fatness as anti-blackness. North Atlantic Books.
Taylor, S. R. (2018). The body is not an apology: the power of radical self-love (First Edition). Berrett-Koehler Publishers.
Williams-Forson, P. A. (2022). Eating while Black: food shaming and race in America. The University of North Carolina Press.
Possley, M., & Armstrong, K. (1999, January 11). Part 2: The flip side of a fair trial. Chicago Tribune. https://www.chicagotribune.com/investigations/chi-020103trial2-story.html
Purkiss, A. (2017). “Beauty Secrets: Fight Fat”: Black Women’s Aesthetics, Exercise, and Fat Stigma, 1900–1930s. Journal of Women’s History, 29(2), 14–37. https://doi.org/10.1353/jowh.2017.0019
Waxman, O.B. (2022). “The White Supremacist Origins of Exercise, and 6 Other Surprising Facts About the History of U.S. Physical Fitness.” Time Magazine. https://time.com/6242949/exercise-industry-white-supremacy/
Harrison, D., Tovar, V. (2021, January 5). Fatphobia (& Foodphobia) is Anti-Blackness with Da’Shaun Harrison, Season 2, Episode 1. Rebel Eaters Club. https://podcasts.apple.com/us/podcast/fatphobia-foodphobia-is-anti-blackness-with-dashaun/id1495401238?i=1000504393373
Harrison, D., Young, R. (2023, September 21). Destruction w/ Da’Shaun Harrison. Episode 6. Weight for it. https://podcasts.apple.com/us/podcast/destruction-w-dashaun-harrison/id1686599391?i=1000628697389
Disclosures
The hosts and guests report no relevant financial disclosures.
Citation
Harrison DL, Williams-Forson P, Cooper A, Krishnamurthy S, Siddiqui H, Calac A, Pitre A, Pierce G, Essien UR, Fields NF, Lopez-Carmen V, Nolen L, Onuoha C, Watkins A, Williams J, Tsai J, Ogunwole M, Khazanchi R. “Anti-Blackness, Anti-Fatness, and Food Shaming” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. November 7, 2023.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/11/RLR-Mainpodcast.mp3Episode description
Reza and Rabih discuss a case of a young woman with a fever of 105
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https://clinicalproblemsolving.com/wp-content/uploads/2023/10/Episode-307.mp3In this Infectious Disease Rafael Medina Subspecialty Episode, Dr. Navila Sharif presents a case to Dr. Natasha Spottiswoode of a patient presenting for fevers and chills.
Session facilitator: Youssef Saklawi
The goal of this series is to provide greater access to subspecialty, primary care, and internal medicine-adjacent specialty education for learners worldwide. For those interested in participating as a case presenter or discussant (or to nominate an educator or attending), the nomination form is available here.
Case Discussant: Natasha Spottiswoode, MD, PHD
Natasha is a fellow in the Division of Infectious Diseases at the University of California, San Francisco. Her interests include the use of combined host-pathogen metagenomics to diagnose and treat critically ill patients, and the development of better treatments for patients with rare infectious syndromes. She also loves climbing, trail running and backcountry skiing.
Case Presenter: Navila Sharif, MD
Navila is a second year internal medicine resident at Emory University in Atlanta, GA. She is passionate about health equity and advocacy, and is interested in general hospital medicine and gastroenterology, with a keen interest in transplant hepatology. Outside of work, she enjoys exploring coffee shops, binging reality TV, and any hike with the promise of a view.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/10/SchemaEp10.19.23_RTP.mp3Sharmin, Jack, and Maddy discuss their approaches to severe acute liver injury, abdominal pain, and hyperferritinemia as they talk through a case presented by Ann-Marie.
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Severe Acute Liver Injury
Abdominal Pain
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https://clinicalproblemsolving.com/wp-content/uploads/2023/10/EditedEPISODEOctober-12-Neuro-VMR-_09.26_-Audio.mp3Episode 305: Neurology VMR – Shallow breathing
Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Vaness presents a case of shallow breathing to Maria and Sridhara.
Neurology DDx Schema
Vanessa Roque
Vanessa, a proud Filipino through and through, has dedicated herself to medicine. She has been serving her countrymen since earning her medical degree. Practicing in areas of limited resources, she has sharpened her clinical eye allowing her to realize her passion for neurology where localizing lesions is as intellectually stimulating and satisfying as a daily crossword puzzle. Her interests include cognitive neurology, vascular neurology, and neurocritical care. A true “jill of all trades”, she is always down for a new adventure. She has explored dance and theater, film and photography, various musical instruments, different languages, and swimming. At home, you are most likely to find her in the kitchen preparing your new favorite meal
Maria Jimena Aleman
@MariaMjaleman
María Jimena Alemán was born and raised in Guatemala where she currently works in community and rural health care. After suffering from long standing neurophobia, she has embraced her love for neurology and will pursue a career in this field. She looks forward to dedicating her life to breaking barriers for Latin women in medical fields and improving medical care in her country. Maria is one of the creators of a medical education podcast in Spanish called Intratecal. Her life probably has a soundtrack of a mix between Shakira and Ella Fitzgerald. Outside of medicine, she enjoys modern art, 21st century literature, and having hour-long conversations over a nice hot cup of coffee or tequila.
Sridhara Yaddanapudi
@syaddana_neuro
Sridhara is a board-certified internist, neurologist, vascular neurologist, and hypertension specialist. Currently, he holds the position of Clinical Assistant Professor at Thomas Jefferson University Hospital and serves as the Director of Neurology for Jefferson New Jersey.
As a medical professional, he is passionate about case-based learning, clinical reasoning, and teaching decision-making while avoiding the pitfalls of heuristics. His goal is to bridge the ever-growing gap between neurology and internal medicine, an area in which he has a keen interest.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/10/10.5.23-SLS-RTP_2.mp3Episode description:
The spaced learning series team discusses a case of a patient with hyperbilirubinemia secondary to acute alcoholic hepatitis, who then developed hypoxia and hemolysis.
Featuring: Anna Fretz
Priyanka Athavale
Kirtan PatoliaSchemas
HyperbilirubinemiaHypoxemiaHemolysisDownload CPSolvers App here
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https://clinicalproblemsolving.com/wp-content/uploads/2023/09/9.21.23-WDx-RTP.mp3Sharmin & Kaylin are joined by María Jimena Alemán, CPSolvers co-director of internal operations & future neurologist with a passion for global health. They discuss how her upbringing has informed & shaped her passions & values, how she got involved with CPSolvers, the growth that comes from being a leader, the power of community & good mentor-mentee relationships.
María Jimena Alemán was born and raised in Guatemala where she currently works in community and rural health care. After suffering from long-standing neurophobia, she has embraced her love for neurology and will pursue a career in this field. She looks forward to dedicating her life to breaking barriers for Latin women in the medical field and improving neurology care around the world. She loves being a part of The Clinical Problem Solvers where she serves as the co-director of internal operations alongside Madellena Conte. Her life soundtrack is a mix between Shakira and Ms. Lauryn Hill. Outside of medicine, she enjoys contemporary art, crossword puzzles, and having hour-long conversations over a nice hot cup of coffee or tequila.
Kaylin Nguyen is a non-invasive cardiologist with interests in medical education, women in medicine, and health disparities. She was born in Vietnam and grew up in Southern California. She completed medical school and Internal Medicine residency at UCSF. She then made her way down the peninsula to Palo Alto, where she completed cardiology fellowship at Stanford, serving as a chief fellow. She is super excited to be back in Los Angeles and to help care for the underserved community as a clinician-educator at Olive View-UCLA Medical Center. Outside of medicine, you can find her hiking with her dog, making (and eating) baked goods, and buying and neglecting plants*.
*Her plants are alive & well. We promise.
Episode description Reza and Rabih discuss a curious case of Anasarca Student discount https://www.rlrcpsolvers.com/student-discounts/ IMG discount Use coupon code RLRIMG at check out https://rlrcpsolvers.com/annual-plan
https://clinicalproblemsolving.com/wp-content/uploads/2023/09/GI-Subspecialty.mp3In this Gastroenterology Rafael Medina Subspecialty episode, Dr. Allyson Richardson presents a case to Dr. Ryan Flanagan of a 68 year old woman presenting with chronic diarrhea.
Session facilitator: Şeyma Yıldırım
The goal of this session is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.
Case discussant: Dr. Ryan Flanagan is a gastroenterologist and faculty member at the Brigham and Women’s Hospital and Instructor in Medicine at Harvard Medical School in Boston. He has a clinical focus on the inpatient GI consult service and is the Associate Program Director for the Gastroenterology Fellowship Program.
Case presenter: Dr. Allyson Richardson is a second year Gastroenterology/Hepatology fellow at Brigham and Women’s Hospital.
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Jack, AMK, and Maddy discuss their approaches to cytopenias and DVTs as they talk through a case presented by Sharmin. Frameworks: Pancytopenia Thrombocytopenia Download CPSolvers App here RLRCPSOLVERS
Episode 299: Neurology VMR – Clumsiness Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, María presents a case of clumsiness to Andrea and Sridhara. Neurology DDx Schema Maria Jimena Aleman @MariaMjaleman María Jimena Alemán was born and raised in Guatemala where she currently works in… Read More »Episode 299 – Neurology VMR – Clumsiness
Episode description: The spaced learning series team discusses a case of nausea, vomiting and right upper quadrant pain in a pregnant patient. Featuring: Simone Vais Moses Murdock Valeria Roldan
In this episode of WDx, Dr Casey Albin joins Kiara, Jane, & Sharmin to discuss a clinical unknown. Presented by Kiara, the case starts with the chief concern of difficulty recognizing family members. Casey Albin, MD is an Assistant Professor at Emory University School of Medicine where she is a member of the department of… Read More »Episode 297: WDx #24 – Clinical Unknown Discussion with Dr. Casey Albin
Episode description RR discuss a grounding case of chest pain Student discount https://www.rlrcpsolvers.com/student-discounts/ IMG discount Use coupon code RLRIMG at check out https://rlrcpsolvers.com/annual-plan
In this Infectious Disease Rafael Medina Subspecialty episode, Dr. Jorge Salazar presents a case to Dr. Monica Gandhi of a transgender woman with a recent diagnosis of HIV presenting with fatigue and weight loss. Session facilitator: Maddy Conte The goal of this series is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty… Read More »Episode 295: Rafael Medina Subspecialty Series – fatigue in patient living with HIV
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CPSolvers: Anti-Racism in Medicine Series Episode 22 – Live from SGIM 2023: Best of Antiracism Research at the Society of General Internal Medicine’s 2023 Annual Meeting Show Notes by Alec J. Calac June 22, 2023 Summary: This episode highlights a selection of antiracism research presentations at a live recording of the podcast at the… Read More »Episode 293 – Antiracism in Medicine Series – Episode 22 – Live from SGIM 2023: Best of Antiracism Research at the Society of General Internal Medicine’s 2023 Annual Meeting
Episode description RR discuss a grounding case of chest pain Student discount https://www.rlrcpsolvers.com/student-discounts/ IMG discount Use coupon code RLRIMG at check out https://rlrcpsolvers.com/annual-plan
Dr. Kimberly Manning and her father, Mr. William Draper, commemorate Juneteenth, the holiday that celebrates the day when all remaining enslaved Black Americas were freed in Galveston Texas, on June 19th, 1865, with this hour-long storytelling event.
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz.This time, Dr.Gabriela Pucci presents a case of right arm weakness to Promise and Ravi Download CPSolvers App hereRLRCPSOLVERS
Episode description: The spaced learning series team discusses a case of intermittent episodes of presyncope in a patient found to have hypoglycemia and polycythemia. Featuring: Anna FretzKirtan PatoliaPriyanka Athavale Schemas:SyncopeHypoglycemiaPolycythemia Download CPSolvers App here RLRCPSOLVERS
https://clinicalproblemsolving.com/wp-content/uploads/2023/05/WDx-05.25.23-RTP.mp3In this episode of WDx, Dr Rebecca Berger joins Kara, Jane, & Sharmin to discuss a clinical unknown. Presented by Kara, the case starts with a young woman presenting with chronic isolated thrombocytopenia.
Dr. Rebecca Berger
Rebecca is an academic hospitalist and assistant professor of medicine at Weil Cornell Medicine and New York Presbyterian Hospital. In addition to her clinical work, she serves as the Director of Patient Safety for Inpatient Services for the Department ofMedicine and teaches medical students and residents, including leading small groups with students on their medicine clerkships focused on clinical reasoning and diagnosis.Rebecca obtained her undergraduate degree from Stanford University in 2009, her medical degree from Columbia University Vagelos College of Physicians and Surgeons in 2013, and completed her internal medicine internship and residency training at Massachusetts General Hospital (MGH) in 2016. She served as a NEJM Editorial Fellow from 2016-2017 and worked as a hospitalist at MGH before moving to Cornell in 2018.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/05/RLR-56_One-life.-So-many-dreams.mp3RR dedicate this episode to our beloved Rafa Medina.
Rafa’s GoFundMe page.
https://clinicalproblemsolving.com/wp-content/uploads/2023/05/1stSubspecialtyPodcastEpWithIntro_PostAuphonic.mp3Maddy Conte and Seyma Yildirim introduce a new series on the podcast: “The Rafael Medina Subspecialty Series,” which will always be in loving memory of our dear friend and CPSolvers family member, Dr. Rafael Medina. Rafa presents a nephrology clinical unknown to Drs. Ashita Tolwani and Mustafa Muhammad.
The goal of this series is to expand access to subspecialty, primary care and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant, fill out this form here: https://forms.gle/RLbx6A2vELp6PTYp9
Case presenter and facilitator: Dr. Rafael Medina
Rafa was a Brazilian medical graduate who proudly shared on Twitter, “Son of a tailor and confectionary vendor born and raised in rural Brazil. And now incoming internal medicine resident at the University of Colorado. Never let anyone tell you that your dreams are too big for you!” He tragically passed away last week. He impacted the lives of so many and touched every corner of the CPSolvers community, and rippled far beyond. Rafa helped spearhead the subspecialty series; this series has been renamed after Rafa and will continue strong in his honor. Rafa, we love you.
Case discussants:
Dr. Ashita Tolwani, Professor of Medicine at the University of Alabama at Birmingham (UAB). She was the Nephrology Fellowship Training Program Director from 2004-2010 and is now the Associate Program Director. She is also the Director for ICU Nephrology at UAB. (Twitter: luck_urine)
Dr. Mustafa Noor Muhammad, nephrology fellow at the University of Alabama at Birmingham.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/05/CPSolvers-ARM-Episode-21-Audio.mp3CPSolvers: Antiracism in Medicine Series
Episode 21 – Psychosocial and Cultural Considerations for Providing Healthcare to Immigrant and Refugee Populations
Show Notes by Kiersten T. “Gillette” Gillette-Pierce
May 2, 2023
Summary: This episode highlights the psychosocial and cultural considerations for providing healthcare to immigrant and refugee populations. During this episode, we hear from Dr. Altaf Saadi, a neurologist who focuses on neuropsychiatric health disparities and addressing the needs of displaced populations at Mass General Hospital and Harvard Medical School, and Dr. Naweed Hayat, a child and adolescent psychiatry fellow at the University of California San Diego, who applies his own lived experience of resettlement to his clinical practice. Together, our guests explain how trauma shows up in those who experience resettlement, and the role of trauma-informed and culturally-responsive care for refugee, asylee, and immigrant population in clinical practice.. This discussion is hosted by Sudarshan Krishnamurthy, Ashley Cooper, and LaShyra Nolen.
Episode Learning Objectives
After listening to this episode, learners will be able to…
- Explain how the current state at the border is informed by historical immigration injustices.
- Describe how physiological and psychological trauma show up among immigrant and refugee populations as a result of the violence and injustices experienced during migration, at the border, during the resettlement process and across the lifecourse thereafter.
- Identify the role of trauma-informed, culturally-responsive care for refugee, asylee, and immigrant populations and how it can be operationalized in clinical practice.
Credits
- Written and produced by: Sudarshan Krishnamurthy, Ashley Cooper, LaShyra Nolen, Kiersten Gillette-Pierce, Rohan Khazanchi, MD, MPH, Dereck Paul, MD, Jazzmin Williams, Victor A. Lopez-Carmen MPH, Naomi F. Fields, Jennifer Tsai MD, MEd, Chioma Onuoha, Ayana Watkins, Michelle Ogunwole MD, Utibe R. Essien MD, MPH
- Hosts: Sudarshan Krishnamurthy; Ashley Cooper, and LaShyra Nolen
- Infographic: Creative Edge Design
- Audio Edits: Garrett Weskamp
- Show Notes: Gillette Pierce
- Guests: Dr. Altaf Saadi and Dr. Naweed Hayat
Time Stamps
0:28 Introduction
0:31 Episode introduction
1:15 Guest introductions
3:50 Origin stories
8:06 The current state of the border
18:13 Culturally competent and trauma-informed care
24:50 ICE and policing
36:28 Application of teachings
Episode Takeaways
- Origin Stories — For Dr. Hayat and Dr. Saadi, the work that they do is deeply informed by their lived experiences as migrants themselves as well as in their professional roles as clinicians who serve immigrant and refugee populations.
- State of the Border — Policies that happened under the Trump administration and now under the Biden administration have left people vulnerable to injustices in Mexico and other Central American nations. People are fleeing persecution, gang violence, and other violence such as sexual or other violent assaults and now they must also face the additional burden of the lack of access to basic necessities like food, water and shelter. A lot of compounding trauma occurs at the border that has potential downstream mental health implications for individuals and their families.
- Culturally Competent and Trauma-Informed Care — Interpersonal components such as screening for trauma exposure and providing resources to families are an important aspect of trauma-informed care, and it should also include efforts at the organization level to create sanctuary or immigrant-friendly spaces and implement immigration-informed care, which builds on the concept of trauma-informed care by honing in on the unique factors associated with immigrant populations, e.g. protocols for broaching sensitive topics like immigration status and policies to ensure people are safe from immigration enforcement.
- ICE and Policing — Instances of immigration enforcement in healthcare settings are rare, and when they do happen they can look like patients being interrogated at the bedside or even being arrested as they step out of the hospital just after visiting someone. These instances contribute to immense fear that can act as a deterrent from seeking care or engaging with any other helping professional institutions in the future–this goes for the individual(s) directly impacted and the people within their communities.
- Impact of Health Records — The impact of health records within the context of healthcare for immigrant populations is complex because migration status really should not be documented explicitly as it can open people up to harms such as stigma from providers or being turned over to law enforcement agencies who may cooperate with immigration enforcement. Many organizations, such as the American Medical Association Journal of Ethics, recommend against documenting immigration status in medical records.
- Application of teachings — It is advised to amplify the work that is already being done in communities and identify what areas at the systems level need to change as well as the key stakeholders.
Pearls
- Dr. Hayat discusses the five major waves of migration in the last fifty years, resulting from the Soviet-Afghan War, the Afghan Civil War, the Fall of the Taliban, August 2021 US and western forces departure, and how he grew up during the 1990s right after the collapse of the government. He recounts street fights in Kabul as well as an overall theme of people going back to a focus on survival, or the need for food, shelter, water and safety.
- Dr. Saadi discusses how her parents left Iraq under Saddam Hussein’s dictatorship, where he was targeting many Iraqis with Iranian ancestry and Shi’a Muslims–which included members of her family. She notes she was born in Iran and her family emigrated to Canada and then to the United States just a month before 9/11. She recounts this time as particularly tumultuous for not only Muslim Americans but also South Asian Americans, Sikh Americans, as well as Arab Americans who were not Muslims.
- Dr. Saadi highlights that the majority of immigrants do not come through the US-Mexico border, even for undocumented folks. Additionally, in the case of folks who are undocumented, it is likely the case that they attained this status as a result of overstaying their previously valid visa.
- Dr. Saadi discusses the Biden administration rule proposal that would essentially prohibit refugees from seeking asylum in the US, making them ineligible for asylee status.
- Dr. Saadi highlights that there needs to be a greater focus on the continuum of experiences when we discuss patients who are immigrants or forcibly displaced because there is not often a clear pre-post distinction. Many people’s journeys can involve being in an encampment, being detained in immigration prisons, or stopping in multiple countries before reaching the final destination.
- Dr. Saadi also uplifts the fact that while we focus primarily on those we have clinical encounters with, it is always important to mention that there are many people that did not make it to clinic for an amalgam of reasons — many people lost their lives in the quest for better lives and freedom from persecution.
- Dr. Hayat stresses the difference that cultural psychiatry, cultural competency, and the biopsychosocial model make in building rapport and there is a lot that goes on in between pre- and post-resettlement and those experiences have to be taken into account, especially in cases where there are language and cultural barriers. He highlighted the DSM-5 Cultural Formulation Interviews.
- Dr. Saadi recommends avoiding documentation of immigration status in medical records, or having clear guidelines on what to do if immigration enforcement is present at the clinical setting.
- Dr. Saadi notes that we must not see people as the sum of their traumas, they are so much more than that — especially in the case of forcibly displaced peoples and immigrants. We must not reduce people to their trauma exposure alone.
- Dr. Hayat interestingly mentions that some organizations have been able to build relationships with law enforcement, educate them, and share different challenges to help realize a common goal.
- Dr. Hayat notes that while organizations recommend against documenting immigration status in medical records, needs can still be met through partnerships with community organizations. Dr. Saadi adds that we can collect this data, and there is immense groundwork that must be done to develop protections for immigrant and refugee populations and ensure the data are protected.
- Dr. Saadi mentioned a toolkit around policies and actions that can be implemented at an organizational level that is publicly available at www.doctorsforimmigrants.com. She also mentions additional organizational-level policies and actions that can take place beyond what is mentioned in the toolkit such as setting up a medical legal partnership where people can connect to attorneys that can help them with their immigration case or civic engagement promotion. She also mentioned Dr. Mark Kuczewski’s sanctuary doctrine toolkit that focuses more on the individual level. Refer to Good Sanctuary Doctoring for Undocumented Patients for more information. Dr. Hayat mentioned his colleague, Dr. Olivia Shadid, who does work on mental health evaluations for asylum seekers, which can be found here.
References
- Morris JE, Saadi A. The Biden administration’s unfulfilled promise of humane border policies. Lancet. 2022 May 28;399(10340):2013. doi: 10.1016/S0140-6736(22)00741-3. Erratum in: Lancet. 2022 Jun 2;: PMID: 35644152.
- Saadi, A. Undark. Opinion: Covid-19 Shows Us Why We Should Keep ICE Out of Hospitals. https://undark.org/2020/03/25/covid-19-immigration-hospitals/
- Saadi. A. Boston Globe. The invasion of Ukraine reminds me of growing up in Iran. The trauma is lasting. https://www.bostonglobe.com/2022/03/16/magazine/invasion-ukraine-reminds-me-growing-up-iran-trauma-is-lasting/?outputType=amp
- Shi M, Stey A, Tatebe LC. Recognizing and Breaking the Cycle of Trauma and Violence Among Resettled Refugees. Curr Trauma Rep. 2021;7(4):83-91. doi: 10.1007/s40719-021-00217-x. Epub 2021 Nov 13. PMID: 34804764; PMCID: PMC8590436.
