The Surgical Palliative Care Podcast

#028 - Join host Dr. Red Hoffman as she interviews Andy Baxter, the founder of the Cunniff-Dixon Foundation.  The Foundation is named in honor of Andy's wife, Carley, who died of breast cancer in 2005, as well as in honor of her physician, Dr. Peter S. Dixon.  The mission of the Cunniff-Dixon Foundation is to enrich the Doctor-Patient relationship near the end of life by fostering human development in medicine and supporting and funding projects relating to Palliative Care. In 2009, along with the American College of Surgeons, the Foundation produced Surgical Palliative Care: A Resident's Guide.  For many years, this was the only readily available resource available for surgeons who were interested in learning how to integrate palliative medicine into the care of surgical patients.  The Foundation's latest project, Planning Way My, is a free resource created to help guide people through their Advance Care Planning journey.  To learn more about the Cunniff-Dixon Foundation click here.To read Surgical Palliative Care: A Resident's Guide click here.To learn more about Planning My Way click here.To learn more about the recently launched Surgical Palliative Care Society, visit the website at  www.spcsociety.org or twitter @spcsociety.To learn more about the surgical palliative care community, visit twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com or twitter @redmdnd.

#027 - Join host Dr. Red Hoffman as she interviews neurosurgeon and writer Dr. Jody Stern.   Jody discusses his recently released book, Grief Connects Us, which was inspired by his sister Victoria's illness and death from leukemia as well as his brother in law Pat's death from a ruptured aneurysm.   Jody speaks candidly about how these experiences changed him as both a person and as a surgeon.  He reflects upon the importance of emotional agility and the challenges of practicing as a surgeon while maintaining an open heart.  However, he also notes that "if a neurosurgeon can do it, anyone can!"   Jody's essays in the New York Times:Grief As My Guide:  How My Sister Made Me a Better DoctorMoral Distress in NeurosurgeryDying in the Neurosurgical ICUTo purchase Grief Connects Us:  A Neurosurgeon's on Love, Loss and Compassion, go here. To purchase Emotional Agility by Susan David, click here.To learn more about the Schwartz Center for Compassionate Healthcare, click here.To learn more about the recently launched Surgical Palliative Care Society, visit the website at  www.spcsociety.org or twitter @spcsociety.To learn more about the surgical palliative care community, visit twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com or twitter @redmdnd.

#026 - Join host Dr. Red Hoffman as she once again has the privilege of interviewing Dr. Balfour Mount, the founder of Palliative Medicine.  Bal recently released his 500-page memoir entitled Ten Thousand Crossroads:  The Path as I Remember It and he generously returns to the show to  talk about his book.  He discusses his friendships with both Dame Cicely Saunders and Elizabeth Kubler Ross and shares lessons he learned from both women.  He also reflects upon the many lessons he learned from his patients and  how his own journey with multiple cancers influenced his practice of medicine throughout his career. Bal is a cultural icon and it is a pure pleasure to sit back and listen to him reflect upon his life and his career.   I cannot recommend his book highly enough; besides stories about Dame Cicely Saunders and Elizabeth Kubler Ross, he also includes memories about meeting Viktor Frankl and the Dalai Lama, as well as a funny phone call with Mother Teresa.  To purchase Ten Thousand Crossroads:  The Path as I Remember It, go here.To learn more about the recently launched Surgical Palliative Care Society, visit the website at  www.spcsociety.org or twitter @spcsociety. To learn more about the surgical palliative care community, visit twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com or twitter @redmdnd.

#025 - Join host Dr. Red Hoffman as she interviews Drs. Buddy Marterre and Pringl Miller, whom - along with Red - founded the recently launched Surgical Palliative Care Society (SPCS), the first inter-disciplinary society dedicated to the integration of high quality palliative medicine into the care of surgical patients.  They discuss the origins of the society, review its mission and talk about how Buddy's work as a beekeeper inspired the non-hierarchical approach to the creation of our Council and Committees.Membership is open to all healthcare professionals involved in the care of surgical patients (including surgeons, physicians, nurses, advanced practice providers, social workers, chaplains and respiratory therapists) as well as to students and trainees.  Please visit the website and consider joining as an inaugural member (inaugural dues are half-price through the end of 2021.)To learn more about the Surgical Palliative Care Society, visit the website at  www.spcsociety.org or twitter @spcsociety.  To learn more about the surgical palliative care community, visit us on twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com or twitter @redmdnd.