- Valtis Y, Okah E, Davila C, Krishnamurthy S, Essien UR, Calac A, Fields NF, Lopez-Carmen VA, Nolen L, Onuoha C, Watkins A, Williams J, Tsai J, Ogunwole M, Khazanchi R. “Episode 16: Live from SGIM: Best of Antiracism Research at the Society of General Internal Medicine’s 2022 Annual Meeting” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. May 3, 2022
- Berkman JM, Rosenthal JA, Saadi A. Carotid Physiology and Neck Restraints in Law Enforcement: Why Neurologists Need to Make Their Voices Heard. JAMA Neurol. 2021;78(3):267–268. doi:10.1001/jamaneurol.2020.4669
- James J, Heard-Garris N, Krishnamurthy S, Cooper A, Calac A, Watkins A, Onuoha C, Lopez-Carmen VA, Krishnamurthy S, Calac A, Nolen L, Williams J, Tsai J, Ogunwole M, Khazanchi R, Fields NF, Gillette-Pierce K. “Episode 18: Remedying Health Inequities Driven by the Carceral System” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. October 18, 2022.
- Chiesa V, Chiarenza A, Mosca D, Rechel B. Health records for migrants and refugees: A systematic review. Health Policy. 2019 Sep;123(9):888-900. doi: 10.1016/j.healthpol.2019.07.018. Epub 2019 Jul 30. PMID: 31439455.
Disclosures
The hosts and guests report no relevant financial disclosures.
Citation
Saadi A, Hayat N, Krishnamurthy S, Cooper, A, Nolen L, Gillette-Pierce K, Calac A, Essien UR, Fields NF, Lopez-Carmen VA, Onuoha C, Watkins A, Williams J, Tsai J, Ogunwole M, Khazanchi R. “Episode 21: Antiracist Healthcare for Immigrant and Refugee Populations ” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. April 25, 2023
Show Transcript
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https://clinicalproblemsolving.com/wp-content/uploads/2023/04/RLR.mp3RR recap a mystery case presented by Aaron.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/04/4.13.23-Neuro-VMR-RTP.mp3We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Dr. Ravi Singh presents a case of right arm weakness to Yazmin and Sridhara.
Neurology DDx Schema
Yazmin Heredia
@minheredia
Yazmin is a Mexican Graduate from the Universidad Autonoma de Yucatan. During her medical training, she developed a strong interest in Public Health, Medical Education, and Health Equity and is looking forward to pursuing a career in Internal Medicine. When she is not volunteering on a project, she likes taking care of her plants, developing her skills in the fine arts, or learning a new language.
Sridhara Yaddanapudi
@syaddana_neuro
Sridhara is a board-certified internist, neurologist, vascular neurologist, and hypertension specialist. Currently, he holds the position of Clinical Assistant Professor at Thomas Jefferson University Hospital and serves as the Director of Neurology for Jefferson New Jersey.
As a medical professional, he is passionate about case-based learning, clinical reasoning, and teaching decision-making while avoiding the pitfalls of heuristics. His goal is to bridge the ever-growing gap between neurology and internal medicine, an area in which he has a keen interest.
Ravi Singh
@rav7ks
Ravi (Ravitej) Singh is originally from Greenwich, London U.K where he grew up playing soccer and rugby. He attended medical school at University of Debrecen, Hungary and completed residency at Medstar Harbor Hospital in Baltimore. Currently he is an associate program director for Sinai Hospital IM residency program in Baltimore as well as a Hospitalist on the teaching service. He is a faculty member at the Johns Hopkins School of Medicine and takes time out of his schedule to run a series of case-based teaching sessions as well as medical simulation with all of the medical students that rotate at Sinai throughout the year. He is also a co-chair of the ACP Maryland IMG committee where he advocates for IMG issues Jo and highlights their contributions to the healthcare system
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https://clinicalproblemsolving.com/wp-content/uploads/2023/04/ARM-Ep20-Medical-Racism-and-Indigenous-Peoples.mp3CPSolvers: Anti-Racism in Medicine Series
Episode 20 – Medical Racism and Indigenous Peoples
Show Notes by Sudarshan (“Sud”) Krishnamurthy
April 4, 2023
Summary: This episode highlights the checkered past of medicine and the advancements in the field that have occurred at the expense of the humanity of Indigenous peoples. During this episode, we hear from Dr. Nav Persaud, a staff physician in the Department of Family and Community Medicine at St. Michael’s Hospital in Unity Health Toronto, and Dr. Alika Lafontaine, the current President of the Canadian Medical Association. Together, our guests explain how Indigenous knowledge systems are the foundation of modern medicine and also share strategies to promote truth and reconciliation with Indigenous Peoples in North America. This discussion is hosted by Alec Calac and Gillette Pierce.
Episode Learning Objectives
After listening to this episode, learners will be able to…
- Explain how the dark legacy of discrimination and deliberate oppression of Indigenous Peoples has led to present-day disparities across the world
- Describe how medicine has held some white men to high esteem, even when they harbored significant racist and sexist notions
- Identify the role of Indigenous knowledge systems in shaping much of modern medicine today, yet experiencing erasure from the mainstream
Credits
- Written and produced by: Alec J. Calac, Gillette Pierce, Sudarshan Krishnamurthy, Rohan Khazanchi, MD, MPH, Dereck Paul, MD, Jazzmin Williams, Victor A. Lopez-Carmen MPH, Ashley Cooper, Naomi F. Fields, LaShyra Nolen, Jennifer Tsai MD, MEd, Chioma Onuoha, Ayana Watkins, Michelle Ogunwole MD, Utibe R. Essien MD, MPH
- Hosts: Alec J. Calac and Gillette Pierce
- Infographic: Creative Edge Design
- Audio Edits: Caroline Cao
- Show Notes: Sudarshan (“Sud”) Krishnamurthy
- Guests: Dr. Nav Persaud and Dr. Alika Lafontaine
Time Stamps
0:00 Introduction
0:45 Episode Introduction
1:10 Guest Introductions
3:30 Existing global disparities among Indigenous Peoples
6:00 How access to medications are impacted among Indigenous Peoples in Canada
8:30 Framing around the Design of Structures in Canada to suppress Indigenous voices
13:30 Legacy of Osler and the importance of rediscovering forgotten dark histories
16:20 Dehumanization of individuals belonging to marginalized groups by the healthcare system
27:50 Modern medicine and its roots in Indigenous knowledge systems
31:30 Provision of healthcare to Indigenous Peoples in Canada
34:50 Alec’s own advocacy around renaming a campus parking garage
36:55 Weaponization of professionalism
45:00 Clinical takeaways and practical tools for clinician listeners
Episode Takeaways
- Indigenous communities around the world experience significant disparities in life expectancy, burden of disease, and socioeconomic status, due to deliberate exclusion of Indigenous Peoples from the mainstream and suppression of their voices in the design of the system.
- Within medicine, we tend to hold white men from history books in high esteem, often without recognizing the dark legacy that accompanied their lives. William Osler is one such example who, along with numerous other sexist and racist misconducts, took remains of Indigenous people with him as a gift to his mentor in Germany, that is still held by a German museum who refuses to return it.
- The dehumanization of individuals of color at the margins of society by the healthcare system is not simply a thing of the past, and is certainly a persistent phenomenon. Cindy Gladue, Brian Sinclair, and Joyce Echaquan are three Indigenous individuals who suffered immense harm at the hands of the healthcare system.
- There is strength in reconciling Indigenous history, and we must prevent further erasure of Indigenous knowledge systems. The solutions to these issues do not fall upon one community’s shoulders, but instead on the shoulders of all of us along with the oppressive systems that have led us here.
Pearls
- Alec begins by contextualizing this episode with the fact that although Indigenous people make up 6% of the global population, they compose 15% of the global population experiencing extreme poverty. Additionally, Indigenous communities experience lower life expectancy, higher burden of disease, and lower socioeconomic status compared to non-Indigenous Peoples. These disparities are likely attributable, in part, to the disruption of Indigenous knowledge systems, inadequate infrastructure, and poor identification of health data among these groups, rather than individual behavior. [Supplementary Resource for Listeners: CPSolvers Episode 12: Addressing Anti-Indigenous Racism in Medicine with team members Alec Calac and Victor Anthony Lopez-Carmen]
- Nav discusses that despite publicly funded healthcare systems in Canada and federal protections in place for certain Indigenous groups, Indigenous populations and other groups facing discrimination and historic oppression are much more likely to report not being able to take medications due to cost. Although healthcare services are publicly funded, access to medications depends on private or public insurance and is linked with employment. While some have the impression that there is a safety net in Canada for life-saving medications, Nav still sees patients in his practice who are harmed by the system and not able to afford life-saving medications, many of them Indigenous, and this is a violation of their right to access essential medicines.
- Alika expands on Nav’s framing by highlighting the three broad demographics in Canada: the Inuit, the Métis, and the First Nations. In contrast to settlers in the United States where “conquering” through deception was a priority, the spread of settlers was more so through the signing of agreements that were never lived up to. Indigenous peoples in Canada have deliberately been left out of the mainstream to ensure their voices were suppressed in the design of the system.
- Alika elaborates on the history of Indigenous populations in Canada and how they would conduct X-Rays on the Inuit children, and ship these kids away for 3 to 10 years if they found tuberculosis in the lungs, without even allowing the children to say goodbye to their parents. Alika recalls stories of individuals in Ottawa who were on the same floor for several years, only to realize that they were members of the same family after being placed in these TB sanatoriums and crossing paths there.
- Nav begins to discuss how Osler is still revered as one of the most prominent historical physicians in Canada and the United States. A colleague brought information to Nav that Osler had brought remains of Indigenous people as a gift to one of his mentors in Germany. This led him to look into Osler’s history a little further, and Nav found it easy to find other instances of racist and sexist misconduct by William Osler. These remains are still in a museum in Germany, with no plan of return to Indigenous communities. [Supplementary Resource for Listeners: Read Dr. Persaud’s initial article on Osler here]
- Osler lived in the time of Numbered Treaties and the North-West Rebellion under Louis Riel, when Indigenous rights were front and center. It is ridiculous to consider that a physician brought Indigenous remains with him as a gift during this period in history, when Osler knew Indigenous people were fighting for their rights and lives. So, we must rethink the esteem that we hold white men like Osler in, and rediscover the forgotten history that accompanies them. [Supplementary Resource for Listeners: You can read more about the North-West Rebellion here]
- Alika discusses the dehumanization of individuals of color and other identities who exist at the margins within the healthcare system and emphasizes that these are not phenomena of the past. He highlights the hostility within the healthcare system and how healthcare must be a service that is available equally to everybody, and not treated as a favor being done to individuals. He narrates the stories of Cindy Gladue, Brian Sinclair, and Joyce Echaquan, all of whom suffered immense harm at the hands of the healthcare system as Indigenous individuals. [Supplementary Resource for Listeners: You can read about Cindy Gladue, Brian Sinclair, and Joyce Echaquan here]
- Nav expands on this aspect of dehumanization of Indigenous peoples and speaks about how the Indigenous remains are being treated in Germany today. Although there is guidance that they must be returned, they have decided to retain them. In addition, there is writing within these skulls with numbers written on the inside, as if to catalog them. The museum has also added multiple barriers for those who wish to rightfully receive these remains, and has placed the onus on these communities for these remains to be returned.
- Alec importantly highlights that while these harms might seem historical and like things of the past, they have taken place within one or two generations and even today. He discusses his experiences as an Indigenous person in California who attends a medical school that begrudgingly decided to return Indigenous remains, from one of the largest collections in the world.
- Alika talks about strength in knowing his history. He discusses the medical knowledge of settlers in Canada believing in four humors and the practice of bloodletting to relieve sickness. At that time, Indigenous Peoples were harvesting plants at their peak potency and concentrating these plants in teas, and delivering medications through oral and transdermal routes. He talks about how Atropine, a commonly used drug by anesthesiologists like Alika, is derived from Belladonna and how folks practicing traditional medicine use Belladonna.
- Alika also delves deeper into the provision of healthcare to Indigenous peoples in Canada. He mentions that healthcare was provided to Indigenous peoples rooted in a charitable effort, rather than as a basic human right. It is important to move beyond being nice to each other, and begin to think about the requirements and obligations we have to each other as human beings.
- Alec goes on to highlight that as much as we have gained, we have much more to fight for. In episode 12, we discussed how the American Indian and Alaskan Native life expectancy as of 2021 was equivalent to that of the American public in the 1940s. The solution to these issues shouldn’t fall upon one or a few of our shoulders, but instead upon the shoulders of all of us along with the systems that have the resources and infrastructures to inform change.
- Alec used Nav’s article to advocate for the renaming of a parking garage on campus that was named after William Osler. Our spaces reflect our values, so the question he asked was why they had a parking garage named after an individual who has no relation to the local community in San Diego? We think about the legacy in medicine, but forget about the community we are in. [Supplementary Resource for Listeners: Read Alec’s Editorial about his advocacy related to renaming a street and parking structure in his medical school campus here.]
- Nav describes professionalism as a vague concept that is often used to oppress individuals from racialized and marginalized backgrounds. Professionalism is often antithetical to a rights-based approach to medicine, where every member of a team feels comfortable to speak up when everything is not right with a patient’s care and professionalism can scare people from speaking out when needed.
- Alika expands on this explanation of professionalism in terms of what is acceptable, decided by whoever is in control. It can be used to amplify what leaders think is important and suppress what leaders do not like, demonstrating the importance of leadership from diverse backgrounds and varied lived experiences. Retaliation can be severe to violations of professionalism, and it’s hard to know the effects of retaliation unless one has experienced these themselves. [Supplementary Resource for Listeners: Read about the experience Dr. Lafontaine describes regarding his own experience with reporting unprofessional and unacceptable conduct here]
- Nav states that it is important for us to reflect on what has happened and recollect all of the work people have done to chronicle anti-Indigenous racism. Racism is not new, and there have been numerous reports that document racism and anti-Indigenous discrimination over decades and centuries. We must respect what has happened, and recognize as non-Indigenous people that we benefit from advocacy and efforts of Indigenous peoples for Indigenous rights over generations.
- Alika emphasizes that the point of this conversation is not to make anyone feel like they are a bad person, but instead to help them acknowledge that in this healthcare system we provide both health and harm. Providing our patients with more space and ensuring our patients feel human again is a great first step. It is also important to remember that in the course of restructuring power, there are winners and losers and we may not all have the same voice around the table that we did before. We entered medicine to help people, and sometimes the best way to help people is by getting out of the way and allowing for others to step forward.
References
- Persaud N, Butts H, Berger P. William Osler: saint in a “White man’s dominion”. CMAJ. 2020;192(45):E1414-E1416. doi:10.1503/cmaj.201567
- Reid P, Cormack D, Paine SJ. Colonial histories, racism and health-The experience of Māori and Indigenous peoples. Public Health. 2019;172:119-124. doi:10.1016/j.puhe.2019.03.027
- Redvers N, Blondin B. Traditional Indigenous medicine in North America: A scoping review. PLoS One. 2020;15(8):e0237531. Published 2020 Aug 13. doi:10.1371/journal.pone.0237531
- Fredericks CF. Mapping the Sustainable Development Goals onto Indian Nations. In: Miller RJ, Jorgensen M, Stewart D, eds. Creating Private Sector Economies in Native America: Sustainable Development through Entrepreneurship. Cambridge: Cambridge University Press; 2019:185-194. doi:10.1017/9781108646208.011
- Browne AJ, Lavoie JG, McCallum MJL, Canoe CB. Addressing anti-Indigenous racism in Canadian health systems: multi-tiered approaches are required. Can J Public Health. 2022;113(2):222-226. doi:10.17269/s41997-021-00598-1
- Persaud N, Ally M, Woods H, et al. Racialised people in clinical guideline panels. Lancet. 2022;399(10320):139-140. doi:10.1016/S0140-6736(21)02759-8
- Lafontaine AT, Lafontaine CJ. A retrospective on reconciliation by design. Healthc Manage Forum. 2019;32(1):15-19. doi:10.1177/0840470418794702
- Lafontaine A. Indigenous health disparities: a challenge and an opportunity. Can J Surg. 2018;61(5):300-301. doi:10.1503/cjs.013917
- Durand-Moreau Q, Lafontaine J, Ward J. Work and health challenges of Indigenous people in Canada. Lancet Glob Health. 2022;10(8):e1189-e1197. doi:10.1016/S2214-109X(22)00203-0
- Okpalauwaekwe U, Ballantyne C, Tunison S, Ramsden VR. Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review. BMC Public Health. 2022;22(1):1630. Published 2022 Aug 29. doi:10.1186/s12889-022-14047-2
- Berger P. Canadian Physicians’ Breach of Duty to Patients and Communities from the Acquisition of Indigenous Skulls in the 19th Century to the Abandonment of People with AIDS in the 20th Century. J Biocommun. 2021;45(1):E13. Published 2021 Aug 15. doi:10.5210/jbc.v45i1.10849
- Calac AJ. Opinion: William Osler desecrated Indigenous remains. His name should be removed from UCSD. The San Diego Union Tribune. https://www.sandiegouniontribune.com/opinion/commentary/story/2021-08-24/sir-william-osler-uc-san-diego-indigenous-skulls-racist
- Canadian Press. Alberta surgeon handed 4-month suspension for hanging noose on operating-room door. Haida Gwaii Observer. https://www.haidagwaiiobserver.com/news/alberta-surgeon-handed-4-month-suspension-for-hanging-noose-on-operating-room-door/
Disclosures
The hosts and guests report no relevant financial disclosures.
Citation
Persaud N, Lafontaine A, Calac A, Pierce G, Krishnamurthy S, Essien UR, Fields NF, Lopez-Carmen VA, Cooper A, Nolen L, Onuoha C, Watkins A, Williams J, Tsai J, Ogunwole M, Khazanchi R. “Episode 20: Advancing Medicine at the Expense of Indigenous Humanity” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. April 4, 2023
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https://clinicalproblemsolving.com/wp-content/uploads/2023/03/3.23.23-TCQ-RTP.mp3Dr. Vipul Kumar presents a fascinating case of pancytopenia and rash to guest discussant, Dr. Anand Patel. Dr. Vipul Kumar MD PhD is a hematology-oncology fellow at UCSF. He is currently in his second year of fellowship and has a clinical interest in oncology of all forms as well as a passion for teaching. Dr. Anand Patel is an assistant professor of medicine at University of Chicago where he treats patients with leukemia and myeloid malignancies. He also serves as medical director of the inpatient leukemia service. His research focuses on the development of clinical trials to help improve the standard of care for patients with high risk leukemias and myeloid malignancies.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/03/Promo-episode.mp3Aaron presents a mystery in reverse to RR
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https://clinicalproblemsolving.com/wp-content/uploads/2023/02/12.16.23-Neuro-VMR-RTP.mp3We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Yazmin presents a case of lethargy and myoclonus to Kiara and Maria.
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Maria Jimena Aleman
@MariaMjaleman
María Jimena Alemán was born and raised in Guatemala where she currently works in community and rural health care. After suffering from long standing neurophobia, she has embraced her love for neurology and will pursue a career in this field. She looks forward to dedicating her life to breaking barriers for Latin women in medical fields and improving medical care in her country. Maria is one of the creators of a medical education podcast in Spanish called Intratecal. Her life probably has a soundtrack of a mix between Shakira and Ella Fitzgerald. Outside of medicine, she enjoys modern art, 21st century literature, and having hour-long conversations over a nice hot cup of coffee or tequila.
Kiara Camacho
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Kiara Camacho-Caballero was born in Lima, Perú and she is a medical doctor at Universidad Científica del Sur. She is passionate about Internal Medicine, Cardiology, and medical education. Her research interests are cardiology, neurology, and, geriatrics. Her plans are to apply for Internal Medicine residency in the US this year. Outside medicine, she is a past triathlete and her dream is to perform an IRONMAN 70.3 someday. Kiara enjoys running, and spending time with her dog named Zack and her favorite food is turkey legs.
Yazmin Heredia
@minheredia
Yazmin is a Mexican Graduate from the Universidad Autonoma de Yucatan. During her medical training, she developed a strong interest in Public Health, Medical Education, and Health Equity and is looking forward to pursuing a career in Internal Medicine. When she is not volunteering on a project, she likes taking care of her plants, developing her skills in the fine arts, or learning a new language.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/02/02.09.23-ARM-Ep19-RTP.mp3CPSolvers: Anti-Racism in Medicine Series
Episode 19 – Reframing the Opioid Epidemic: Anti-Racist Praxis, Racial Health Inequities, and Harm Reduction
Show Notes by Alec Calac
February 9, 2022
Summary: This episode highlights racialized disparities in addiction treatment. During this episode, we hear from Dr. Jessica Isom, a board-certified community psychiatrist and faculty leader in the Yale Department of Psychiatry’s Social Justice and Health Equity Curriculum, and Dr. Ayana Jordan, the endowed Barbara Wilson Associate Professor in the Department of Psychiatry, Addiction Psychiatrist and Associate Professor in the Department of Population Health at New York University (NYU) Grossman School of Medicine. Together, our guests explore and unpack how the criminalization and racialization of substance use builds to the present-day opioid epidemic and shapes inequities in care. There is a special emphasis on the use of public health models that prioritize harm reduction and person-centered care to prevent drug-related fatalities and curb the opioid epidemic along lines of race and class. This discussion is hosted by Ashley Cooper, Sudarshan Krishnamurthy, and new team member Gillette Pierce.
Episode Learning Objectives:
After listening to this episode, learners will be able to…
- Explain how the criminalization and racialization of substance use builds to the present-day opioid epidemic and shapes inequities in care.
- Describe how the media shapes public sentiment toward substance use and addiction treatment.
- Identify realistic solutions to drug policy reform that promote health equity among marginalized communities living in the United States.
Credits:
- Written and produced by: Ashley Cooper, MPhil; Sudarshan Krishnamurthy; Gillette Pierce; Alec J. Calac; Michelle Ogunwole, MD, PhD; Ayana Watkins; Chioma Onuoha; Naomi F. Fields, MD; Victor A. Lopez-Carmen, MPH; Rohan Khazanchi, MPH; Sudarshan Krishnamurthy; Utibe R. Essien, MD, MPH; Jazzmin Williams; LaShyra Nolen; Jennifer Tsai MD, MEd
- Hosts: Ashley Cooper, Sudarshan Krishnamurthy, and Gillette Pierce
- Infographic: Creative Edge Design
- Audio Edits: Caroline Cao and Ashley Cooper, MPhil
- Show Notes: Alec Calac
- Guests: Jessica Isom, MD, MPH and Ayana Jordan, MD, PhD
Time Stamps:
1:30 Guest Introductions
4:15 Framing the Sociohistorical Context of the Opioid Epidemic
10:47 Racialization of Substance Use and Medicalization of the Human Experience
14:28 Changing “Faces of Addiction” and Impact on U.S. Drug Policy
16:35 United States, Chinese Laborers, and Anti-Chinese Sentiment (“Opium Fiends”)
19:30 “Moral Panic”
23:00 Separating Minoritized Individuals from the Majority
23:40 Cocaine Possession Sentencing Disparities
26:50 Shifting Social Attitudes Toward Substance Use and Addiction
30:30 (Mis)framing of Substance Use as a White Problem to Enact Change
33:15 Rectifying Racial Health Inequities in Opioid Addiction Treatment
36:10 Take-Home Methadone and a Less Clear Need for Methadone Clinics
40:40 Understanding Substance Use Disparities with Racially Disaggregated Data
47:00 Pushing Back Against “One Size Fits Most”
49:30 Harm Reduction Practices
53:00 Narrowing the Empathy Gap and Connecting with Patients
55:25 Spirit of Sankofa: Looking Back to Move Forward
59:15 Reducing Harm and “Optimizing Safety”
1:08:00 Community-Centered Solutions
1:10:20 Drug Policy Reform
1:15:42 Episode Takeaways
Episode Takeaways:
- Health care providers, especially physicians, cannot be equity-ignorant or egalitarian in our racialized society. They can use their training and privilege to advocate for meaningful policy reform.
- The opioid epidemic is more than a white problem. Demographic data in research and practice must always be disaggregated by race and ethnicity.
- Screening for substance use and offering connections to treatment and community-based services are important strategies that clinicians can implement in their own practice today.
Pearls:
- In 2020, American Indian and Alaska Native (Indigenous) communities experienced the highest drug overdose mortality rate of any racial or ethnic group, also surpassing rates among the non-Hispanic white population. Between 2007 – 2019, Black individuals experienced a higher death rate for opioid overdose deaths than any other racial or ethnic group. [Supplementary Resource for Listeners: CPSolvers Episode 12: Addressing Anti-Indigenous Racism in Medicine with team members Alec Calac and Victor Anthony Lopez-Carmen]
- Dr. Jordan begins our episode by framing the racialization and criminalization of substance use in the larger history of the United States, emphasizing that American society has seen substance use as “criminal behavior” or a moral failing, rather than as a medical condition, which began towards the early 2000s. She mentions that academia, as well as the media, have contributed to this complex social phenomenon by tying together race, gender, and substance use, especially in the context of maternal health and neonatal abstinence syndrome. The foundational literature in this area has furthered stigma and bias, especially towards Black birthing persons. These narratives have vilified individuals who would benefit from comprehensive, person-centered substance use treatment, rather than incarceration and other adverse harms.
- Dr. Isom continues the conversation around the intentionality of these structural processes and the language that frames the racialization of substance use in the United States by lawmakers, media, and the healthcare profession. This parallels another process, which is the medicalization of human experiences, especially those relating to childbirth and pregnancy. A more Western perspective on health care emphasizes the role of physicians and health care providers and marginalizes the role and contributions of doulas and midwives. She then ties this back to Dr. Jordan’s conversation about the criminalization of substance use and how resources and infrastructure are dedicated to incarceration, rather than psychotherapy and related treatments. [Supplementary Resource for Listeners: Advancing Health Equity: A Guide to Language, Narrative and Concepts]
- Sudarshan goes further into the changing “faces of addiction” and asks our guests to describe its impact on drug policy in the United States. Dr. Isom first challenges our listeners to engage with anti-racist praxis and challenge dominant racial narratives about substance use, policing, and other encounters. She then goes into how the racialization of substance use drove positive public sentiment for the adoption of punitive outcomes for substance use. One example that is presented involves the complicated relationship between the United States and Chinese immigrants and farmworkers in California. Once the need for labor was largely met, anti-Chinese narratives (e.g., opium fiends) emerged around opium, gambling, and prostitution, which fits into this pattern or formula of associating specific racial and ethnic groups with substance use as a rhetorical threat to the “most valued demographic” in the United States (white women and children) to drive the adoption of punitive measures. This largely obscures the reality that substance use rates are similar among different racial and ethnic groups. [Supplementary Resource for Listeners: San Francisco Opium Ordinance described in Race and the Criminalization of Drugs – National Press Foundation | NPF featuring Dr. Jessica Isom and Dr. Helena Hansen]
- Dr. Jordan echoes these thoughts and posits that divergence from the “ideal” American identity (i.e., white, cisgender, heterosexual) makes it possible to other (verb) individuals and enact policies and laws that punish individuals with marginalized identities. She shared that rhetoric used by Nixon and the subsequent war on drugs has similarities to Trumpism and messaging associated with Make America Great Again (MAGA). This is then reaffirmed during the Reagan Administration and is later codified into sentencing structures, in which we see vastly different amounts of cocaine possession (100:1 crack versus powder cocaine possession offenses) amounting to similar sentences, with crack cocaine use most prevalent among minoritized individuals and powder cocaine use most prevalent among the white majority. Involvement with the carceral system further intersects with issues around employment, household income, and other related disparities. To our listeners, how might we begin redressing these harms and reinvest in minority communities adversely affected by the war on drugs? [Supplementary Resource for Listeners: Cracks in the System: 20 Years of the Unjust Federal Crack Cocaine Law | American Civil Liberties Union]
- The conversation then shifts into changing social attitudes toward substance use and addiction. Dr. Isom breaks down media messaging and the varying tones and contexts used to describe substance use disparities and how that contributes to social stigma. She explains how different types of stigma intersect with media messaging to craft narratives that encourage sympathy or even a lack of sympathy towards certain racial and ethnic groups and health behaviors. Dr. Isom then discusses that policy reform and changing attitudes toward substance use and addiction are largely driven by the hurt and pain of those in the white majority with substance use disorder, further minimizing the experiences of marginalized communities.
- Dr. Jordan agrees with this characterization and goes more into the historical media coverage of substance use and the dehumanizing language that was (and is still) used to describe drug use among minority individuals. This segues into a conversation about the legacy of the war on drugs and today’s racial inequities in opioid addiction treatment. Ashley delineates that methadone has been disproportionately prescribed in predominantly Black communities, as a means to drive down crime, whereas white patients undergoing substance use treatment are more likely to receive buprenorphine. Dr. Jordan highlights the harm that these prescribing practices cause as they falsely associate race and substance use with criminal activity and neighborhood safety. She further goes into the stigma and stereotyping that continues to this day with the incessant and inhumane need to pick up prescription treatment once daily, submit “clean” urine samples under direct supervision, and submit to oral examinations. Dr. Jordan then questions the utility and continued operation of methadone clinics, especially as the United States largely moves on from the COVID-19 pandemic. She highlights actions taken by the United States Substance Abuse and Mental Health Services Administration (SAMHSA) to expand access to take-home methadone doses, which promoted patient autonomy and had comparable adherences outcomes and no significant changes in potential adverse harms, such as overdose and diversion. Other actions include elimination of the United States Drug Enforcement Administration (DEA) X waiver which was needed to prescribe buprenorphine. Dr. Jordan concludes by thinking about incentive strategies that would encourage health care providers to change their prescribing practices and minimize racial inequities in opioid addiction treatment [Supplementary Resource for Listeners: Lessons from COVID 19: Are we finally ready to make opioid treatment accessible? – PMC]
- Dr. Isom highlights the differences in substance use disparities and infrastructure utilization from the national level moving into discrete communities. Using an equity lens, she shares her own experiences in Massachusetts examining treatment utilization and encourages health care providers to examine racially disaggregated data to make sure that services offering suboxone (buprenorphine and naloxone) are reaching and being used in the most impacted communities. She also discusses the importance of the patient-provider relationship and shared-decision making, which helps ensure that a full range of services are being offered to patients. Dr. Jordan and Dr. Isom both agree that simply offering treatment services and having an “open door” are not enough. Dr. Jordan discusses the importance of de-centering the majority and identifying the factors that are most relevant to minoritized individuals and communities. Oftentimes, researchers and practitioners working to implement addiction treatment programs and interventions are not from those same communities. Dr. Jordan pushes back on the notion that “one size fits most” is the optimal approach for treating substance use disorder and that the evidence we rely on for patients undergoing substance use treatment was largely informed by the experiences of white individuals. Therefore, traditional settings of addiction care may unintentionally cause harm to individuals with marginalized identities.
- Gillette moves the conversation into strategies addressing substance use disparities, particularly those that emphasize the importance of harm reduction. Dr. Isom begins by sharing her experiences in the clinic and how harm reduction approaches such as offering fentanyl test strips humanize substance use treatment and place individual and community health and well-being at the center of treatment. To her dismay, she also learned that her racially and linguistically diverse patient population was one of most affected by the opioid epidemic in the Commonwealth of Massachusetts. Reflecting on these health data and rethinking “traditional” addiction treatment strategies helped her connect with her patients and close a self-described empathy gap that she says patients accessing treatment often have with their health care provider. Dr. Jordan enters into the conversation and also shares how she best connects with her patients who often feel unheard and marginalized by the health care system. She discusses the strengths and limitations of harm reduction approaches and the continued need for a clinician-researcher workforce that reflects the diversity seen in communities experiencing hardship. An important part of her discussion includes the contributions of community health workers and a need not just to focus on harm reduction, but also to optimize safety among individuals using substances such as alcohol and opioids. This complementary approach has the potential to increase the positive impact that the harm reduction movement has made over time.
- The group briefly discusses Dr. Isom’s article Nothing About Us Without Us in Policy Creation and Implementation | Psychiatric Services (2021) which highlights the need for patients and communities to be included in the creation and implementation of drug policy. This approach has the potential to best direct resources to the most impacted communities and may be more impactful than traditional community engagement models. Dr. Jordan has also written about culturally-responsive programs benefiting Black communities affected by the opioid epidemic and has completed a pilot study providing addiction treatment in partnership with faith-based organizations. Both guests acknowledge that academics do not always have the right solutions and that practitioners have to listen openly to community knowledge holders.
- Towards the end of the episode, Dr. Jordan highlights opportunities for meaningful drug policy reform, including examining federal methadone regulations (e.g., dosing, availability), investing in harm reduction and safety optimization, and decreasing police involvement in mental health crisis response and police presence in substance use treatment settings.
New Host! Kiersten TâLeigh (Ta-Lee) “Gillette” Gillette-Pierce (she/they) is currently a student at Johns Hopkins School of Public Health pursuing a Master of Science in Public Health with a double concentration in Maternal, Fetal, and Perinatal Health and Women, Sexual and Reproductive Health. As an academic researcher, they focus on transnational racial/ethnic and gender disparities in pregnancy-related, sexual, and reproductive health outcomes for all persons with gynecologic organs, with a specific interest in people of African descent. She is published in the Journal of Advanced Nursing and Medicine, Science, and Law. Gillette has also published work with Rewire News Group and the Center for American Progress focusing on sexual and reproductive health and rights policy, reproductive justice, and health outcomes for Black birthing persons. With almost ten years of experience in the global sexual and reproductive health, rights, and justice field, Gillette aims to improve sexual and reproductive health care and outcomes for disenfranchised communities and significantly improve pregnancy-related outcomes for people of African descent.
Speaker Biographies
Dr. Jessica Isom, MD, MPH, is a board-certified community psychiatrist and faculty leader in the Yale Department of Psychiatry’s Social Justice and Health Equity Curriculum. She primarily works in Boston as an attending psychiatrist at Codman Square Health Center where she is leading a grant effort to infuse antiracism in Opioid Use Disorder (OUD) services. She is a nationally recognized expert on racial equity and justice in psychiatry with a focus on workforce development and organizational transformation. Her professional interests include working toward eradicating racial and ethnic mental health disparities, mitigating the impact of implicit racial bias on clinical care, and the use of a community-centered population health approach in psychiatric practice. She serves on multiple advisory boards and is a consultant, curriculum developer and presenter to a variety of organizations including Fortune 500 companies and medical societies through her company, Vision for Equity LLC. Dr. Isom received her MD from the University of North Carolina School of Medicine, and completed her residency at Yale University.
Ayana Jordan, MD, PhD, is the Barbara Wilson Associate Professor in the Department of Psychiatry, Addiction Psychiatrist and Associate Professor in the Department of Population Health at New York University (NYU) Grossman School of Medicine. She also serves as Pillar Co-Lead for Community Engagement at NYU Langone’s Institute for Excellence in Health Equity. As Principal Investigator for the Jordan Wellness Collaborative (JWC), she leads a research, education, and clinical program that partners with community members to provide optimal access to evidence-based treatments for racial and ethnic minoritized patients with mental health disorders. Through her multifaceted work, she provides addiction treatment in faith settings, studies health outcomes for people with opioid use disorder in the carceral system, and trains addiction specialists to provide culturally-informed treatment. Dr. Jordan is dedicated to creating spaces and opportunities for more people of color, specifically Black women in academia who are vastly underrepresented. She has numerous peer-reviewed publications, has been featured at international conferences, and is the proud recipient of various clinical and research awards. The fundamental message of equity and inclusion has informed her research, clinical work, and leadership duties at NYU and beyond.
References
- Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2022. Designed by LM Rossen, A Lipphardt, FB Ahmad, JM Keralis, and Y Chong: National Center for Health Statistics.
- American Medical Association; Manatt Health. National roadmap on state-level efforts to end the opioid epidemic: leading-edge practices and next steps. https://www.end-opioid-epidemic.org/wp-content/uploads/2019/09/AMA-Manatt-National-Roadmap-September-2019-FINAL.pdf. Published September 2019. Accessed October 17, 2022.
- Balasuriya, L., Isom, J., Cyrus, K., Ali, H., Sloan, A., Arnaout, B., Steinfeld, M., DeSouza, F., Jordan, A., Encandela, J., & Rohrbaugh, R. (2021). The Time Is Now: Teaching Psychiatry Residents to Understand and Respond to Oppression through the Development of the Human Experience Track. Academic Psychiatry, 45(1), 78–83. https://doi.org/10.1007/s40596-021-01399-x
- Castillo, E. G., Isom, J., DeBonis, K. L., Jordan, A., Braslow, J. T., & Rohrbaugh, R. (2020). Reconsidering Systems-Based Practice: Advancing Structural Competency, Health Equity, and Social Responsibility in Graduate Medical Education. Academic Medicine, 95(12), 1817–1822. https://doi.org/10.1097/ACM.0000000000003559
- DeSouza, F., Mathis, M., Lastra, N., & Isom, J. (2021). Navigating Race in the Psychotherapeutic Encounter: A Call for Supervision. Academic Psychiatry, 45(1), 132–133. https://doi.org/10.1007/s40596-020-01328-4
- Friedman, J. R., & Hansen, H. (2022). Evaluation of Increases in Drug Overdose Mortality Rates in the US by Race and Ethnicity Before and During the COVID-19 Pandemic. JAMA Psychiatry, 79(4), 379. https://doi.org/10.1001/jamapsychiatry.2022.0004
- Godkhindi P, Nussey L, O’Shea T. “They’re causing more harm than good”: a qualitative study exploring racism in harm reduction through the experiences of racialized people who use drugs. Harm Reduct J. 2022 Aug 25;19(1):96. doi: 10.1186/s12954-022-00672-y. PMID: 36008816; PMCID: PMC9406271.
- Goldman, M. L., Swartz, M. S., Norquist, G. S., Horvitz-Lennon, M., Balasuriya, L., Jorgensen, S., Greiner, M., Brinkley, A., Hayes, H., Isom, J., Dixon, L. B., & Druss, B. G. (2022). Building Bridges Between Evidence and Policy in Mental Health Services Research: Introducing the Policy Review Article Type. Psychiatric Services, 73(10), 1165–1168. https://doi.org/10.1176/appi.ps.202100428
- Hansen H, Jordan A, Plough A, Alegria M, Cunningham C, Ostrovsky A. Lessons for the Opioid Crisis-Integrating Social Determinants of Health Into Clinical Care. Am J Public Health. 2022 Apr;112(S2):S109-S111. doi: 10.2105/AJPH.2021.306651. PMID: 35349328; PMCID: PMC8965192.
- Hughes M, Suhail-Sindhu S, Namirembe S, Jordan A, Medlock M, Tookes HE, Turner J, Gonzalez-Zuniga P. The Crucial Role of Black, Latinx, and Indigenous Leadership in Harm Reduction and Addiction Treatment. Am J Public Health. 2022 Apr;112(S2):S136-S139. doi: 10.2105/AJPH.2022.306807. PMID: 35349317; PMCID: PMC8965189.
- Isom, J., & Balasuriya, L. (2021). Nothing About Us Without Us in Policy Creation and Implementation. Psychiatric Services, 72(2), 121–121. https://doi.org/10.1176/appi.ps.72202
- Isom, J., Jordan, A., Goodsmith, N., Medlock, M. M., DeSouza, F., Shadravan, S. M., Halbert, E., Hairston, D., Castillo, E., & Rohrbaugh, R. (2021). Equity in Progress: Development of Health Equity Curricula in Three Psychiatry Residency Programs. Academic Psychiatry, 45(1), 54–60. https://doi.org/10.1007/s40596-020-01390-y
- James K, Jordan A. The Opioid Crisis in Black Communities. J Law Med Ethics. 2018 Jun;46(2):404-421. doi: 10.1177/1073110518782949. PMID: 30146996.
- Jordan, A., Mathis, M. L., & Isom, J. (2020). Achieving Mental Health Equity: Addictions. Psychiatric Clinics of North America, 43(3), 487–500. https://doi.org/10.1016/j.psc.2020.05.007
- Jordan A, Babuscio T, Nich C, Carroll KM. A feasibility study providing substance use treatment in the Black church. J Subst Abuse Treat. 2021 May;124:108218. doi: 10.1016/j.jsat.2020.108218. Epub 2020 Dec 3. PMID: 33771290.
- Kuehn, B. M. (2022). Black Individuals Are Hardest Hit by Drug Overdose Death Increases. JAMA, 328(8), 702. https://doi.org/10.1001/jama.2022.13702
- Lagisetty, P. A., Ross, R., Bohnert, A., Clay, M., & Maust, D. T. (2019). Buprenorphine Treatment Divide by Race/Ethnicity and Payment. JAMA Psychiatry, 76(9), 979. https://doi.org/10.1001/jamapsychiatry.2019.0876
- Naseem S. Miller. (2021, May 17). Racial disparities in opioid addiction treatment: Primer & research roundup. The Journalist’s Resource. https://journalistsresource.org/home/systemic-racism-opioid-addiction-treatment/
- Nweke, N., Isom, J., & Fashaw-Walters, S. (2022). Health Equity Tourism: Reckoning with Medical Mistrust. Journal of Medical Systems, 46(5), 27. https://doi.org/10.1007/s10916-022-01812-4
- Portnoy, G. A., Doran, J. M., Isom, J. E., Wilkins, K. M., DeViva, J. C., & Stacy, M. A. (2021). An evidence-based path forward for diversity training in medicine. The Lancet Psychiatry, 8(3), 181–182. https://doi.org/10.1016/S2215-0366(21)00024-9
- Race and the Criminalization of Drugs. (2021, April 22). National Press Foundation. https://nationalpress.org/topic/race-and-the-criminalization-of-drugs/
- Roxas, N., Ahuja, C., Isom, J., Wilkinson, S. T., & Capurso, N. (2021). A Potential Case of Acute Ketamine Withdrawal: Clinical Implications for the Treatment of Refractory Depression. American Journal of Psychiatry, 178(7), 588–591. https://doi.org/10.1176/appi.ajp.2020.20101480
- Townsend, T., Kline, D., Rivera-Aguirre, A., Bunting, A. M., Mauro, P. M., Marshall, B. D. L., Martins, S. S., & Cerdá, M. (2022). Racial/Ethnic and Geographic Trends in Combined Stimulant/Opioid Overdoses, 2007–2019. American Journal of Epidemiology, 191(4), 599–612. https://doi.org/10.1093/aje/kwab290
- Wyatt JP, Suen LW, Coe WH, Adams ZM, Gandhi M, Batchelor HM, Castellanos S, Joshi N, Satterwhite S, Pérez-Rodríguez R, Rodríguez-Guerra E, Albizu-Garcia CE, Knight KR, Jordan A. Federal and State Regulatory Changes to Methadone Take-Home Doses: Impact of Sociostructural Factors. Am J Public Health. 2022 Apr;112(S2):S143-S146. doi: 10.2105/AJPH.2022.306806. PMID: 35349318; PMCID: PMC8965186.
Show Transcript
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https://clinicalproblemsolving.com/wp-content/uploads/2023/02/02.07.2023-Schema-Episode-with-Dan-RTP.mp3Sharmin, Dan, Ann Marie, and Jack discuss an interesting case of non-resolving pneumonia with some radiologic surprises!
Schemas:
CAP
Pulmonary Disease and Eosinophilia
Lung Nodules
Lung Cavities
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https://clinicalproblemsolving.com/wp-content/uploads/2023/01/RLR-41_Unilateral-Lower-Extremity-Edema-w-Glass-Sponsorship.mp3Reza and Rabih discuss a fascinating case of unilateral lower extremity edema.
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https://clinicalproblemsolving.com/wp-content/uploads/2023/01/1.19.23-WDx-RTP.mp3Sukriti and Maani present a clinical unknown to Dr. Reza, followed by a brief discussion about addressing roadblocks that women in medicine face.
Dr. Nosheen Reza
Dr. Nosheen Reza is a cardiologist and translational researcher at the University of Pennsylvania focusing on advanced heart failure and transplant cardiology and cardiovascular genetics. She obtained her medical degree from the University of Virginia School of Medicine and completed internal medicine residency at the Massachusetts General Hospital. She then completed both her Cardiovascular Disease and Advanced Heart Failure and Transplant Cardiology fellowships at the University of Pennsylvania. At Penn, Dr. Reza pursued additional scholarship in genomic medicine as an NIH T32-funded postdoctoral fellow and in healthcare quality as a Penn Benjamin & Mary Siddons Measey Fellow in Quality Improvement and Patient Safety. Now, as an Assistant Professor of Medicine, she cares for patients in the Penn Center for Inherited Cardiovascular Disease and in the Section of Heart Failure, Transplantation, and Mechanical Support. Dr. Reza is also an Assistant Program Director of the Cardiovascular Disease Fellowship and the Director of the Penn Women in Cardiology program.
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https://clinicalproblemsolving.com/wp-content/uploads/2022/12/12.22.22-RTP.mp3We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time,Valeria presents a case of headache and altered mental status to Joy and Mattia.
Neurology DDx Schema
Valeria Roldán
@valeroldan23
Valeria is a medical student at Universidad Peruana Cayetano Heredia. She was born and lives in Lima, Perú. She hopes to pursue Neurology residency. Her interests include neuro-infectious diseases, transgender health and medical education. Her work with CPSolvers involves being a part of the Virtual Morning Report team and serving on the Spanish schemas team. Outside of Medicine she loves running, hiking, cooking pasta and spending time with her dogs.
Joy Glanton
@joytibalan
Joy is a neuro enthusiast who has completed her neuroscience undergrad and medical studies in the Philippines. She is passionate about neurology and believes “the brain is everything; it’s what makes us who we are.” She is hoping to match into Neurology in 2023, and is currently in NYC completing clinical externships/rotations in neurology. Post residency, she aspires to do translational/clinical research work or pursue a career in academic/general neurology. Joy enjoys running, swimming, literary art, debates in neuroscience, and listening to rock and roll and classical music.
Mattia Rosso
@MattiaRosso3
Mattia Rosso is a neurology resident at the Medical University of South Carolina (MUSC) in Charleston, South Carolina. He is interested in movement disorders, behavioral neurology, and autoimmune neurology. He is also passionate about the intersection between the humanities and medicine. He started a Neurohumanities group at MUSC, which meets monthly and features internal and guest speakers. This group focuses on the role of the Arts, Cinema, Literature, Philosophy, and Music in medicine and neurosciences. Outside work, he enjoys photography, cinema, and discovering new music. Since starting residency, the Clinical Problem Solvers have been an irreplaceable source of learning and inspiration.
https://clinicalproblemsolving.com/wp-content/uploads/2022/12/12.15.22-WDx-RTP.mp3Maani and Emily are joined by Dr. Rachael Lee for a clinical unknown.
Dr. Rachael Lee
@DoctorRachael
Dr. Lee joined the UAB Division of Infectious Diseases at UAB in 2016 and is currently an Associate Professor. She is the UAB Chief Healthcare Epidemiologist and in this role, she utilizes evidence based medicine to prevent the spread of healthcare-associated infections. Her research focuses on multi-drug resistant pathogens as they relate to infection prevention and control.
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https://clinicalproblemsolving.com/wp-content/uploads/2022/12/RLR-for-podcast.mp3Reza and Rabih discuss a fascinating case of AMS, infection and polyuria.
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Moses presents a case of hypoglycemia to Vale and Simone. Hypoglycemia Schema Download CPSolvers App here Patreon website
Ann Marie, Jack and Dan discuss and delve deeper into hypokalemia and hypophosphatemia schemas based on a case presented by Sharmin. Schemas Hypokalemia Hypokalemia a practical approach Hypophosphatemia Download CPSolvers App here RLRCPSOLVERS
Reza and Rabih discuss a fascinating case of hypercalcemia. rlrCPSOLVERS.COM Get a personalized clinical reasoning curriculum to take your skills to the next level AND support the CPSolvers while you are at it. Check out our sample content page here! Click here to create an account for a 3 day free trial with coupon… Read More »Episode 264: RLR – A Dual Diagnosis of Hypercalcemia
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, John presents a case of diplopia to Valeria and Madellena. Neurology DDx Schema John Acquaviva @DrJAStrange John Acquaviva is a fourth-year medical student attending Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania. He has a passion for both clinical… Read More »Episode 263: Neurology VMR – Diplopia
CPSolvers: Anti-Racism in Medicine Series Episode 18 – Remedying Health Inequities Driven by the Carceral System Show Notes by Ayana Watkins October 18, 2022 Summary: This episode highlights the history and roots of the carceral system, as well as its far-reaching impacts on the health of women and children today. During this episode, we gain… Read More »Episode 262: Anti-Racism in Medicine Series – Episode 18 – Remedying Health Inequities Driven by the Carceral System
Reza discussed a mind-blowing case presented by Rabih rlrCPSOLVERS.COM RLR have transitioned from Patreon to have their website rlrCPSolvers.com Check out this virtual classroom full of bonus schemas, illness scripts, teaching videos and case challenges. Rlrcpsolvers.com
In this WDx episode, Sharmin and Dr Lekshmi Santhosh delve into the world of written evaluations: why are they important, implicit biases they can contain and how to do a better job in both writing and interpreting evaluations. Dr. Lekshmi Santhosh Dr. Lekshmi Santhosh is an associate professor of medicine at UCSF. She specializes in… Read More »Episode 260: WDx #20 – Exploring the World of Evaluations with Dr. Lekshmi Santhosh
This episode is dedicated to the loving memory of Gabriel Talledo, we reflect on how greatly he touched our lives followed by his story, as told by him in the first episode of Queer Rounds. Please consider donating here to the Gabriel Talledo’s Scholarship benefiting young medical students of the LGTBQIA community in hopes of… Read More »Episode 259: In Loving Memory of Gabriel Talledo
The SLS team tackles the case of a young woman presenting with a prolonged, inflammatory pulmonary syndrome is found to have pulmonary granulomas, headaches and hyponatremia. Join them as they apply CPSolvers schemas to real life Patient care to facilitate the diagnostic reasoning process. Download CPSolvers App here Patreon website
Sharmin, Ann Marie, and Dan discuss a case that takes us on a journey through the pancreas and hepatobiliary systems with schemas at every stop of the way! Schemas: Acute Pancreatitis Pancreatic Mass Pancreatic Mass (Simple) Jaundice Download CPSolvers App here Patreon website
RLR discussing an intriguing case of nausea. Big news RLR are ending their time on Patreon soon and hosting content on their own website. Stay tuned for more info. Download CPSolvers App here Patreon website
We cannot wait to share the new RLR website with you as our time on Patreon is coming to an end. The website is our dream project. You will be notified once the website is up before anyone else. We are a few weeks away!!! And remember to reach out to us if there are… Read More »Patreon exclusive: RLR 106_Headache
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, CPSolvers team member Rafael Medina presents a case of frequent falls for CPSolvers team member Yazmin and Alice. Neurology DDx Schema Rafael Medina dos Santos @Rafameed Rafael Medina dos Santos is a Brazilian medical graduate. Before medicine, Rafael wanted to be… Read More »Episode 255: Neurology VMR – Frequent Falls
Dr. Rezigh presents a case of fever in a patient newly diagnosed with HIV to Dr. Woc-Colburn. Dr. Alec Rezigh Alec Rezigh is an academic hospitalist at Baylor College of Medicine in Houston, TX. He completed medical school at McGovern Medical School in Houston and his residency at The University of Colorado. His clinical interests include medical… Read More »Episode 254: Clinical Unknown with Drs. Kumfer, Rezigh, and Woc-Colburn
“Welcome back Clinical Problem Solvers,” Uncle Bob said. “Wow, that is so good, so so good,” Rabih reflexively responded. “Hey, wait a minute, I’ve given 104 intros and never received a compliment for my welcome back ‘clinical problem solvers,’ Rabih!!!” Reza quipped We hope you have fun while learning. And Uncle Bob is the type… Read More »Patreon exclusive: RLR 105_Nausea feat Uncle Bob
We are excited to bring you this special Clinical Unknown episode with Eleanor, Kate, David, and Mike discussing a case of back pain. Download CPSolvers App here Patreon website
Dear Patrons, Many times in medicine it is not one diagnosis but multiple diagnoses each contributing a different amount to the clinical problem. This cryptic message will become clear once you listen to this jam-packed episode. Enjoy RR This episode is available on Patreon only. Why? More about the RLR series here.
Reza discusses a mind-blowing case presented by Rabih. RLR now have over 100 episode on Patreon – consider subscribing here. This episode is available on Patreon only. Why? More about the RLR series here.
We hope you enjoy! RR This episode is available on Patreon only. Why? More about the RLR series here.
In this episode, Dr. Ashley McMullen, Dr. Simone Vais, and Jane Lock share stories of setbacks in medicine related to the theme, “I thought I was alone.” Session moderated by Madellena Conte. Interested in sharing a story during a future Setbacks in Medicine discussion? Fill out this form here: https://forms.gle/hoddk5iSod1SmCbL8 Ashley McMullen Dr. Ashley… Read More »Episode 251: WDx #18 – Setbacks in Medicine: “I thought I was alone”
Nothing is more important than the fundamentals! We hope you enjoy. RR This episode is available on Patreon only. Why? More about the RLR series here.
Dan, Jack, and Sharmin discuss a case of dyspnea, and hypertension presented by Ann Marie. Dyspnea Secondary hypertension AKI overview Glomerulonephritis Download CPSolvers App here Patreon website
Moses and Valeria review their approaches for fever in the inpatient and anemia, as they talk through a case presented by Simone. Schema: Fever: the journey Anemia Thought Train Download CPSolvers App here Patreon website
We think you will LOVE this case. Enjoy. RR This episode is available on Patreon only. Why? More about the RLR series here.
Dr. Lisa Sanders joins RLR for a fascinating case of neuropathy that was published in the New York Times Magazine. Read it here. RLR now have over 100 episode on Patreon – consider subscribing here. This episode is available on Patreon only. Why? More about the RLR series here.
We have made it to 100 episodes. We are grateful for each and everyone of you. If you are enjoying this content, please recommend it to a friend and/or colleague. We will have fun learning medicine together. Thank you, RR This episode is available on Patreon only. Why? More about the RLR series here.
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Valeria Roldan presents a case of tremors and myoclonus to Dr. Aaron Berkowitz. Neurology DDx Schema Valeria Roldán @valeroldan23 Valeria is a medical student at Universidad Peruana Cayetano Heredia. She was born and lives in Lima, Perú. She hopes to pursue… Read More »Episode 247: Neurology VMR – Tremors & Myoclonus
“Is it a rare disease or a disease that is rarely diagnosed?” Such powerful words from Dr. Lisa Sanders. She presented RR a case before it was published in NYT. Enjoy. This episode is available on Patreon only. Why? More about the RLR series here.
Pratik presents a case of dyspnea and RUQ pain to Fred. Dr. Fred McLafferty Fred McLafferty, MD is a fellow in the Division of Pulmonary and Critical Care at the University of California, San Francisco. His research interest is in how certain environmental particles and pathogens drive lung remodeling and pulmonary fibrosis. He is clinically… Read More »Episode 246: Clinical Unknown with Fred, Pratik, and Simone
Dr. Jen Davis presents a consult question to Dan, Doug, Emma, Sukriti, and Dr. Laila Woc-Colburn. Dr. Laila Woc-Colburn Dr. Laila Woc-Colburn is an associate professor in the Division of Infectious Diseases at Emory University School of Medicine in Atlanta. She is a renowned medical educator and has a wide range of clinical interests including tropical… Read More »Episode 245: The Consult Question #7 – Brain Abscesses
Dear Patrons, Enjoy episode 98!!! Almost at 100. We are looking forward to your reflections. RR
Vale, Brodie, and Gabriel discuss basic terminology of the LGBTQ+ community, the importance of communication in healthcare, and pieces of advice when using gender-inclusive language. Download CPSolvers App here Patreon website
Vale, Brodie, and Gabriel talk about their journey as LGBTQ+ members and the genesis of Queer Rounds, a platform that highlights the reality of gender and sexual diverse communities in healthcare. Download CPSolvers App here Patreon website
Dear Patrons, You don’t want to miss this episode. Two cases in one hour. CPSolvers’ team member and extraordinary diagnostician, Kirtan, presents two fascinating cases to RR that have a similar theme. We highly recommend you follow Kirtan on Twitter to enhance your diagnostic skills @KirtanPatolia. Kirtan: We wish you the best as… Read More »Patreon exclusive: RLR 97_2 Cases (Anasarca, Hemoptysis) with Kirtan!!
In this episode, Maani and Sharmin are joined by Dr. Tara Gadde who presents a clinical unknown case to Dr. Aimee Zaas followed by a discussion on leadership, mentorship, and career transition points. Uttara (Tara) Gadde Uttara (Tara) Gadde is an internal medicine resident at the University of Pennsylvania. She went to Cornell University for… Read More »Episode 242: WDx #17 – “The Next Play”
Hi Patrons, You don’t want to miss this one with one our of favorite teachers, mentors, and clinician-educators, Uncle Bob!! We hope you enjoy. UBRLR This episode is available on Patreon only. Why? More about the RLR series here.
Smitha and Simone tackle inpatient infections and glomerulonephritis as they work through a case presented by Anna. Schema: Infection in the inpatient Glomerulonephritis Download CPSolvers App here Patreon website
Dear Patrons, The 2nd episode of this week. We hope you enjoy. RR This episode is available on Patreon only. Why? More about the RLR series here.
Dear Patrons, We are excited for this week! We are going to bring you two back-to-back episodes. The first one is an “eye opener!” The second one is bread and butter medicine. Thank you for all your support. And remember … Keep diagnosing friends RR This episode is available on Patreon only. Why? More about the… Read More »Patreon exclusive: RLR 94_The Eye Patch
CPSolvers: Anti-Racism in Medicine Series Episode 17 – ‘Just’ Births: Reproductive Justice & Black/Indigenous Maternal Health Equity Show Notes by Ayana Watkins May 31, 2022 Summary: This episode centers the roles of reproductive justice and anti-racist action in rectifying inequities faced by Black and Indigenous birthing persons. This discussion is hosted by Naomi Fields,… Read More »Episode 240: Anti-Racism in Medicine Series – Episode 17 – ‘Just’ Births: Reproductive Justice & Black/Indigenous Maternal Health Equity
Sharmin, Ann Marie, and Jack discuss a fascinating case of back pain and granulomas presented by Dan. Schemas: Low Back Pain Overview Bony Back Pain Overview Granuloma on Histopath Bone Lesions Antibiotic Failure Download CPSolvers App here Patreon website
RLR discussed an intriguing case of a chronic consolidation Thank you to our dear friend and colleague Dr. Kelley Chuang for her help with the production of this episode. (You are a legend, Kelley!) @kelleychuang To listen to more RLR episodes, consider subscribing to Patreon: https://www.patreon.com/cpsolvers
Dear Patrons!!! We wish you a lovely week full of learning. Huge shout out to our guest and dear friend, Anand, on this week’s episode. Anand is a trail blazer in making the invisible, in clinical reasoning, visible for undergradute medical trainees. https://twitter.com/AnandJag1 The final dx is a doozy. Keep diagnosing friends. RR This… Read More »Patreon exclusive: RLR 93_Live from San Diego!!!
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time Dr. Doug Pet presents a case of slurred speech to Angelita and Diane. Neurology DDx Schema Doug Pet @doug_pet Doug is a resident in neurology at UCSF. He grew up surrounded by cow farms and crab-apple trees in New Milford,… Read More »Episode 237: Neurology VMR – Slurred Speech
We hope you enjoy this episode as much as we did recording it. Let us know what you think! Press pause after each aliquot, analyze the data, unpause, listen to RR, and repeat. Thank you for your support. RLR This episode is available on Patreon only. Why? More about the RLR series here.
We are grateful to each of you. RR often discuss their fortune in finding such a supportive community. We hope you enjoy the 2nd episode of the week. Huge shout out to the residents at Legacy Health in Portland. They are smart, kind, and hungry for diagnostic expertise. #Gratitude Next Sunday we will learn what… Read More »Patreon exclusive: Bonus Episode_RLR 91 – Recurrent intubation
Hi Patrons, You won’t want to miss this episode. Trust us. #EpicCase Krishna is finishing his last week of MS3 year @ VCU School of Medicine. He did a PHENOMENAL job presenting the case. Huge shout out to Dr. Patrick Fadden @ptfaddenMD, a superb clinician-educator, for guiding Krishna and being a great colleague to RR… Read More »Patreon exclusive: RLR 90 w/ Krishna Ravindra
CPSolvers: Anti-Racism in Medicine Series Episode 16 – Live from SGIM: Best of Antiracism Research at the Society of General Internal Medicine’s 2022 Annual Meeting Show Notes by Sudarshan Krishnamurthy May 3, 2022 Summary: This episode was recorded in front of a live audience at the Society of General Internal Medicine’s 2022 Annual Meeting in… Read More »Episode 236: ARM Episode 16 – Live from SGIM: Best of Antiracism Research at the Society of General Internal Medicine’s 2022 Annual Meeting
Dear dear dear patrons, We hope you enjoy part 1 of this 2 part series. The RIDDLER aka the mathematician is at it again. “Make each day your masterpiece.” Joshua Wooden (father of teacher and coach John Wooden) Enjoy, RR This episode is available on Patreon only. Why? More about the RLR series here.
Reza discussed a case that begins with dysuria, but ends in a way you will not believe. To listen to more RLR episodes, consider subscribing to Patreonhttps://www.patreon.com/cpsolvers
Dear Patrons, We hope you enjoy this episode as much as we enjoyed recording it. It doesn’t matter whether you get the dx or not. What matters is that you are (slightly) better tomorrow than you are today. Thank you to our dear friend and colleague Dr. Kelley Chuang for her help with the… Read More »Patreon exclusive: RLR 88 – Fever
Dr. Blythe Butler presents a case to Dr. Alexandra “Jay” Teng, followed by a discussion about her experience as a woman in an Internal Medicine procedural subspecialty. Alexandra “Jay” Teng Alexandra “Jay” Teng hails from Berkeley and graduated from Harvard with a bachelor’s degree in history and science. After college, she worked at UCSF as… Read More »Episode 234: WDx #16 – Clinical Unknown with Dr. Alexandra “Jay” Teng
Dear friends, The only way we significantly grow is through reflection! Listen to this episode, reflect, and become better for the patient you treat tomorrow and the student you teach tomorrow. We thank you for your support. Is it Reza loves Rabih or Rabih loves Reza … it is the best palindrome … This… Read More »Patreon exclusive: RLR 87 – Dysuria
Hello friends, We hope you enjoy this episode. It features three short cases! We appreciate your continued support of RLR. And remember … keep diagnosing lovely people RR This episode is available on Patreon only. Why? More about the RLR series here.
In this case, Anna and Moses work through the schemas of dyspnea, AMS, HIV & infection, and lymphocytic pleocytosis as they discuss a case presented by Simone. Schema: DyspneaAMS 2.0HIV & infectionLymphocytic pleocytosis Download CPSolvers App here Patreon website
We hope you enjoy this episode recorded on Reza’s birthday, April 3rd. The best gift you could give us is to share RLR series with your friends and family. Thank you for supporting CPSolvers. Rabih and Reza aka RLR This episode is available on Patreon only. Why? More about the RLR series here.
CPSolvers: Anti-Racism in Medicine Series Episode 15: Housing is Health: Racism and Homelessness – Clinician + Community Perspectives Show Notes by: Victor Anthony Lopez-Carmen, MPH April 5, 2022 Summary: This episode highlights homelessness’ impact on health, the structural and racialized nature of homelessness, and practical interventions to address housing inequities. This is the last of… Read More »Episode 232: Anti-Racism in Medicine Series – Episode 15 – Housing is Health: Racism and Homelessness – Clinician + Community Perspectives
Ann Marie, Jack, and Dan talk through the hemoptysis and pulmonary-renal syndromes schemas based on a case presented by Sharmin Schemas: Hemoptysis Pulmonary Renal Syndrome Download CPSolvers App here Patreon website
Dr. Rehman presents an unsolved Dx mystery from Pakistan! Patreon We’ve spiced up Patreon! Check out these two examples tier 3 videos The Tale of the Toe – https://vimeo.com/689507245 Spontaneous versus Secondary Peritonitis – https://vimeo.com/687572741 And here’s the main Patreon website: Patreon.com/CPSolvers.
We are incredibly grateful to Dr. Rabia Qaiser for sharing a superb case with RR. You might need Dr. Google for this one. Thank you for your support. Without you, the RLR series would not exist. RR This episode is available on Patreon only. Why? More about the RLR series here.
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Vijay presents a case of left upper extremity weakness to Vale and John. Neurology DDx Schema Valeria Roldan @ValeRoldan23 Valeria is a medical student at Universidad Peruana Cayetano Heredia. She was born and lives in Lima, Perú. She hopes to pursue a Neurology… Read More »Episode 229: Neurology VMR – Left Upper Extremity Weakness
Travis and Simone present a clinical unknown to Anand. Schema: Dyspnea Splenomegaly Download CPSolvers App here Patreon website
Dear Patrons, This was an EPIC recording with one of our dearest friends and colleagues, Dr. Aisha Rehman! You can follow her on Twitter @ https://twitter.com/ai_rehman Dr. Aisha Rehman, thank you for taking the time to present your patient’s case. We are still awaiting a final diagnosis. Dr. Rehman and RR would appreciate any thoughts… Read More »Patreon exclusive: RLR 83 from Pakistan with Dr. Aisha Rehman! (Part 1)
Dr. Croglio presents a riveting diagnostic journey to RLR. For more RLR episodes and short teaching videos, support us on Patreon.
Happy Sunday to our dear patrons. We hope you enjoy this one as much as we enjoyed recording it. You will want to follow https://twitter.com/mendesthiagob after listening to the episode! Many thanks, RR This episode is available on Patreon only. Why? More about the RLR series here.
RR discuss a fascinating cause of confusion and a tremor For more RLR episodes, consider subscribing to Patreon: https://www.patreon.com/cpsolvers
It is hard to believe we are already at 80 episodes with 719 patrons. We cannot thank each of you enough for allowing RR to chase their dream of teaching/learning diagnostic reasoning. We all are on an epic journey together. This episode is very special because we feature a mentor, advisor, and supporter of CPSolvers’… Read More »Patreon exclusive: RLR 80 with Uncle Bob – Hyperkalemia
Cardionerds, Tommy and Dinu, present a case to Dr. Vaidya, Lindsey, and Dan. Dr. Anjali Vaidya Dr. Vaidya is a heart failure and transplant cardiologist at the Lewis Katz School ofMedicine at Temple University, where she serves as the co-director of the Pulmonary Hypertension, right heart failure, and CTEPH program, as well as APD for… Read More »Episode 225: The Consult Question #6 Featuring CardioNerds – Shortness of Breath
Dear Patrons! Sometimes things are not what they seem. We hope you enjoy this episode. Many thanks for your continued support. Your two goofy clinical problem solvers, RR This episode is available on Patreon only. Why? More about the RLR series here.
In this episode, Anna & Smitha review the schemas of Inflammation and Glomerulonephritis as they work through a case presented by Emma. Glomerulonephritis Inflammation – Overview Download CPSolvers App here Patreon website
Dear friends, This episode is longer than usual but trust us that you will enjoy the magic created by Mike. He is a storyteller and a superb teacher. Mike – we are grateful you joined us for the hour. Hands down one of the top 3 cases RR have ever discussed. Thank you patrons for… Read More »Patreon exclusive: RLR 78 – Dr. Michael Croglio presents an EPIC case to RLR
CPSolvers: Anti-Racism in Medicine Series Episode 14: Race, Place, and Health: Clinician and Community Perspectives Show Notes by Alec Calac February 15th, 2022 Summary: This episode highlights how racism manifests in the built environment, and how community and individual-level efforts can mitigate these inequities. This discussion is the second of three planned conversations around the… Read More »Episode 223: Anti-Racism in Medicine Series – Episode 14 – Race, Place, and Health: Clinician and Community Perspectives
RR discuss an important patient phone callFor more RLR episodes, consider subscribing to Patreon: The Clinical Problem Solvers is creating podcasts, videos, schemas, illness scripts and more | Patreon
Dear Patrons, We enjoyed this tremendously. It was an honor to discuss a case at the University of Pittsburgh Medical Center. We hope you enjoy it. Ryan, we cannot thank you enough for being such an amazing friend and colleague. You put the case together expertly. You presented it flawlessly. You made it an experience… Read More »Patreon exclusive: RLR 77 – Jaundice and weight loss
Lindsey presents a case of fever in a returning traveler to Sharmin, Jack, and Dan. Fever in a Returning Traveler Schema Download CPSolvers App here Patreon website
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Maria presents a case of increased drowsiness to Dr. Mathieu Brunet and Dr. Mattia Rosso. Neurology DDx Schema Maria Jimena Aleman Maria Jimena Aleman María Jimena Alemán was born and raised in Guatemala where she currently works in community and rural health care.… Read More »Episode 220: Neurology VMR – Drowsiness
In this episode, Dr. Elliot Tapper discusses a clinical unknown case presented by Dr. Jennifer Mundell Jennifer Mundell Jennifer Mundell, MD FACP is the associate program director for Ascension St Vincent Internal Medicine Residency Program. She graduated from University of Louisville School of Medicine and completed IM residency at Ascension St. Vincent in 2016. The residents… Read More »Episode 219: Clinical Unknown with Dr. Tapper, Dr. Mundell, & Travis
Emma presents a case to Dr. Yao Heng, followed by a discussion about her experience as a woman in Internal Medicine procedural subspecialty. Dr. Yao Heng Dr. Yao Heng was born in Bangkok, Thailand. She immigrated to the US in her 20’s. After graduating from the University of California, Berkeley with a Bachelor of Arts… Read More »Episode 218: WDx #15 – Iron Lady, GI Edition
Our dearest friend Samy, from the Medical University of Graz in Austria, presented RR a doozy of a case. We always get nervous when Samy presents, and we know it is ON once we hear “the labs may be helpful.” Happy Sunday. Thank you as always for your support. And thank you Samy for the… Read More »Patreon exclusive: RLR 76 – “The Labs May Be Helpful”
We are thrilled to share an episode where R does not rudely interrupt the other R! We hope you enjoy this one as much as we enjoyed recording it. Thank you as always. RR This episode is available on Patreon only. Why? More about the RLR series here.
RLR are back on the podcast with 4 fascinating cases. Over the winter, they’ve been releasing a lot of cool content on Patreon. Check it out for much more RLR content. https://www.patreon.com/cpsolvers
We wish each of you a happy new year! Thank you for all your support. We hope you enjoy the final RLR episode of 2021. Rabih and Reza This episode is available on Patreon only. Why? More about the RLR series here.
Doug presents an unknown case of vision loss to Dr. Cherayil, Lindsey and Dan. Dr. Neena Cherayil. Dr. Cherayil is an Assistant Professor of Neurology in the Departments of Neurology and Ophthalmology at Northwestern University Feinberg School of Medicine in Chicago, Illinois. She completed her neurology residency followed by a neuro-ophthalmology fellowship at the… Read More »Episode 216: The Consult Question #5 – Vision Loss
CPSolvers team members Rafael Medina and Simone Vais take a moment to reflect on what is going on in the world of medicine focusing on vaccine uptake with two incredible experts on the matter about what their experiences have been. Dr. Matifadza Hlatshwayo Davis. Dr. Davis is the Director of Health for the… Read More »Episode 215: Vaccine Hesitancy – with Dr. Davis and Dr. Villela
Sharmin presents a case of angioedema to Jack, Dan and Lindsey. Download CPSolvers App here Patreon website
CPSolvers: Anti-Racism in Medicine Series Episode 13: Centering Asian Americans: Racism, Violence, and Health Show Notes by Naomi F. Fields December 21, 2021 Summary: This episode is about racism faced by Asian-Americans, why it often goes unrecognized, and how we can work to rectify these wrongs. This discussion is hosted by Jazzmin Williams, Rohan Khazanchi,… Read More »Episode 213: Antiracism in Medicine Series – Episode 13 – Centering Asian Americans: Racism, Violence, and Health
Rabih discusses the case with one key question: Do we use an AND or an Or or, Both? Support the CPSolvers and tune in to much more RLR by subscribing to Patreon. https://www.patreon.com/cpsolvers
Wow. What a session. Thank you so much for your support. And thank you to our live audience. It was wonderful seeing each of you. RR This episode is available on Patreon only. Why? More about the RLR series here.
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Maria presents a case of episodic transient loss of consciousness to Gabriel and Ravi. Schema 1 Schema 2 Neurology DDx Schema Maria Jimena Aleman Maria Jimena Aleman was born and raised in Guatemala where she currently is a medical student in Universidad Francisco… Read More »Episode 211: Neuro VMR – Episodic transient loss of consciousness
We truly hope you enjoy this one. It is a superb case. Thank you as always for your support. Fasten your seatbelts … and … let’s go! Thanks, RR This episode is available on Patreon only. Why? More about the RLR series here.
Dr. Kushal, Dr. Saman, and Dr. Brandon discuss a case of worsening dyspnea and fever. Schema Dr. Kushal Vaishnani Dr. Kushal Vaishnani is a Hospitalist at Atrium Health. He finished his medical school at B.J. Medical College, Ahmedabad, India. He completed his transitional year at Brandon Regional Hospital and Internal Medicine residency at LSUHSC –… Read More »Episode 210: Clinical unknown with Dr. Kushal, Dr. Saman, and Dr. Brandon
CPSolvers: Anti-Racism in Medicine Series Episode 12: Our Land is Our Health: Addressing Anti-Indigenous Racism in Medicine Show Notes by LaShyra Nolen November 23rd, 2021 Summary: This episode is about the ways we can combat anti-Indigenous sentiments and actions in our efforts to promote anti-racism in medicine and public health. This discussion is hosted by our… Read More »Episode 209: Antiracism in Medicine Series – Episode 12 – Our Land is Our Health: Addressing Anti-Indigenous Racism in Medicine
Reza discusses the case of a young man who suddenly became to feel unsteady. Support the CPSolvers and tune in to much more RLR by subscribing to Patreon. Learn more about the ABMS Visiting Scholars Program here
Dr. Michael Thomashow presents an unknown case to Dr. Anisha Dua, Dan Minter, Doug Pet and Lindsey Shipley. Schema 1 Schema 2 Anisha B. Dua MD, MPH Anisha B. Dua MD, MPH is an Associate Professor of Medicine in the Division of Rheumatology, Rheumatology Fellowship Program Director and Director of the Northwestern Vasculitis Center at… Read More »Episode 207: The Consult Question #4 – Fevers and Arthralgias
In the diagnostic journey, nothing is more important than the frame. The wrong frame leads to the wrong diagnosis. However, sometimes you need multiple frames with the flexibility to pivot from one frame to another like Lionel Messi and his left foot. Rabih shows us the power of the frame in this episode. Happy Sunday!… Read More »Patreon exclusive: RLR 69 – Power of the frame
Sharmin and Dr. Kaylin Nguyen delve deeper into the imposter phenomenon. They discuss the origin of the term, the problems with the mainstream definition, and how it should be reframed. Imposter Syndrome Treat the Cause, Not the Symptom Contextualizing the Impostor “Syndrome” Stop Telling Women They Have Imposter Syndrome End Imposter Syndrome in Your Workplace Dr. Kaylin Nguyen Dr. Kaylin Nguyen was born in Vietnam and… Read More »Episode 206: WDx #14 – Feeling like an Imposter? Let’s Talk.
Medicine is quite humbling. We are fallible. We would love for each of you to try and solve this case as it unfolds and then share your thoughts with us. Thank you for your continued support. RR This episode is available on Patreon only. Why? More about the RLR series here.
Dr. Ravi Singh interviews CPSolvers team members Rafael Medina, Sukriti Banthiya, and Rabih Geha who illustrate the Do’s (Rafael and Sukriti) and Don’ts (Rabih) of a residency application interview. This is for anyone interviewing, but especially for IMGs. Enjoy part 2 with Rabih Geha. Dr Ravi Singh Doctor Ravi Singh graduated from the University Medical School of Debrecen… Read More »Episode 205- Global VMR Special Episode – The Mock Interview – The Do’s and Don’ts with Dr. Ravi Singh – Part 2
Dr. Ravi Singh interviews CPSolvers team members Rafael Medina, Sukriti Banthiya, and Rabih Geha who illustrate the Do’s (Rafael and Sukriti) and Don’ts (Rabih) of a residency application interview. This is for anyone interviewing, but especially for IMGs. Enjoy part one with Rafael and Sukriti. Dr Ravi Singh Doctor Ravi Singh graduated from the University… Read More »Episode 205- Global VMR Special Episode – The Mock Interview – The Do’s and Don’ts with Dr. Ravi Singh – Part 1
We hope you enjoy! And as always, thank you for your support. The RLR series is only possible because of you. This episode is available on Patreon only. Why? More about the RLR series here.
In this episode, Simone & Emma review the schemas of Altered Mental Status and Microangiopathic Hemolytic Anemia as they work through a case presented by Moses. Schema 1 Schema 2 Schema 3 Download CPSolvers App here Patreon website
Lisa Sanders, MD, founder and writer of the popular Diagnosis column for New York Times Magazine, and Laura Glick, MD, STUMP RR through a very exciting case. We hope you enjoy it as much as we enjoyed being stumped. Join us on Patreon for more cases with Dr. Sanders, and 5 bonus episodes a month with RLR.
CPSolvers team members–Rafael Medina (lead organizer),Valeria Roldán, Gabriel Talledo, and Andrea Guzman facilitate a conversation with Drs. Gallo and Singh who shared authentic, practical, and inspirational insight into the IMG journey to apply to residency in the USA. Dr Alice Gallo Doctor Alice Gallo graduated from the Medical School of the Pontifícia Universidade Católica do… Read More »Episode 202: Global VMR Special Episode – Residency Applications for IMGs Part 2
CPSolvers team members–Rafael Medina (lead organizer),Valeria Roldán, Gabriel Talledo, and Andrea Guzman facilitate a conversation with Drs. Gallo and Singh who shared authentic, practical, and inspirational insight into the IMG journey to apply to residency in the USA. Dr Alice Gallo Doctor Alice Gallo graduated from the Medical School of the Pontifícia Universidade Católica do… Read More »Episode 202: Global VMR Special Episode – Residency Applications for IMGs Part 1
Any topic in medicine is more enjoyable once you learn the topic. I did not have a systematic approach to ataxia one year ago and it was a tough day at work. I used that energy to create an approach with a dear friend. We hope you are kind to yourselves and use such reminders… Read More »Patreon exclusive: RLR 66 – Ataxia
Jack, Sharmin, Lindsey, and Dan discuss a case of Jaundice and Lung Nodules. Jaundice schema Lung Nodules schema Download CPSolvers App here Patreon website
CPSolvers: Anti-Racism in Medicine Series Episode 11: Racism, Redlining, and the Path Towards Reconciliation Show Notes by Sud Krishnamurthy, Michelle Ogunwole, Chioma Onuoha October 12th, 2021 Summary: This episode is part of a 3-part series on Race, Place, and Health. In this episode, we invite Mr. Richard Rothstein, distinguished Fellow of the Economic Policy Institute… Read More »Episode 200: Antiracism in Medicine Series – Episode 11 – Racism, Redlining, and the Path Towards Reconciliation
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Gabriela presents a case of impairment of speech to Gabriel and Valeria. Neurology DDx Schema Want to test your learning? Take our Episode Quiz Gabriela Pucci Gabriela has graduated from Medical School at Unicamp and recently finished her neurology residency at Unesp, both… Read More »Episode 199: Neurology VMR – Diplopia
On this episode, Rabih presents two cases at once for Reza. We truly hope you enjoy these cases. If you are not driving or doing an activity that needs your full attention, pause after each aliquot and share your thoughts out loud. Then compare your thoughts to RR’s thoughts. Think like no one is watching… Read More »Patreon exclusive: RLR 64 – Identical Symptoms Different Outcomes
Alec presents a case of abdominal pain and hematochezia to Laura, Stef, and Jack. Laura Geiszler Laura Geiszler is a third-year Internal Medicine resident at Lankenau Medical Center in Wynnewood, Pennsylvania. Laura completed her medical school at Philadelphia College of Osteopathic Medicine.She has a passion for humanizing medicine and promoting health and wellness to… Read More »Episode 198: HumanDx Unknown with Laura, Stef, and Jack – hematochezia and abdominal pain
It was such a privilege having our dear friend and expert, Dr. Aaron Berkowitz aka The Neurologist aka author of One by One by One, join us. We hope you enjoy it as much as we did recording it. We will have exclusive schema(s) and illness script(s) for tiers 2 and 3 Patrons! RR This episode… Read More »Patreon exclusive: RLR 63 – Bonjour
Dr. Titer, Dr. Williams, Maani and Lindsey discuss macro/microaggressions in the clinical setting. Dr. KeAndrea Titer Dr. KeAndrea Titer is an Assistant Professor in the Division of General Internal Medicine at University of Alabama at Birmingham. She was born and raised in Tampa, Florida. She received her Bachelor of Science in Biology from Oakwood University in Huntsville, Alabama. She went… Read More »Episode 197: WDx #13 – Macro/microaggressions
Lisa Sanders, MD, founder and writer of the popular Diagnosis column for New York Times Magazine, and Laura Glick, MD, STUMP RR through a very exciting case. We hope you enjoy it as much as we enjoyed being stumped. There will be exclusive schema(s) and/or illness script(s) with this episode for tier 2 and tier 3… Read More »Patreon exclusive: RLR 62 – Lisa Sanders, MD, presents a case to R&R
We made it to 600 Patrons!!! We are just so grateful to each of you. Our current efforts would not be possible without you. Enjoy this episode. Consider upgrading to tier 2 or 3 for exclusive schemas and illness scripts (tier 2 and 3) and live sessions (tier 3). “Bullies of infection and cancer …”… Read More »Patreon exclusive: RLR 61 – Reza’s mind blown
We were thrilled to be hosted by our dear friend Kevin Grudzinski at Rush University Grand Rounds where he presented a fascinating case to us. If you are interested us having RLR at your institution, simply message us on Patreon. This episode is available on Patreon only. Why? More about the RLR series here.
Anna presents a case of metabolic acidosis, pulmonary nodules, and fevers to Smitha and Simone Schema 1 Schema 2 Schema 3 Download CPSolvers App here Patreon website
This one was very special for many reasons. For exclusive schema(s) associated with this episode, consider subscribing to tiers 2 and 3! Tier 3 will get you a zoom link to participate during the actual recording! Today was so special because of our live audience. We are so lucky! RR This episode is available on Patreon only.… Read More »Patreon exclusive: RLR 59 – R consults R
RLR are recording an episode with author of the New York Time Diagnosis column, Dr. Lisa Sanders Subscribe to our Join Live tier to join us on Zoom in real time on Monday August 30 at 9:30 AM PST/12:30 PM PST. A few weeks later, we will release this episode to all our Patreon tiers.… Read More »Announcement About a Very Special Event!
RLR are back on the podcast with a fascinating case. Over the summer, they’ve been releasing a lot of cool content on Patreon. Check it out here for much more RLR content. Schema One Schema Two More about the RLR series here.
We discuss 5 topics picked up a live audience – AMS, Encephalitis, Weakness, Seizures and Joint pain This episode is available on Patreon only. Why? More about the RLR series here. To join us live and be part of the conversation, subscribe to the $20/month tier. For 2 exclusive schemas related to this episode, subscribe to $10/month tier.
Lindsey presents a case of polyuria to Dan, Jack, and Sharmin Hypernatremia schema Polyuria schema Download CPSolvers App here Patreon website
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Gabriela presents a case of impairment of speech to Maria and Kirtan. Neurology DDx Schema Want to test your learning? Take our Episode Quiz Gabriela Pucci Gabriela has graduated from Medical School at Unicamp and recently finished her neurology residency at Unesp,… Read More »Episode 193: Neurology VMR – Impairment of Speech
Dr. Palmer presents a clinical unknown case to Dr. Stanley Schema Dr. Marion Stanley Dr. Marion Stanley is a hospitalist and an internal medicine residency associate program director at Northwestern Memorial Hospital. She completed medical school at University of Chicago, Pritzker School of Medicine and graduated from University of California, San Francisco for residency. She… Read More »Episode 192: Clinical unknown with Dr. Marion Stanley & Dr. Geralyn Palmer
Dr. Julia Armendariz presents a clinical unknown to Dr. Laura Huppert. Dr Laura Huppert Laura Huppert, MD, is a third year Hematology/Oncology Fellow at the University of California, San Francisco (UCSF). Her clinical interest is in solid tumor malignancy, including the treatment of breast cancer and melanoma. She is also interested in medical education, and… Read More »Episode 191: Wdx # 12 – Clinical Unknown with Dr. Laura Huppert and Dr. Julia Armendariz
Jack, Dan, and Emma teach us an approach to intrarenal AKI and anemia. Schema 1 Schema 2 Learning Objectives By the end of this episode, listeners will be able to: Describe the clinical features that can help clinicians determine which organ system is causing lower extremity edema Produce a prioritized differential diagnosis for an acute… Read More »Episode 190: Spaced Learning Series – Intrarenal AKI & Anemia
Shanthi presents a clinical unknown to Sam, Michael, and Jack. Want to test your learning? Take our episode quiz here Michael Vu Michael Vu is a second year Internal Medicine resident at Methodist Dallas. He completed his undergraduate education at the University of Texas at Dallas and his medical training at the University of North Texas Health… Read More »Episode 189: HumanDx Unknown with Jack – bilateral arm and leg weakness
In this episode, we invite the powerful sister duo Oni Blackstock, MD, MHS and Uché Blackstock, MD to share their experiences on leaving public health and academia to become social entrepreneurs, creating their own organizations in health equity. Episode Learning Objectives After listening to this episode learners will be able to… Recognize some common factors… Read More »Episode 188: Antiracism in Medicine Series – Episode 10 – Counterspaces in Medicine: Creating Safe Spaces and Redefining Value
This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our episode quiz here
Schema Want to test your learning? Take our episode quiz here This episode is available on Patreon only. Why? More about the RLR series here.
Want to test your learning? Take our episode quiz here This episode is available on Patreon only. Why? More about the RLR series here.
Schema Want to test your learning? Take our episode quiz here This episode is available on Patreon only. Why? More about the RLR series here.
Dr. Frederick Weber discusses an approach to chronic diarrhea with the TCQ squad Chronic Diarrhea Schema Want to test your learning? Take our Episode Quiz Dr. Frederick Weber Dr. Frederick Weber is a Clinical Professor of Medicine at the University of Alabama Birmingham in the Division of Gastroenterology and Hepatology. He is the former Medical… Read More »Episode 187: The Consult Question #3 – Chronic Diarrhea
We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz Neurology DDx Schema Want to test your learning? Take our episode quiz here Gabriela Pucci Gabriela has graduated from Medical School at Unicamp and recently finished her neurology residency at Unesp, both in Brazil. She is interested in Medical Education and Clinical… Read More »Episode 186: Neurology VMR – Involuntary Movements
Rabih and Reza discuss learning during the process of clinical reasoning on VMR. Download CPSolvers App here Patreon website RLR website VMR sign up
Simone and Lindsey present a case to Dr. Kirsten Austad, followed by a discussion about women in leadership and “the double bind” Want to test your learning? Take our episode quiz here Dr. Kristen Austad Kirsten Austad MD, MPH is an Assistant Professor of Family Medicine at Boston University School of Medicine and a hospitalist at Boston… Read More »Episode 184: Wdx #11- Clinical Unknown with Dr. Kirsten Austad
Bronson presents a clinical unknown to Mohit, Kai, and Lindsey. Want to test your learning? Take our Episode Quiz Mohit Harsh Mohit is a current Chief Resident in the Department of Internal Medicine at WashU. He is from Huntington, West Virginia and attended Marshall University School of Medicine in his hometown. He loves clinical… Read More »Episode 183: Human Dx with Lindsey – cough and rash
Sue Ellen presents a clinical unknown to Nick, Jennifer, and Dan Schema Episode Quiz Nicholas Hornstein Nicholas Hornstein is a PGY-3 at UCLA Ronald Reagan Medical Center. He was born and raised in Los Angeles, earned his undergraduate degree from Brandeis University, and graduated from Columbia University with an MD and a PhD in Computational… Read More »Episode 182: Human Dx with Dan – AMS and lower extremity weakness
Summary In this special episode of the Antiracism in Medicine Series, originally recorded for the 2021 Society of General Internal Medicine Annual Meeting, the CPSolvers Antiracism team discusses what must be done to make medical education more antiracist. The conversation spans stages of academic medical career progression, ranging from recruitment to training to retention. The… Read More »Episode 181: Antiracism in Medicine Series – Episode 9 – Moving Towards Antiracism in Medical Education
Rabih moderates as an interactive, international virtual morning report community discusses a case of fever Fever Overview Schema Inflammation Thought Train Schema Want to test your learning? Take our episode quiz here Dr. Hernán Carrillo Hernán Carrillo is Head of the Internal Medicine Department at Las Higueras Hospital in Talcahuano, Chile. He’s also an… Read More »Episode 180: Clinical Unknown – Global VMR
Description: We continue our campaign to #EndNeurophobia led by Aaron Berkowitz! This time, Doug presents a case of headache and blurry vision to Hannah and Dhruv. Neurology DDx Schema Want to test your learning? Take our Episode Quiz Dhruv Srinivasachar Dhruv Srinivasachar is a soon-to-be 1st year Medicine-Pediatrics resident at Western Michigan University and a graduate of Virginia Commonwealth University School… Read More »Episode 179: Neurology VMR – Headache and blurry vision
Sharmin, Rabih, Reza, and Arsalan tackle a schema for pulmonary disease with eosinophilia Patreon website Download CPSolvers App here Schema Episode Quiz Give us feedback here
Dr. Katrina Armstrong and Dr. Vineet Arora join the #bosslady Wdx team to discuss navigating negotiations as women in medicine Dr. Katrina Armstrong Dr. Katrina Armstrong is the Jackson Professor of Clinical Medicine at Harvard Medical School, Chair of the Department of Medicine and Physician-in-Chief of Massachusetts General Hospital. She is an internationally recognized investigator in… Read More »Episode 177: Wdx #10 – Negotiations
Thank you for your continued support and please give us feedback here! Rabih and Reza tackle a salty problem Schema Episode Quiz This episode is available on Patreon only. Why? More about the RLR series here.
“There’s nothing new under the sun, but there are new suns” – Octavia E. Butler Summary: We invite social justice champion and acclaimed scholar of race, gender, and the law, Dorothy E. Roberts, JD, to discuss the history of race-based medicine and the movement for health equity and justice. Episode Learning Objectives After listening to… Read More »Episode 176: Antiracism in Medicine Series – Episode 8 – Towards Justice and Race Conscious Medicine
Thank you for your continued support and please give us feedback here! Dan, Doug, and Lindsey are joined by expert neurologist Dr. Aaron Berkowitz to help break down a consult question about back pain and double vision Schema Download CPSolvers App here Patreon website Episode Quiz
Thank you for your continued support and please give us feedback here! Epic RLR case of a rash! Want to test your learning? Take our episode quiz here This episode is available on Patreon only. Why? More about the RLR series here.
Thank you for your continued support and please give us feedback here! We continue our campaign to #EndNeurophobia, as Gabriela, Sherry, and Kaitlyn discuss a case with Dr. Aaron Berkowitz Download CPSolvers App here Patreon website Schema Episode Quiz Kaitlyn Thomas Kaitlyn Thomas is a 3rd year medical student at Lake Erie College of Osteopathic… Read More »Episode 174: Neurology VMR: Right sided hemiparesis
Reza and Rabih work through a case of dyspnea and finger swelling, presented to them by Dr. Usha George. Download CPSolvers App here Patreon website Schema Episode Quiz Dr. Usha George Dr. Usha George, MBBS (MAHE India), MSc (Respiratory Medicine) Imperial College University of London, FRCP London, is at present attached to Sunway Medical Centre,… Read More »Episode 173: Clinical unknown with Reza and Rabih at VMR: Dyspnea and finger swelling
Rabih and Reza tackle a case of headache and blurry vision Want to test your learning? Take our episode quiz here This episode is available on Patreon only. Why? More about the RLR series here Download CPSolvers App here
During this WDx VMR series episode, Kiara presents a case of chest pain to Priyanka, Ana Clara, Elena, and Anna. Download CPSolvers App here Patreon website Schema Episode Quiz Ana Clara Ana Clara Miranda is a 4th-year medical student from Brazil. She grew up in Belo Horizonte and moved to Rio de Janeiro in 2017 to… Read More »Episode 172: WDx #9 – VMR: Chest pain
Raha and Shub join #PrezSharmin to tackle a clinical unknown presented by Carlos Download CPSolvers App here Patreon website Want to test your learning? Take our Episode Quiz Dr. Agrawal Shub Agrawal is a PGY-2 at Emory’s J. Willis Hurst Internal Medicine Residency. She grew up in Athens, GA and attended New York University for… Read More »Episode 171: Human Dx Unknown with Sharmin – Face and leg weakness
Eamonn and Ashley join Jack in tackling a clinical unknown presented by Travis Take our episode quiz here Eamonn Maher Eamonn hails from Charleston, West Virginia. He attended Marshall University for medical school and is currently in his final year of Dermatology residency at SLU. He will complete a Complex Medical Dermatology fellowship at NYU… Read More »Episode 170: Human Dx Unknown with Jack – generalized itching
Reza spends his birthday in the best way possible – masterfully breaking down a case presented to him by Rabih! Want to test your learning? Take our episode quiz here!
Summary In this episode of Clinical Problem Solvers: Anti-Racism in Medicine, we are joined by Michelle Morse, MD, MPH, Deputy Commissioner for the Center for Health Equity and Community Wellness (CHECW) and the inaugural Chief Medical Officer at the NYC Department of Health and Mental Hygiene (NYCDOHMH), and Paul Farmer, MD, PhD, Kolokotrones University Professor… Read More »Episode 169: Antiracism in Medicine Series – Episode 7 – Antiracism, Global Health Equity, and the COVID-19 Response
Rabih and Reza tackle a clinical unknown, presented at VMR by Dr. Usha George. Episode Quiz Download CPSolvers App here Patreon website RLR website VMR sign up Dr. Usha George Dr. Usha George (MBBS (MAHE India), MSc (Respiratory Medicine) Imperial College University of London, FRCP London) is at present attached to Sunway Medical Centre, Malaysia. It… Read More »Episode 168: Clinical unknown with Reza and Rabih at VMR
We continue our campaign to #EndNeurophobia by tackling this neurology clinical unknown, with the guidance of Aaron Berkowitz. Episode Quiz Download CPSolvers App here Patreon website Maria Jimena Aleman Maria Jimena Aleman was born and raised in Guatemala where she currently is a medical student in Universidad Francisco Marroquin. After suffering from long standing neurophobia,… Read More »Episode 167: Unilateral sensory changes
Rabih and Reza tackle a case of vision loss. Episode Quiz This episode is available on Patreon only. Why? More about the RLR series here.
The CPSolvers team breaks down a bite-sized case of dysphagia. Schema Download CPSolvers App here Patreon website Episode Quiz
Sarah Onorato presents a case to Dr. Ann Marie Kumfer & Dr. Debra Bynum Want to test your learning? Take our episode quiz here Dr Ann Marie Kumfer is a new residency graduate and academic hospitalist at UNC. After completing medical school at Texas Tech University, she moved up to North Carolina for residency. She liked… Read More »Episode 165: WDx #8 – Clinical unknown with Dr. Ann Marie Kumfer & Dr. Debra Bynum
Jack presents a case of abdominal pain and hypotension to Steph and Dan Download CPSolvers App here Patreon website Schema 1 Schema 2 Episode Quiz
Lindsey, Kiara (#bossladies), and Scott discuss a clinical unknown presented by Devika Download CPSolvers App here Patreon website Want to test your learning? Take our episode quiz Scott Walker Scott Walker grew up in Knoxville, Tennessee (Go Vols) where he completed his Bachelors in Kinesiology and Nutrition. He currently attends The University of Central Florida College of… Read More »Episode 163: Human Dx Unknown with Lindsey – breast mass and joint pain
In Episode 6 of the Antiracism in Medicine series, “Racism, Trustworthiness, and the #COVID19 vaccine,” we are joined by two forces in the field of health equity and academic medicine, Dr. Giselle Corbie-Smith and Dr. Kimberly Manning, to discuss why the pandemic is the moment to ensure trust in medicine. Learning Objectives After listening to… Read More »Episode 162: Antiracism in Medicine Series – Episode 6 – Racism, Trustworthiness, and the COVID-19 Vaccine
Rabih and Reza tackle a case of fever, dyspnea, and back pain presented by guest presenter Lawrence Yuen. This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our episode quiz here
We kick off our new series, “The Consult Question”, aimed at highlighting the clinical reasoning of our subspecialty colleagues, with a case of hypoglycemia presented to master endocrinologist Dr. Elizabeth Murphy. Schema Episode Quiz Dr. Elizabeth Murphy Dr. Elizabeth Murphy is a professor of Medicine at the University of California, San Francisco, where she serves… Read More »Episode 161: The Consult Question #1 – Hypoglycemia
We continue our mission to #EndNeurophobia with an episode of Neurology VMR with Dr. Aaron Berkowitz Download CPSolvers App here Patreon website Episode Quiz Dhruv Srinivasachar Dhruv Srinivasachar is a 4th year medical student at Virginia Commonwealth University School of Medicine (the Medical College of Virginia for all the veteran attendings out there). Introduced to… Read More »Episode 160: Neurology VMR: Hiccups + vertigo
Sean presents a case of dyspnea to Rabih and Reza. Schema This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our episode quiz here.
Rabih, Reza, PrezSharmin, and Arsalan break down thyrotoxicosis, by revisiting a case initially presented at our December 18th VMR. Schema Patreon website Download CPSolvers App here Episode Quiz
Ryan presents a case of dyspnea to Rabih and Reza. Schema This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our episode quiz here
Maani, Priyanka, and Lindsey discuss a clinical unknown with Dr. Jori May. Want to test your learning? Take our episode quiz here Dr. Jori May Jori May, MD, is Assistant Professor of Medicine in the Division of Hematology/Oncology at the University of Alabama at Birmingham (UAB). Her clinical interest is non-malignant hematology, focusing on the… Read More »Episode 158: WDx #7 – Clinical Unknown with Dr. Jori May – Vaginal Bleeding
Rabih and Reza tackle a case of hypotension and leg pain. This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our episode quiz here
Mansour presents a case of sudden vision loss to Dan, Erica, and Kristin. Download CPSolvers App here Patreon website Schema 1 Schema 2 Want to test your learning? Take our Episode Quiz Dr. Erica Smith Erica Smith is a fourth year Internal Medicine-Pediatrics resident at the University of Michigan. She is from Detroit, MI and… Read More »Episode 157: Human Dx Unknown with Dan – Monocular vision loss
Dr. Sabal presents a case of bilateral wrist pain to Sharmin, Dr. Davey, and Dr. Singh. Download CPSolvers App here Patreon website Want to test your learning? Take our episode quiz here Dr. Sonya Davey Sonya Davey attended medical school at the Perelman School of Medicine at the University of Pennsylvania and is currently an… Read More »Episode 156: Human Dx Unknown with Sharmin – Bilateral wrist pain
Rabih and Reza discuss a case of abdominal pain. This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our Episode Quiz
In this episode of Clinical Problem Solvers: Anti-Racism in Medicine, we are joined by Aletha Maybank MD, MPH, the American Medical Association’s (AMA) inaugural Chief Health Equity Officer and director of the AMA’s Center for Health Equity, and Camara Jones MD, PhD, MPH, thought leader in the fields of health equity and public health and… Read More »Episode 155: Antiracism in Medicine Series – Episode 5 – Racism, Power, and Policy: Building the Antiracist Health Systems of the Future
Dr. Dayyan Adoor and Dr. Keith Albrektson present a clinical unknown case to Dr. Armitage Download CPSolvers App here Patreon website Want to test your learning? Take our episode quiz here Dr. Dayyan Adoor Dayyan Adoor is a 2nd year internal medicine resident at Case Western Reserve/University Hospitals. Following residency, he hopes to pursue a… Read More »Episode 154: Clinical unknown with Dr. Armitage – Headache
Our campaign to #EndNeurophobia continues with a neuro VMR featuring one of our favorite chief complaints, AMS! Download CPSolvers App here Patreon website Schema Want to test your learning? Take our Episode Quiz Kaitlyn Thomas Kaitlyn Thomas is a 3rd year medical student at Lake Erie College of Osteopathic Medicine at their Seton Hill campus… Read More »Episode 153: Neurology VMR – AMS
Rabih and Reza take us on a journey through liver function test abnormalities This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our episode quiz here
Sharmin, Rabih, Reza, and Arsalan tackle a schema for glomerulonephritis Patreon website Download CPSolvers App here Schema Want to test your learning? Take our Episode Quiz
Reza and Rabih take a “MIST”ical journey through a case of confusion This episode is available on Patreon only. Why? More about the RLR series here. Schema Want to test your learning? Take our episode quiz here
Dr. Amara Finch presents a case of abdominal pain at VMR to Maani, Maria, Anna and Smitha. Want to learn more about Women in Diagnosis (WDx) series? Blog post– by Smitha Download CPSolvers App here Patreon website Schema Want to test your learning? Take our Episode Quiz Dr. Amara Finch Originally from Atlanta, Georgia, Amara spent… Read More »Episode 151: WDx #6 – VMR: Abdominal pain
Reza and Rabih explore a case of pleuritic chest pain. This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning?Take our Episode Quiz here Schema
Steph presents a case of pleuritic chest pain to Dan and Jack Download CPSolvers App here Patreon website Schema Want to test your learning? Take our Episode Quiz here
Malika presents a Human Dx case of pleuritic chest pain to Lindsey, Aaron, and Kelly Download CPSolvers App here Patreon website Schema Want to test your learning? Take our Episode Quiz here Dr. Kelly Uelmen Kelly is a second-year internal medicine resident at Mercy Health in Muskegon, MI. I’m from Wisconsin and went to medical school… Read More »Episode 149: Human Dx Unknown with Lindsey & the Mercy Health team
This is the second episode of a three-part series on understanding and dismantling race-based medicine. We invite Drs. Nwamaka Eneanya and Jennifer Tsai to discuss the limitations and harms of race-based medicine in clinical practice. Our guests explain how we can incorporate race-conscious medicine in clinical settings, medical education, and biomedical/epidemiological research to responsibly recognize… Read More »Episode 148: Antiracism in Medicine Series Episode 4 – Dismantling Race-Based Medicine Part 2: Clinical Perspectives
Reza, Rabih, Sharmin, and Arsalan break down meningoencephalitis in this bite sized schema episode, inspired by Dr. Kimberly Manning. Want to test your learning? Take our Episode Quiz here Patreon website Download CPSolvers App here
Reza and Rabih tackle a second case of weakness This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our Episode Quiz here Schema
Dhruv and Travis present a case of R sided weakness and numbness to Kiara, Tahir, and Aaron, as we continue our campaign to end neurophobia! Download CPSolvers App here Patreon website Want to test your learning?Take our Episode Quiz here Dhruv Srinivasachar Dhruv Srinivasachar is a 4th year medical student at Virginia Commonwealth University School… Read More »Episode 146: Neurology VMR – Right sided weakness + numbness
Reza and Rabih tackle a case of weakness. This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning?Take our Episode Quiz here
In this episode of Clinical Problem Solvers: Anti-Racism in Medicine, we sit down with Ed Yong, an award-winning journalist and science writer with The Atlantic, to discuss the structural inequities amplified by COVID-19 as well as the social concerns associated with the impending/present second wave of the pandemic. Learning Objectives After listening to this episode… Read More »Episode 145: Antiracism in Medicine Series Episode 3 – Structural Inequities and the Pandemic’s Winter Surge
Reza and Rabih tackle a case of fever at Baystate. This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning?Take our Episode Quiz here
Kushal presents a Human Dx unknown to Jack, Kushal, Gabe, and Jake. Download CPSolvers App here Patreon website Schema 1 Want to test your learning?Take our Episode Quiz here Kushal Vaishani Kushal is a hospitalist and contributing editor for the Adult Medicine section at Human Dx. After finishing his medical school in India, he completed his residency training at Brandon… Read More »Episode 144: Human Dx Unknown with Jack, Kushal, Gabe, and Jake – Back pain + lower extremity weakness
Dr. John Alexander presents a Human Dx unknown to Dr. Courtney Wagner, Dr. Ryan Goetz, and Dan Download CPSolvers App here Patreon website Want to test your learning?Take our Episode Quiz here Courtney Wagner Courtney Wagner is PGY-2 in Internal Medicine resident at the University of Alabama at Birmingham. She is a Florida native and… Read More »Episode 143: Human Dx Unknown with Dan and UAB residents- headache in the time of COVID
Sharmin, Lindsey, and Alex discuss a clinical unknown with Dr. Natasha Chida from Johns Hopkins Want to test your learning?Take our Episode Quiz here Dr. Natasha Chida Dr. Chida is an Assistant Professor in the Division of Infectious Diseases at Johns Hopkins University School of Medicine. She serves as the Associate Program Director for… Read More »Episode 142: WDx # 5 – Clinical Unknown with Dr. Natasha Chida – Altered Mental Status
This is the first episode of a three-part series on understanding and dismantling race-based medicine by unearthing its origin and exposing the paucity of rigorous evidence in support of it. In this episode, we invite Critical Race Theory scholar Edwin Lindo, JD to discuss the invention of race, how its definition has changed over time,… Read More »Episode 141: Antiracism in Medicine Series Episode 2 – Dismantling Race-Based Medicine Part 1: Historical and Ethical Perspectives with Edwin Lindo
Reza and Rabih tackle a case of hematuria. This episode is available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our Episode Quiz here
Reza, Rabih, Sharmin, and Arsalan share their approach to CNS and lung lesions. Lung Nodule Schema Ataxia Schema Patreon website Download CPSolvers App here Want to test your learning? Take our Episode Quiz here.
Reza and Rabih discuss an unknown case presented by Drs. Ramesh and Moriates at Dell Medical School Download CPSolvers App here Patreon website Schema #1 Schema #2 Want to test your learning? Take our Episode Quiz here. Dr. Jan Ramesh Jan Ramesh is the Hospital Medicine Fellow in Quality and Safety at Dell Medical School at The University of Texas at… Read More »Episode 137: Clinical unknown with Dell Medical and Rabih and Reza – dizziness & shortness of breath
Reza and Rabih tackle a case of pruritus. These additional episodes will be available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our Episode Quiz
Episode description Reza and Rabih tackle a case of renal injury. These additional episodes will be available on Patreon only. Why? More about the RLR series here. Want to test your learning? Take our Episode Quiz
Dr. Steph Le shares a story of gender discrimination and Emma and Annette discuss gender biases and stereotypes with UCSF’s Department of Surgery Chair, Dr. Julie Ann Sosa Dr. Julie Ann Sosa Julie Ann Sosa, MD MA FACS is the Leon Goldman MD Distinguished Professor of Surgery and Chair of the Department of Surgery at the University of California… Read More »Episode 134: WDx Episode #4 – The CPSolvers discuss gender biases and stereotypes with special guest Dr. Julie Ann Sosa
Description: Gizem Reyhanoglu presents a Human Dx unknown to Arsalan, Dr. Tranchito, & Dr. Kramer Download CPSolvers App here Patreon website Schema Gizem Reyhanoglu Gizem Reyhanoglu is a 4th-year medical student at LECOM-Bradenton, applying to Internal Medicine this application cycle. She completed her undergraduate degree in biology at the University of Florida and completed a… Read More »Episode 133: Human Dx Unknown with Arsalan & Case Western residents – Syncope
Dr. David Jessee presents a Human Dx unknown to Sharmin, David & Antoinette Download CPSolvers App here Patreon website Want to test your learning? Take our Episode Quiz David Jessee David Jessee is an assistant professor of medicine and academic hospitalist at Virginia Commonwealth University School of Medicine. He was born and raised in Southwest… Read More »Episode 131: Human Dx Unknown with Sharmin & Ohio State residents – headache & myalgias
The CPSolvers share a case of lactic acidosis – let’s practice those schemas together! Download CPSolvers App here Patreon website Schema Want to test your learning? Take our Episode Quiz below. Loading…
Episode Description Dr. Rencic and Colin presents a clinical unknown on Virtual Morning Report to CPSolvers, Rabih and Reza. Download CPSolvers App here Patreon website Schema 1 Schema 2 Whiteboard Want to test your learning? Take our Episode Quiz here.
Zari Zahra, Mel Fellay, Lindsey, Emma, and Sharmin discuss gender biases through stories. Want to learn more about Women in Diagnosis (WDx) series? Blog post– by Smitha Download CPSolvers App here Patreon website Melanie Fellay Melanie Fellay is the CEO and Co-Founder of Spekit, the leading in-app learning and digital enablement companion that helps employees learn their tools… Read More »Episode 127: WDx special episode with Mel Fellay, Zari Zahra & CPSolvers
Dr. Varun Phadke presents a human dx case to Arsalan, Francesca Siegel, and Alec Yu. Download CPSolvers App here Patreon website Schema Want to test your learning? Take our Episode Quiz here. Francesca Siegel Francesca Siegel is a third year medical student at The Ohio State University College of Medicine. She received her masters in Nutritional… Read More »Episode 126: Human Dx Unknown with Arsalan & medical students, Alec and Fran – vision loss
Episode Description Dr. Joshua Inglis presents a Human Dx case to Sharmin, Vivek Nair and Joshua Morris. Human Dx Case Link Download CPSolvers App here Patreon website Schema Want to test your learning? Take our Episode Quiz here. Joshua Morris Josh is a proud cat dad to four kitties and a fourth year student at Dell… Read More »Episode 125: Human Dx Unknown with Sharmin and & medical students, Vivek and Joshua – Diarrhea
Episode description Reza and Rabih tackle a case of Vulvar Pain. More about the RLR series here. Want to test your learning? Take our Episode Quiz here.
Dr. Steph Sherman, Lindsey, Emma, and Sharmin tackle a case presented by Anna Want to learn more about Women in Diagnosis (WDx) series? Blog post– by Smitha Want to test your learning? Take our Episode Quiz here. Dr. Steph Sherman Dr. Stephanie Sherman is a hospitalist and residency associate program director at Baylor College of Medicine (BCM) who rounds at Ben… Read More »WDx Clinical Unknown with Dr. Steph Sherman and the CPSolvers
We invite scholars and antiracism activists, Drs. Rhea Boyd and Rachel Hardeman, to discuss the meaning of structural racism, the health impacts of police violence, the “say her name” movement, and the ways we can ensure our country’s current antiracist movement grows beyond a moment. Learning Objectives After listening to this episode learners will be… Read More »Episode 120: Antiracism in Medicine Series Episode 1 – Racism, Police Violence, and Health
Dr. Krishan Sharma presents a Human Dx case to Sharmin & Baylor residents – Drs. Iqbal and Rana. Download CPSolvers App here Take our Episode Quiz here. Patreon website Cyrus Iqbal Cyrus is a PGY-3 internal medicine resident at Baylor College of Medicine. He loves sports, hip-hop, exploring new restaurants and coffee shops, and writing. He’s… Read More »Episode 117: Human dx unknown with Sharmin and Baylor residents – Leg weakness and difficulty swallowing
Dr. Meredith Lash Dardia presents a Human Dx case to Arsalan & Wake Forest residents – Drs. Maus and Brooks. Download CPSolvers App here Patreon website Human Dx Case Want to test your learning? Take our Episode Quiz here. Dr. Meredith Lash Dardia Dr. Meredith Lash-Dardia is an internist at Weill Cornell Medical Associates in NYC. She graduated… Read More »Episode 116: Human dx unknown with Arsalan and Wake Forest residents – Nasal congestion and rigors
The CPSolvers share a case of abdominal pain and jaundice – let’s practice those schemas together! Patreon website Schemas: abdominal pain, jaundice Thought Train: abdominal pain
Episode description Reza and Rabih tackle a case of Ascites. More about the RLR series here. Ascites Schema Episode Summary An elderly woman with a history of progressive weakness, falls, and recently diagnosed ascites presented with weight loss and functional decline. Her workup was notable for ascites with a low serum-ascites albumin gradient (SAAG), thrombocytosis, and… Read More »Episode 114: RLR #15 – Ascites (patient) and Tears (RR)
Dr. Rezigh presents a clinical unknown on Virtual Morning Report to CPSolvers, Rabih and Reza. Download CPSolvers App here Patreon website Schema Whiteboard Episode Summary A 75-year-old-woman with multiple chronic medical problems presented with right arm pain, anorexia, and diffuse erythematous nodular plaques. Her work up was notable for an elevated serum lactate and S1Q3T3 pattern on ECG. Computed tomography… Read More »Episode 112: Virtual Morning Report #100 with Rabih, Reza, and Dr. Rezigh – Rash and lactic acidosis
Episode Description Emma, Lindsey and Sharmin tackle a case presented by Sarah. Want to learn more about Women in Diagnosis (WDx) series? Blog post– by Smitha
Dr. Hastie presents a Human Dx case to Sharmin & Cleveland Clinic residents – Drs. Almaaitah and Montane. Download CPSolvers App here Patreon website Schema #1 Human Dx Case Dr. Bryce Montane Bryce Montane is a Floridian born and raised! He went to University of South Florida as part of the 7-year medical program for undergraduate and… Read More »Episode 107 – Human dx unknown with Sharmin and Cleveland Clinic residents – abdominal distention, dyspnea on exertion, and fatigue
Dr. Alexandra Rojek presents a Human Dx unknown to Arsalan and Duke residents – Drs. Stacy Bagrova & Micah Schub. Download CPSolvers App here Patreon website Schema #1 Schema #2 Human Dx Case Dr. Alexandra Rojek Alexandra Rojek is currently an internal medicine resident at the University of Chicago, interested in pursuing hematology/oncology with an… Read More »Episode 106: Human dx unknown with Arsalan and Duke residents – cough, dyspnea, & AMS
Episode description Reza and Rabih tackle a case of hypotension. More about the RLR series here.
Dr. Costello presents a clinical unknown to Dr. Dhaliwal. Download CPSolvers App here Patreon website Dr. Anna Costello Anna Costello is a Pediatric Hospitalist at the Children’s Hospital of Philadelphia, where she completed her residency and chief residency. Her interests within Medical Education include clinical reasoning and linguistically and culturally competent care. Outside of the hospital,… Read More »Episode 104: Clinical unknown with Dr. Dhaliwal and Dr. Costello – leg & back pain
Episode description Reza and Rabih tackle a case of abdominal pain. These additional episodes will be available on Patreon only. Why? More about the RLR series here.
Dr. Ryan Haran presents a Human Dx unknown to Arsalan and NYU residents – Drs. Jenny Whealdon and Greg Rubinfeld. Download CPSolvers App here Patreon website Human Dx case Dr. Jenny Whealdon Jenny was born and raised on Bainbridge Island in Seattle, Washington. She attended Haverford College where she studied religion and theoretical chemistry; ultimately… Read More »Episode 102: Human Dx unknown with Arsalan & NYU residents – abdominal swelling & decreased appetite
Dr. Leela Chockalingam presents a Human Dx unknown to Sharmin and BMC resident – Dr. Amir Gilad and Brigham resident – Dr. Hannah Chen. Download CPSolvers App here Patreon website Human Dx case Abdominal pain schema Dyspnea schema Altered mental status schema Amir Gilad Amir Gilad is a PGY-1 (very soon to be PGY-2!) at… Read More »Episode 101: Human Dx unknown with Sharmin & BMC/Brigham residents – Abdominal pain, dyspnea & confusion
Dr. Kimberly Manning and her father, Mr. William Draper, commemorate Juneteenth, the holiday that celebrates the day when all remaining enslaved Black Americas were freed in Galveston Texas, on June 19th, 1865, with this hour-long storytelling event. Click here to watch the video on the CPSolvers Virtual Morning Report platform
Meet the CPSolvers family who share their origin story, and tell you more about all the things we do beyond the podcast. Meet Us VMR Twitter Patreon Download CPS app here Instagram Schema page Illness script page Blog COVID page
Steph, Sharmin, Arsalan and Dan share a case of syncope and splenomegaly – let’s practice those schemas together! Download CPSolvers App here Patreon website Splenomegaly Schema Syncope Schema
Episode description Reza and Rabih tackle a case of acute liver injury. One RLR episode will be freely available each month but the remainder will be uploaded on Patreon only. Why? More about the RLR series here. You can find the article referenced in the episode Here
Episode Description Dr. Julia Burns presents a Human Dx unknown to Sharmin and Mercy residents – Drs. Brady Alling and Aaron Sabal. Download CPSolvers App here Patreon website Human Dx case Dr. Brady Alling Brady is a PGY 3 at Mercy Health in Muskegon, MI. Next year, he will be doing a fellowship in pulmonary &… Read More »Episode 95: Human Dx unknown with Sharmin & Mercy residents – Hypernatremia
Dr. Kavea Panneerselvam presents a Human Dx unknown to Arsalan and Utah residents – Drs. Marja Anton and Guinn Dunn. Download CPSolvers App here Patreon website Human Dx case Dr. Marja Anton Marja is a chief medical resident at the University of Utah. She is originally from Chicago, IL and received her undergraduate degree from… Read More »Episode 94: Human Dx unknown with Arsalan & Utah residents – ankle and hand pain with swelling
Episode description Reza and Rabih tackle a case of dyspnea & lightheadedness. These additional episodes will be available on Patreon only. Why? More about the RLR series here.
Episode description Reza and Rabih tackle a case of abdominal pain. These additional episodes will be available on Patreon only. Why? More about the RLR series here.
Episode description Reza and Rabih have an important announcement about the RLR series. More about the RLR series here.
Rabih and Reza tackle a clinical unknown at MUSC with host, Dr. Marc Heincelman. Download CPSolvers App here Patreon website Schema #1 Schema #2 Dr. Marc Heincelman Marc Heincelman is an assistant professor within the Department of Medicine at the Medical University of South Carolina, where he also serves as director of the Medicine Clerkship… Read More »Episode 90: Clinical unknown with Rabih and Reza at MUSC – fever
Episode description Drs. Kimberly Manning and Gurpreet Dhaliwal discuss an unknown case as part of the 50th CPSolvers Virtual Morning Report. Virtual Morning Report Click here to learn more about joining VMR and learn together, live. Dr. Kimberly Manning Kimberly D. Manning, MD is a general internist/hospitalist who serves as Associate Vice Chair of Diversity,… Read More »Episode – 89 – Virtual Morning Report #50 with Drs. Kimberly Manning and Gurpreet Dhaliwal – Foot Drop
Episode description Reza and Rabih talk through a case RLR #4 – Transient loss of consciousness A 43-year-old man with a history of epilepsy, coronary artery disease, and pulmonary sarcoidosis presented after experiencing an unheralded transient loss of consciousness. His initial evaluation revealed no abnormalities. Ambulatory cardiac event monitoring demonstrated an episode of complete heart block,… Read More »Episode 88 – RLR – Transient Loss of Consciousness
Episode description Reza and Rabih talk through a case RLR #3 – Scrotal pain A 75-year-old man with a history of Alzheimers dementia presented with 2 weeks of bilateral scrotal pain. Genital exam was unremarkable. Chest radiography revealed a right lower lobe opacity and computed tomography of the abdomen was notable for diffuse retroperitoneal lymphadenopathy. Biopsy… Read More »Episode 87 – RLR – Scrotal Pain
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Racial-Disparities-in-the-COVID-19-Pandemic.mp3Student Dr. Dereck Paul, Dr. Utibe Essien and Dr. Kimberly Manning join the CPSolvers to discuss racial disparities. This all-star crew discusses the role of race and inequality in the current COVID-19 pandemic and medicine more broadly. Don’t miss out on this truly powerful episode.
Student Dr. Dereck Paul
Dereck Paul is a 4th-year medical student at the University of California, San Francisco School of Medicine and applying into residency this fall. He studies the relationships between homelessness and health under Dr. Margot Kushel at the UCSF Center for Vulnerable Populations. He was a 2018 Student National Medical Association David E. Satcher MD, PhD Health Disparities Research Fellow for his work mapping the role of structural racism in susceptibility to housing insecurity and homelessness. Outside of his studies and research, he writes about health policy, medical education, and the underrepresented medical trainee experience.
Dr. Utibe Essien
Utibe Essien is an Assistant Professor of Medicine at the University of Pittsburgh and a health disparities researcher in the VA Center for Health Equity Research and Promotion. He completed Primary Care residency and General Internal Medicine fellowship at the Massachusetts General Hospital and Harvard Medical School. Dr. Essien’s research focuses on developing interventions to advance equity in the management of cardiovascular diseases.
Dr. Kimberly Manning
Kimberly D. Manning, MD is a general internist/hospitalist who serves as Associate Vice Chair of Diversity, Equity, and Inclusion for the Department of Medicine at Emory University School of Medicine. Manning was recently promoted to Professor of Medicine and additionally serves as residency program director for the Transitional Year Residency Program at Emory. She has a strong commitment to supporting underrepresented minorities in medicine, serving underserved populations, and creating better understanding of our patients and each other through storytelling and narrative medicine. A huge fan of the CP Solvers, Dr Manning is as enthusiastic about being a teacher as she is being a lifelong learner.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/AVI-Jack-and-Reza-MR-pre-aup-1.mp3Dr. Avital O’Glasser presents a clinical unknown on Virtual Morning Report to CPSolvers, Jack and Reza.
Case overview and teaching points
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Schema
Dr. Avital O’Glasser
Avital O’Glasser is an Associate Professor of Medicine at Oregon Health & Science University (OHSU) in the Division of Hospital Medicine. She is the medical director of OHSU’s hospitalist-led Pre-Operative Medicine Clinic, as well as The Curbsiders Kashlek Memorial Hospital Chief of Perioperative Medicine. She is also the Assistant Program Director for Social Media and Scholarship for OHSU’s Internal Medicine Residency Program. She has been a member of the OHSU faculty since completing her internal medicine residency training there, and she is a graduate of Jefferson Medical College. She enjoys spending time with her husband, two young boys, and labradoodle Matilda.
Case Summary
A 31-year-old man with no prior medical problems presented with subacute abdominal pain, recurrent fevers, and weight loss. His work-up was notable for stigmata of endocarditis, although bacterial blood cultures were persistently negative. Ultimately, he underwent aortic valve replacement, and pathologic examination of the valve tissue demonstrated coliform bacteria with molecular testing confirming a diagnosis of Streptobacillus moniliformis. Further history confirmed that he owned a pet rat and had experienced repeated bites prior to his illness.
Teaching Points
- Streptobacillus moniliformisis a pleomorphic, gram-negative rod that is the predominant cause ofrat bite fever (RBF). This pathogen is found across the United States and is most commonly transmitted by rat bites, with numerous cases being acquired from pets or laboratory animals. Clinical manifestations include fever (potentially relapsing), arthralgias, and rash. Serious complications include infective endocarditis, meningitis, systemic vasculitis, and other organ involvement.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/RLR-Episode-2_Hoarseness.mp3Episode description
Reza and Rabih talk through a case
RLR #2 – Hoarseness
A 54-year-old man with a history of PTSD, depression, and a recent diarrheal illness presented with acute dysphagia to liquids and solids. Neurologic exam was initially unremarkable, but the patient returned the next day with diplopia and ataxia. Exam was notable for new bilateral cranial nerve III palsies and areflexia. Laryngoscopy revealed unilateral vocal cord paralysis. Cerebrospinal fluid analysis was notable for elevated protein and positive GQ1b antibody testing. He was diagnosed with Miller Fisher’s syndrome, a variant of Guillain-Barre Syndrome.
Teaching Points:
- Miller Fisher’s Syndrome(MFS) is a rare variant of Guillain-Barre syndrome (acute inflammatory demyelinating polyneuropathy) that primarily affects the bulbar nerves. MFS is suggested by the classic triad of acute-onset ophthalmoplegia, ataxia, and areflexia and often occurs following a prodromal illness (upper respiratory infection or gastroenteritis). Diagnosis is supported by elevated cerebrospinal fluid protein as well as demonstration of GQ1b ganglioside autoantibodies (which are positive in 85% of cases). Prognosis is typically favorable, and most cases are self-limited.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/RLR-Diffuse-LAD.mp3Episode description
Reza and Rabih talk through a case
RLR #1 – Lymphadenopathy
A woman in her 20’s with a history of prior possible thrombotic thrombocytopenic purpura (TTP) and recently treated secondary syphilis was transferred to a tertiary referral center for evaluation of generalized lymphadenopathy, new anemia, and thrombocytopenia. Laboratory workup was concerning for a Coombs-positive autoimmune hemolytic anemia, possible immune thrombocytopenia, and polyclonal gammopathy. Core and excisional lymph node biopsies were unrevealing for either infection or malignancy. Ultimately, anti-nuclear, anti-dsDNA, and anti-Sm autoantibodies were grossly positive and the patient was diagnosed with systemic lupus erythematosus.
Teaching Points:
- Systemic Lupus Erythematosus(SLE) is a complex autoimmune disease that most frequently presents with inflammatory arthritis, malar rash, and nephropathy.Hematologic abnormalities are common in SLE and are components of both the American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) diagnostic criteria. Common features include leukopenia (both neutropenia and lymphopenia), autoimmune hemolytic anemias (generally Coombs-positive, warm-type), and thrombocytopenia. SLE is a recognized cause of secondary thrombotic thrombocytopenic purpura (TTP), which may present concurrently with or, in some instances, precede the diagnosis of SLE.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/VMR-15-4-26-20-5.52-PM.mp3Dr. Kushal Vaishnani presents a clinical unknown on Virtual Morning Report to student Dr. Jean-Claude Guidi and Dr. Ramya Ramachandran.
Case Overview & Teaching Points
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Problem Representation
A 53-year-old woman with a history of rheumatoid arthritis and amiodarone-induced lung injury on immunosuppression presented with acutely progressive hypoxic respiratory failure and hypotension, found to have a serpiginous truncal rash, acute anemia, and elevated beta-d-glucan.
Schemas
In this episode, we revisit the schemas for fever and rash (which highlights first addressing the life-threatening causes) and diffuse alveolar hemorrhage (which focuses on differentiating vasculitis from other etiologies).
Diagnosis
The patient underwent bronchoscopy with bronchoalveolar lavage fluid demonstrating elevated leukocytes with a neutrophilic predominance as well as progressively bloody fluid, consistent with diffuse alveolar hemorrhage. Silver stain was diagnostic for Pneumocystis jiroveci, and pathology revealed helminthic larvae consistent with Strongyloides stercoralis. The patient was diagnosed with both Pneumocystis pneumonia and Strongyloides hyperinfection syndrome!
Teaching Points:
- Beta-D-glucan(BDG) is a cell wall polysaccharide found in many fungal organisms (with notable exceptions including Cryptococcus, the zygomycetes, and Blastomyces dermatitidis) and is frequently used as a laboratory marker for invasive fungal infections. Caution is advised when interpreting this test, as it is imperfectly sensitive and false positives have been reported in association with certain hemodialysis filters, immunoglobulins (e.g., IVIG), albumin, and beta-lactam antimicrobials (thought to be more of an issue with older formulations).
- Strongyloides stercoralisis an important human pathogen in tropical and subtropical areas throughout the world. While many cases of chronic strongyloidiasis are mild and may go unrecognized, severe manifestations can include the strongyloides hyperinfection syndrome and disseminated strongyloidiasis. Hyperinfection occurs when there is accelerated autoinfection (i.e., the ability to complete the parasitic life cycle entirely within the host – a trait relatively unique to Strongyloides among human helminthiases) and most commonly occurs in the setting of immune dysregulation or exogenous immunosuppression.
- Pneumocystis jiroveciis an important opportunistic infection in immunosuppressed patients. Originally identified by Carlos Chagasin 1909, who believed it to represent a pulmonary manifestation of the parasite Trypanosoma cruzi, it was later reclassified as a fungus in 1988. The most frequent symptoms include subacute dyspnea, nonproductive cough, and low-grade fever, with hypoxemic respiratory failure being the most common manifestation of severe decompensation.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/OHSU-final-sp-aup.mp3Dr. Ruchit Rana presents a Human Dx unknown to Dr. André Mansoor and OHSU residents – Drs. Logan Jones and Patricia Liu.
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Human Dx case
Schema #1
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Dr. Logan Jones
“Logan” Jones is a PGY-3 at OHSU in Portland, and will be joining the faculty as an assistant professor in the Division of Hospital Medicine with an academic focus on student assessment, curricular innovation, learner scholarship, clinical reasoning, and EMR proficiency. He is active in organized medicine with the American Medical Association and the American College of Physicians. Outside of medicine, he enjoys cooking with his sig fig Samantha, spending time on his yoga mat, and hiking throughout the Pacific Northwest.
Dr. Patricia Liu
Pat is currently one of the IM chief residents at Oregon Health & Science University. She will be a hospitalist next year and is interested in medical education, empowering women in medicine and improving care for inpatients with substance use disorders. In her free time, you can find her running, snowboarding and teaching tricks to her cat, Pekoe.
Dr. Ruchit Rana
Ruchit Rana is currently a second-year internal medicine resident at Baylor College of Medicine. He completed medical school at Baylor College of Medicine. He has a passion for practicing and improving medical education at all levels. In his free time, he enjoys cooking and baking dishes across all ethnicities and maintaining his multiple freshwater aquariums at home.
Dr. André Mansoor
André Mansoor is an Assistant Professor of Medicine at Oregon Health and Science University in Portland, Oregon. His favorite book is the Count of Monte Cristo and his favorite band is Stone Temple Pilots. He is the author of an internal medicine textbook called Frameworks for Internal Medicine. https://www.amazon.com/Frameworks-Internal-Medicine-Andre-Mansoor/dp/1496359305.
Case Summary
A 70-year-old man presented with six months of dyspnea on exertion, night sweats, and weight loss. He was found to be febrile and in distributive shock, with laboratory analysis demonstrating cytopenias, coagulopathy, and lactic acidosis. Computed tomography of the abdomen and pelvis was notable for hepatosplenomegaly, and a bone marrow biopsy revealed a monoclonal B-cell population with hemophagocytosis. The patient was diagnosed with diffuse large B-cell lymphoma complicated by hemophagocytic lymphohistiocytosis (HLH).
Teaching Points:
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening, immune-mediated disease caused by impaired NK and cytotoxic T-cell function. While genetic defects play a prominent role in triggering HLH in children, most cases of HLH in adults are secondary to another disorder, such as infections (e.g., EBV, histoplasmosis), hematologic malignancies (e.g., NK, T, or B-cell lymphomas), or autoimmune disease (e.g., systemic lupus erythematosis).
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Human-Dx-IU-FINAL.m4aDr. Anand Patel presents a Human Dx unknown to Rabih and Indiana residents – Drs. Devika Gandhi and Cody Hill.
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Human Dx case
Schema
Dr. Devika Gandhi
Devika Gandhi is a second-year internal medicine resident at Indiana University. She is originally from Dayton, Ohio and received her undergraduate degree from the University of Akron. She earned her medics degree from Northeast Ohio Medical University in Rootstown, Ohio (Go Walking Whales!). After residency, she plans to pursue a career in gastroenterology/hepatology. During her free time, she enjoys reading, cooking, and going out to trivia with friends.
Dr. Cody Hill
Cody Hill is a second-year Med-Peds resident at Indiana University. He attended Clemson University for his undergraduate/graduate studies and the University of South Carolina School of Medicine Greenville for medical school. Although he loves taking care of patients, his true passion lies in medical education, especially when it relates to clinical reasoning and evidence-based medicine. He is also very invested in resident wellness and mentorship, which led him and a fellow classmate to start their own podcast called The Resident Lounge (@resident_lounge). After residency, he plans to pursue a career as a Med-Peds hospitalist and a medical educator with the ultimate goal of one day becoming a program director. Cody also just became a father, so in addition to taking care of his newborn daughter, he and his wife enjoy walking their dog, gardening, cooking and exploring Indianapolis for new craft beers.
Dr. Anand Patel
Dr. Anand Patel is a hematology-oncology fellow at the University of Chicago and the Medical Education Lead at the Human Diagnosis Project. He attended University of Missouri-Columbia for medical school and completed both his internal medicine residency and chief residency at Northwestern. Anand’s academic interests include medical education and clinical reasoning. Specifically within hematology-oncology, he is interested in clinical trial design using targeted therapies for patients with leukemias and myeloid neoplasms.
Case Summary
An 83-year-old woman with acute myeloid leukemia and psoriasis (on immunosuppression) presented with six weeks of fatigue, weight loss, and a dry cough. Her medical history was notable for two indeterminate interferon-gamma release assays. Computed tomography of the chest demonstrated a 3 x 3 cm right lower lobe mass, with subsequent biopsy revealing necrotizing granulomas and acid-fast bacilli. Cultures ultimately grew Mycobacterium avium complex (MAC).
Teaching Points:
Mycobacterium avium complex (MAC) is a ubiquitous water and soil-based organism. Clinical manifestations include pulmonary infections, lymphadenitis, and disseminated disease in severely immunocompromised patients (e.g., those with HIV and CD4 counts < 50 cells/µL). Pulmonary manifestations of MAC include cavitary upper lobe disease similar to tuberculosis, fibronodular bronchiectasis that often develops in the right middle lobe or lingula, solitary pulmonary nodules, and hypersensitivity pneumonitis.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/University-of-Colorado-Human-Dx-FINAL.m4aDr. Anand Jagannath presents a Human Dx unknown to Reza and U of C residents – Drs. Alec and Austin Rezigh.
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Human Dx case
Schema
Dr. Alec Rezigh
Alec Rezigh is a third-year internal medicine resident at The University of Colorado. He is originally from Houston, TX and received his undergraduate degree at the University of Texas at Austin. He then went back to Houston for medical school at the University of Texas at Houston (McGovern) Medical School. In his free time, he loves all things basketball, traveling with his wife, and napping on the couch with his dog. Following completion of his training, he will return to Houston to be an academic hospitalist. He wishes to thank Dr. Juan Lessing for his amazing mentorship and inspiring his interest in clinical reasoning – and introducing him to Rabih and Reza!
Dr. Austin Rezigh
Austin Rezigh is a third-year internal medicine, primary care track resident at the University of Colorado. He completed medical school at UT Southwestern and is excited to pursue a career in academic general internal medicine. In his free time, he enjoys trying new cuisines, exercising, and spending time with his fur-niece, Kensie.
Dr. Anand Jagannath
Dr. Anand Jagannath is a clinician-educator at the University of California, San Diego (UCSD) and hospitalist at the VA San Diego. He completed medical school at the Tufts University School of Medicine and internal medicine residency and chief residency at Albert Einstein College of Medicine/Montefiore Medical Center. At UCSD, Anand’s interests include bedside team rounding, teaching clinical reasoning to medical students and residents, learning from his learners, and promoting a safe and inclusive learning environment. He is also a Section Editor for adult medicine cases at the Human Diagnosis Project. When he’s not getting excited about medicine, you’ll probably find Anand cooking food, watching shows about food on Netflix, running, or playing basketball or his violin.
Human Dx Case Summary
A 66-year-old man with alcohol use disorder and chronic NSAID use presented with one day of abdominal pain and nausea. Laboratory analysis was notable for hypercalcemia to 16 mg/dL (with low parathyroid hormone and vitamin-D levels), metabolic alkalosis, and an acute kidney injury. The patient disclosed that he had recently consumed large amounts of calcium carbonate for his abdominal pain, and he was diagnosed with the milk alkali syndrome. His serum calcium normalized after receiving intravenous fluids and withholding further calcium supplementation.
Teaching Points:
The milk alkali syndrome, the third most common cause of hospital admission for hypercalcemia, develops from excess consumption of calcium supplements (e.g., calcium carbonate). Patients classically present with hypercalcemia, metabolic alkalosis, and renal insufficiency. The metabolic alkalosis is thought to be due to hypercalcemia-induced nephrogenic diabetes insipidus, while renal insufficiency develops as a result of calcium-induced renal tubular damage and vasoconstriction of the renal afferent arteriole. Treatment includes intravenous fluid resuscitation and cessation of calcium supplementation.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/SLS-AKI-and-Hyponatremia-FINAL.m4aThe CPSolvers share a case of hyponatremia and AKI – let’s practice those schemas together!
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Hyponatremia schema
AKI schema
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Aimee-Zaas-EPpost-aup.mp3Dr. Ellie Garbade presents a clinical unknown to Dr. Aimee Zaas and CPSolvers.
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Learn-Live!
Dr. Ellie Garbade
Ellie Garbade is a current chief resident at the University of Rochester Medical Center, where she completed her internship and residency in Internal Medicine. Following chief year, she plans to continue her career at the University of Rochester as an academic hospitalist.
Dr. Aimee Zaas
Aimee Zaas is an Associate Professor of Medicine at Duke University School of Medicine in the Division of Infectious Diseases and International Health. She serves at the Program Director for the Duke Internal Medicine Residency Program and spends her clinical time on the general medicine service with residents and students as well as on the Transplant Infectious Diseases consultative service at Duke Hospital. After completing her medical school at the Feinberg School of Medicine at Northwestern University, she completed her residency and Assistant Chief of Service (Thayer!) at The Johns Hopkins Hospital and her Infectious Diseases fellowship at Duke. She enjoys spending time with her husband, two boys (but, let’s face it, they are teenagers so are never home) and two dogs, cheering on her kids’sports, the Duke Blue Devils and St. Louis Cardinals as well as trying out new restaurants and excellent coffee.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Sal-Reza-Boateng_Human-Dx-3-21-20-7.18-PM.mp3Dr. Sneha Thatipelli presents a Human Dx case to student doctor Boateng Kubi and CPSolvers Sal and Reza.
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Human Dx case
Student Doctor Boateng Kubi
Boateng Kubi is a third-year medical student at Johns Hopkins University School of Medicine and will be applying to residency programs this fall.
He is excited to pursue a career in academic surgery and has developed an early interest in cardiothoracic surgery. He is interested in outcomes research, medical education, and clinical reasoning. His clinical interests include cardiovascular infections, thoracic malignancies, and heart & lung transplantation. A Maryland native, he enjoys spending his free time with family, working out, or exploring restaurants in Baltimore with friends.
Dr. Sneha Thatipelli
Sneha Thatipelli is a third year internal medicine resident at Northwestern Memorial Hospital. She completed her medical school at UCSF, and is excited to pursue a career in Infectious Disease with a focus on HIV medicine. She is passionate about medical education and understanding barriers to provide equitable care for vulnerable populations. She will be a graduate of the Health Equity and Advocacy Clinical Scholars (HEACS) program at McGaw and hopes to use this training for clinical care and also medical education of trainees.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Einstein-HDX-FINAL.mp3Dr. Hajduczok presents a a Human Dx case to Einstein residents, Dr. Gandhi and Dr. Bressman, and Rabih.
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Human Dx Case
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Dr. Himali Gandhi
I graduated from NYU medical school and am now finishing my PGY-3 year at Montefiore Medical Center in the Bronx, NY. My clinical interests include preventative cardiology and medical education and I am excited to be starting my cardiology fellowship at Northshore University Hospital- Northwell in Long Island. When I am not in the hospital I love hiking, running, cooking, and exploring different styles of dance.
Dr. Max Bressman
I went to Swarthmore College where I played tennis for the college team (ranked top 25), went to NYU Medical School (switched to golf, now attempt to qualify for the US Open every year and came 1 stroke from making the US national amateur championship last year). Finishing PGY-3 year at Montefiore in the Bronx, NY. Was originally planning on cardiology, but changed my mind and am going to stay as a Hospitalist at Montefiore and get involved in education. While at Montefiore, published abstracts, posters, and just got a manuscript into AJM. Anand Jagannath was my chief as an intern and we wrote and abstract/poster (along with Firm-1 leader Matt Shaines) that won the top prize at SHM in 2018.
Alex Hajduczok
Alex Hajduczok is a second-year internal medicine resident at Penn State Hershey Medical Center. He is originally from Buffalo, New York and completed is undergraduate degree in biochemistry at the University of Rochester and stayed at the University of Rochester School of Medicine & Dentistry for medical school. After residency, he plans to pursue a career as a clinician-investigator in cardiology. He is currently engaged in heart failure remote monitoring research at Penn State Hershey. In his free time, he enjoys working out, coaching CrossFit, and playing hockey.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Case-Based-COVID-FINAL.m4aEpisode description
Student Dr. Emma Levine moderates a COVID-19 case discussion with expert input from Drs. Brian Block, Neeta Thakur and Peter Chin-Hong
Dr. Peter Chin-Hong
Peter Chin-Hong is Associate Dean for Regional Campuses at UCSF School of Medicine. He is a medical educator who specializes in treating infectious diseases, particularly infections that develop in patients who have suppressed immune systems, such as as solid organ and hematopoietic stem cell transplant recipients and HIV+ organ transplant recipients. He directs the immunocompromised host infectious diseases program at UCSF. He has been involved in the COVID19 clinical consultation and treatment team.
Dr. Neeta Thakur
Neeta Thakur is a Pulmonary Critical Care Physician and health disparities researcher at UCSF. Her main research interests are in understanding how the social environment contributes to disease and modifies disease course in low-income communities and communities of color. Dr. Thakur’s experience as a clinician and Medical Director of the Zuckerberg San Francisco General Hospital Chest Clinic, gives her first-hand insight on how social and environmental stress negatively affect asthma and other health outcomes, and practical knowledge of the existing barriers to adoption of evidence-based interventions into practice. With the evolving COVID-19 epidemic, her research focus has shifted to better understand the fears, needs, and socioeconomic impact in low-income, diverse communities.
Dr. Brian Block
Brian Block is an Instructor of Medicine and Research Fellow in the Division of Pulmonary and Critical Care Medicine at UCSF. He has interests in medical ethics and critical illness communication. He graduated from Harvard Medical School and completed Internal Medicine training at Columbia University where he was also a Chief Resident. He then came to UCSF to complete fellowship training in Pulmonary and Critical Care medicine. His UCSF bio also describes him as a “mediocre golfer” and now he can’t figure out how to have that removed.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Joel-Episode-3-16-20-8.49-AM.mp3Dr. Madeline McCrary and Dr. Bob Centor present a clinical unknown to Dr. Joel Topf.
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Schema #2
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Dr. Joel Topf
Joel Topf went to medical school at Wayne state University School of Medicine and did Med-Peds at Indiana University. He completed an adult fellowship in nephrology at the University of Chicago. He is currently a clinical nephrologist in Detroit at Oakland University William Beaumont School of Medicine. Joel’s passion is using social media and new media to teach nephrology. He started his blog, PBFluids in 2008. He developed NephMadness and NephJC to leverage the power of community, digital scholarship and creativity to teach nephrology. He is the founder and program director of the Nephrology Social Media Collective internship which trains medical professionals to use social media for medical education. Joel is a pioneer in bringing visual abstracts to nephrology and is a visual abstract editor for CJASN and the American Journal of Nephrology. He is creator and host of the nephrology podcast, Freely Filtered. He was recognized by the American Society of Nephrology with the Robert Narins award for innovations in Teaching in 2017.
Dr. Madeline McCrary
Madeline McCrary is a third year Internal Medicine resident at Christiana Care in Delaware. She is originally from Annapolis, MD but moved down south to North Carolina for the next 10 years. She went to Duke for undergrad then switched sides and went to UNC for medical school. She will be starting Infectious Diseases fellowship at UNC in July. In her spare time, she enjoys exploring with her dog Sammie, spending time with family and friends, and playing board games.
Dr. Bob Centor
Dr. Centor is Professor Emeritus of Internal Medicine at the University of Alabama at Birmingham, Chair Emeritus for the Board of Regents for the American College of Physicians (ACP) and a retired Dean working part-time at Huntsville and the VA in Alabama.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/COVID-Italy-2-FINAL.m4aEpisode description
Mike Rose, Ryoko Hamaguchi, Reza Manesh and Rabih Geha interview Drs. Ripa and Monti from the IRCCS San Raffaele Hospital
CPSolver morning report
Dr. Marco Ripa
Marco Ripa is a Researcher and Infectious Disease physician working at IRCCS San Raffaele Hospital in Milan. His main research topics are sepsis, bloodstream infections and infective endocarditis. During his specialty training, he worked for one year at the Hospital Clinic in Barcelona with professor Alex Soriano and professor José Maria Miró in the Nosocomial Infections and Cardiovascular Infection Units. He is a member of the ESCMID Study Group for Bloodstream Infections, Endocarditis and Sepsis (ESGBIES). Currently, he is working in the COVID-19 dedicated ward of San Raffaele Hospital.
Dr. Giacomo Monti
Giacomo Monti is a consultant in Anesthesia and Intensive Care working in the general ICU, medical emergency team and emergency operating room of one the most important University Hospital in Italy. He’s actively involved in scientific research on sepsis, invasive and non-invasive ventilation, outcome after surgery, sedation in ICU, and kidney failure. He has been the Principal Investigator for many international collaborative studies. Currently, he’s leading different research projects, thanks to different grants from public and private founders. He’s active in teaching as adjunct professor on different topics both for medical and post graduates students.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/COVID-ITALY-1-final.mp3Episode description
Mike Rose, Ryoko Hamaguchi, Reza Manesh and Rabih Geha interview Drs. Ripa and Monti from the IRCCS San Raffaele Hospital
Dr. Marco Ripa
Marco Ripa is a Researcher and Infectious Disease physician working at IRCCS San Raffaele Hospital in Milan. His main research topics are sepsis, bloodstream infections and infective endocarditis. During his specialty training, he worked for one year at the Hospital Clinic in Barcelona with professor Alex Soriano and professor José Maria Miró in the Nosocomial Infections and Cardiovascular Infection Units. He is a member of the ESCMID Study Group for Bloodstream Infections, Endocarditis and Sepsis (ESGBIES). Currently, he is working in the COVID-19 dedicated ward of San Raffaele Hospital.
Dr. Giacomo Monti
Giacomo Monti is a consultant in Anesthesia and Intensive Care working in the general ICU, medical emergency team and emergency operating room of one the most important University Hospital in Italy. He’s actively involved in scientific research on sepsis, invasive and non-invasive ventilation, outcome after surgery, sedation in ICU, and kidney failure. He has been the Principal Investigator for many international collaborative studies. Currently, he’s leading different research projects, thanks to different grants from public and private founders. He’s active in teaching as adjunct professor on different topics both for medical and post graduates students.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Episode-70-CVOD-w-Dr.-Del-Rio.mp3Episode description
Student Dr. Emma Levine & the CPSolvers talk COVID-19 with Dr. Carlos Del Rio
Dr. Carlos Del Rio
Carlos del Rio, MD is Distinguished Professor of Medicine at Emory University School of Medicine and Professor of Global Health and Epidemiology at the Rollins School of Public Health of Emory University. He is co-Director of the Emory CFAR and co-PI of the Emory-CDC HIV Clinical Trails Unit and the Emory Vaccine Treatment and Evaluation Unit. Dr. del Rio is a native of Mexico where he was Executive Director of the National AIDS Council of Mexico (CONASIDA, the Federal agency of the Mexican Government responsible for AIDS Policy throughout Mexico), from 1992 through 1996. He was also a member of the National Academy of Medicine.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Lactic-Acidosis-Final-V2.mp3Episode description
Rabih, Reza, Arslan, Sharmin and Tony Breu share their approach to lactic acidosis.
Lactic Acidosis Schema
Hyperacute CHF Schema
Tweetorial
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https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Human-Dx-UNC-FINAL.mp3Dr. Travis Smith presents a Human Dx unknown to Rabih and UNC residents – Drs. Kumfer and Diddams.
Human Dx case
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Dr. Ann Marie Kumfer
Dr. Kumfer is a third year resident at the University of North Carolina Internal Medicine Residency. She completed medical school at Texas Tech University Health Science Center. She is pursuing a career in hospital medicine and is interested in medical education and diagnostic clinical reasoning. In her time away from work, she enjoys traveling, running, and spending time with her husband and dog.
Dr. Maxwell Diddams
Dr. Maxwell Diddams is a 3rd year resident in Internal Medicine at the University of North Carolina at Chapel Hill where he will be staying for his fellowship in pulmonary and critical care. Max can be easily identified by the portable ultrasound he always carries, and is interested in point-of-care ultrasound for the internist and intensivist. Outside of medicine he enjoys rock climbing, good jokes, Chinese language learning, and pants with pockets large enough for the whole bottle of ultrasound gel.
Dr. Travis Smith
Travis Smith is an attending EM doc and clinical preceptor at St. Vincent’s Southside in Jacksonville, Florida. He also currently serves as a Regional Dean for the Lake Erie College of Osteopathic Medicine where he helps mentor 50 wonderful and bright third and fourth year medical students. He is a graduate from the University of Florida Emergency Residency-Jacksonville campus in 2012 and Lake Erie College of Osteopathic Medicine-Bradenton in 2009. He received a degree in Biological Science from The Florida State University in 2005 (go Noles). In his spare time, he enjoys being a father of 3 young kids, golfing as much as possible, FSU football, and bedside ultrasound with his new Butterfly IQ.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Pitt-and-Reza-Round-2.mp3Dr. Janna Raphelson presents a Human Dx unknown to Reza and Pitt residents – Drs. Mallarino-Haeger and Augustin.
Human Dx case
Schema
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Dr. Christina Mallarino-Haeger
Christina Mallarino-Haeger is a third year Internal Medicine resident at UPMC/University of Pittsburgh. Originally from Bogota, Colombia; Christina completed her medical school at the Pontificia Universidad Javeriana, followed by a postdoctoral research fellowship at Brigham and Women’s hospital in Boston. Christina will be moving to Atlanta to continue her training in infectious diseases at Emory and is interested in pursuing a career as a physician-scientist and HIV researcher. When not in the hospital, Christina enjoys riding her bike, going to the symphony and watching movies.
Dr. Ryan Augustin
Ryan Augustin is a second-year internal medicine resident at the University of Pittsburgh Medical Center. He is originally from Minnesota (Twin Cities) and received his undergraduate degree in biochemistry from the University of St. Thomas. He graduated from Case Western Reserve University School of Medicine where his love for all things med-ed took root. After residency, he plans to pursue a career in medical oncology. During his free time, he enjoys playing piano and cooking with his wife.
Dr. Janna Raphelson
Janna Raphelson is a PGY-1 in Internal Medicine at UC San Diego. She is a born Midwesterner who moved to Montreal to complete her medical degree at McGill University and learn some French. Her clinical interests include physical exam teaching, clinical anatomy for internists, and point of care ultrasound. Since moving to California, she spends her free time running outside all year round and reading books on the beach.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Clinical-Unknown-LS-Final.m4aCPS team Stephenie Le, Dan Minter, and Rabih Geha present a clinical unknown case to Dr. Lekshmi Santhosh.
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Dr. Lekshmi Santhosh
Dr. Santhosh is Assistant Professor at UCSF in the Divisions of Pulmonary/Critical Care Medicine and Hospital Medicine. She cares for patients at UCSF in the medical and neurological ICUs, the general pulmonary outpatient clinic, and on the general medicine teaching service. She serves as the Associate Program Director of the UCSF Pulmonary/Critical Care Fellowship Program and is the Co-Director of the UCSF Women in Leadership Development program. She is involved in medical education at the medical student, resident, and fellow levels and is passionate about clinical reasoning, medical education, and leadership development.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/SLS-3_hemolytic-anemia-FINAL.m4aEpisode description
The CPSolvers share a case of hemolysis and infection – let’s practice those schemas together!
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Schemas
Hemolysis
Infection in inpatient
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Episode-64-Human-Dx-with-Mike-and-Jack.mp3Dr. Mady Heldman presents a Human Dx unknown to Rabih and CPSolvers, Drs. Penner and Rose.
Human Dx case
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Dr. Mady Heldman
Dr. Heldman is currently an infectious diseases fellow at the University of Washington. Originally from Cincinnati, OH, she completed her undergraduate education at Brown University in Providence, RI. She then began making her way west across the country, completing both medical school and internal medicine residency at Northwestern in Chicago, before heading out to the Pacific Northwest. Her academic interests include transplant ID, immunocompromised hosts, and medical education. In her spare time, she enjoys running, hiking, and exploring new restaurants.
Drs. Jack Penner & Mike Rose
Meet Us
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/HumanDx-Pitt-FINAL.m4aEpisode description
Dr. Nick Duca presents a Human Dx unknown to Reza and Pitt team – Drs. Mallarino-Haeger and Augustin.
Human Dx case
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Dr. Ryan Augustin
Ryan Augustin is a second-year internal medicine resident at the University of Pittsburgh Medical Center. He is originally from Minnesota (Twin Cities) and received his undergraduate degree in biochemistry from the University of St. Thomas. He graduated from Case Western Reserve University School of Medicine where his love for all things med-ed took root. After residency, he plans to pursue a career in medical oncology. During his free time, he enjoys playing piano and cooking with his wife.
Dr. Christina Mallarino-Haeger
Christina Mallarino-Haeger is a third year Internal Medicine resident at UPMC/University of Pittsburgh. Originally from Bogota, Colombia; Christina completed her medical school at the Pontificia Universidad Javeriana, followed by a postdoctoral research fellowship at Brigham and Women’s hospital in Boston. Christina will be moving to Atlanta to continue her training in infectious diseases at Emory and is interested in pursuing a career as a physician-scientist and HIV researcher. When not in the hospital, Christina enjoys riding her bike, going to the symphony and watching movies.
Dr. Nick Duca
Dr. Nick Duca is an assistant professor of medicine in the division of general internal medicine at Penn State College of Medicine. He completed his internal medicine residency and chief residency at the University of Pittsburgh Medical Center- Presbyterian. He joined as faculty at Penn State College of Medicine in July of 2017. His clinical roles include outpatient medicine as well as attending on the inpatient teaching services at Hershey Medical Center. He has a strong interest in mentoring and clinical reasoning. He currently serves as clerkship director for the internal medicine clerkship. In his free time he loves spending time with his wife, Lauren, 3-month-old daughter Natalie, and their Beagle, Simon. He also enjoys fishing the beautiful trout streams of central Pennsylvania, hiking, and practicing mindfulness meditation.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/CPSolvers-DEM-Final.mp3Episode Description
Dr. Andrew Olson presents a clinical unknown case to Reza & Rabih at DEM, with an introduction by Dr. Gurpreet Dhaliwal.
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Schema #1
Schema #2
Show notes
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Dr. Andrew Olson
Andrew Olson is an Associate Professor of Medicine and Pediatrics at the University of Minnesota Medical School. He grew up on a farm in Iowa and then attended medical school at the University of California, Davis, did an internship in medicine at UCSF, and then residency in Medicine and Pediatrics at the University of Minnesota. A hospitalist, his work focuses on improving diagnostic performance through education as well as educational approaches to teach clinical reasoning. He is the co-chair of the Education Section of the Society to Improve Diagnosis in Medicine.
Dr. Gurpreet Dhaliwal
Dr. Dhaliwal is a clinician-educator and Professor of Medicine at the University of California, San Francisco. He is the site director of the internal medicine clerkship at the San Francisco VA Medical Center, where he teaches medical students and residents in the emergency department, urgent care clinic, inpatient wards, outpatient clinic, and morning report. His academic interests are the cognitive processes underlying diagnostic reasoning and clinical problem-solving and the study of diagnostic expertise. Dr. Dhaliwal enjoys playing pickup basketball with his two sons … even though both can handily defeat him.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Hypoglycemia-new-ambulance-post-AUP.mp3Episode description
Rabih, Reza, Arsalan, Sharmin, and Jack share their approach to hypoglycemia.
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Hypoglycemia Schema
Tweetorial
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Show notes
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Episode-60-CPsolvers-Human-Dx-Penn.mp3Episode description
Dr. Travis Smith presents a Human Dx unknown to Reza and Penn team – student Drs. Hernando and Murdock.
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Mary Ann Hernando
Mary Ann Hernando is a 5th-year medical student at the University of Pennsylvania in the process of applying in Internal Medicine. She is originally from Miami, Florida and received her undergraduate degree in neuroscience from the University of Miami. During medical school, she took a year out to pursue a Master of Public Health at Johns Hopkins University with a concentration in health systems and policy. In her spare time, Mary Ann enjoys cooking with friends, live music, and working her way through every escape room in Philadelphia.
H. Moses Murdock
H. Moses Murdock is a 5th year medical student at the University of Pennsylvania applying in Internal Medicine. He is originally from Orlando, Florida, and received his undergraduate degree at the University of Central Florida in molecular biology and microbiology. In his free time, Moses enjoys running, reading, and discovering new vegetarian restaurants.
Dr. Travis Smith
Travis Smith is an attending EM doc and clinical preceptor at St. Vincent’s Southside in Jacksonville, Florida. He also currently serves as a Regional Dean for the Lake Erie College of Osteopathic Medicine where he helps mentor 50 wonderful and bright third and fourth year medical students. He is a graduate from the University of Florida Emergency Residency-Jacksonville campus in 2012 and Lake Erie College of Osteopathic Medicine-Bradenton in 2009. He received a degree in Biological Science from The Florida State University in 2005 (go Noles). In his spare time, he enjoys being a father of 3 young kids, golfing as much as possible, FSU football, and bedside ultrasound with his new Butterfly IQ.
https://clinicalproblemsolving.com/wp-content/uploads/2017/05/Episode-59-CPSolvers-Human-Dx-UCSD.m4aEpisode description
Dr. Patrick Murphy presents a Human Dx clinical unknown to UCSD team – student Dr. Deshpande and Drs. Hastie & Jagannath
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Rima Deshpande
Rima Deshpande is a fourth year medical student at the University of California San Diego (UCSD) School of Medicine. She is originally from Thousand Oaks, California and completed her undergraduate biology degree from UCSD. She is interested in pursuing residency in Internal Medicine. In her free time she enjoys cooking, hiking, and going to the dog beach with her dog Rajah.
Dr. Elizabeth Hastie
Elizabeth (Lizzy) Hastie is a second year Internal Medicine resident at the University of California San Diego. She is originally from Cincinnati and graduated from Emory University School of Medicine. She is currently a part of the RACE (Resident as Clinical Educator) Track at UCSD and is interested in pursuing a career in medical education. During her free time, she enjoys hiking, running, and watching scary movies.
Dr. Anand Jagannath
Dr. Anand Jagannath is a clinician-educator at the University of California, San Diego (UCSD) and hospitalist at the VA San Diego. He completed medical school at the Tufts University School of Medicine and internal medicine residency and chief residency at Albert Einstein College of Medicine/Montefiore Medical Center. At UCSD, Anand’s interests include bedside team rounding, teaching clinical reasoning to medical students and residents, learning from his learners, and promoting a safe and inclusive learning environment. He is also a Section Editor for adult medicine cases at the Human Diagnosis Project. When he’s not getting excited about medicine, you’ll probably find Anand cooking food, watching shows about food on Netflix, running, or playing basketball or his violin.
Dr. Patrick Murphy
Pat is currently a 2nd year fellow in an acute care surgery and trauma fellowship in Indianapolis, Indiana. Originally from Nova Scotia, Canada he completed his General Surgery training at Western University in London, Ontario. During his training he successfully completed with MPH from Johns Hopkins University and his MSc from Western University. His main areas of interests are outcomes and health services research in emergency general surgery and trauma, with a focus on quality of care. Outside of medicine he enjoys competing in triathlons and playing soccer.
Human Dx
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