#024 - Join host Dr. Red Hoffman as she interviews Dr. Patricia Murphy.   Pat is a nurse and is recently retired as the Clinical Clinical Ethicist at University Hospital in Newark, New Jersey. She is an associate professor in the Rutgers-New Jersey Medical School Department of Surgery and served as a member of the New Jersey Bioethics Commission, the multidisciplinary body that developed the Advance Directive and Brain Death legislation in New Jersey.  She is responsible for teacher generations of medical students, residents and attendings how to care for patients and families during the most difficult times of their lives.   In this episode, Pat shares how her time with Dr. Elizabeth Kubler Ross as well as her time in the Faculty Scholars Program of the Project on Death in American shaped her career in palliative care.  She discusses her decades of work in the Department of Surgery at Rutgers NJ Medical School, where she worked closely with Dr. Anne Mosenthal to study the integration of palliative medicine into the care of trauma patients.   Pat gives tips on how to deliver bad news and how best to code status and goals of care with patients and families.   Lastly, she discusses the importance of communication amongst team members and reminds us to listen to our nurses!To read more about the work of Pat Murphy and Anne Mosenthal click here. To hear the story about how Pat influenced the career of Dr. Jessica Zitter watch here. To learn more about the surgical palliative care community, visit us on twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com.

#023 - Join host Dr. Red Hoffman as she interviews pharmacist Dr. Mary Lynn McPherson, Professor and Executive Director of the Advanced Post-Graduate Education in Palliative Care in the Department of Pharmacy Practice and Science at the University of Maryland,  Program Director of the Online Master of Science and Graduate Certificates in Palliative Care (also at University of Maryland), host of the Palliative Care Chat Podcast and author of the very well-known book  Demystifying Opioid Conversion Calculations: A Guide for Effective Dosing.  Lynn is a well-known speaker and a respected educator and was named as a 2018 Visionary in Hospice and Palliative Medicine by the American Academy of Hospice and Palliative Medicine.   Lynn discusses the role of the pharmacist on the interdisciplinary palliative care team, including the very important role of de-prescribing medications.  She then offers a step-wise approach to the treatment of common symptoms such as nausea, constipation (spoiler alert- we are using way too much zofran and docusate!), delirium and pain.  Lastly, she answers some of Red's burning questions about tylenol, toradol, transdermal delivery systems and buprenorphine.  Lynn is consistently one of the most most sought-after speakers at the AAHPM Annual Assembly and it is incredible to have the opportunity to learn from her!  To find a copy of Demystifying Opioid Conversion Calculations click here.To listen to the Palliative Care Chat Podcast click here.To learn more about the University of Maryland Online Master of Science and Graduate Certificates in Palliative Care click here. To learn more about the surgical palliative care community, visit us on twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com.

#022 - Join host Dr. Red Hoffman as she interviews Dr. Dan Hinshaw, professor emeritus of surgery and palliative care consultant at University of Michigan.  Dan discusses how his wife's work with HIV positive veterans first led him to contemplate the nature of  suffering and spirituality.   He shares how his surgical training has made him a more effective palliative care doctor and how his palliative care training made him feel like a "complete surgeon."  Dan offers practical skills about how to take an effective spiritual history and how to share "bad news" while maintaining hope.  As you'll learn from this podcast, Dan is a wonderful storyteller and he seamlessly weaves the stories of many patients he has cared for throughout our conversation.To learn more about EPEC: Education in Palliative and End-of-Life Care click here.To learn more about FICA Spiritual Assessment Tool used to take a spiritual history click here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com.

#021 - Join host Dr. Red Hoffman as she interviews Dr. Rebecca Aslakson, an anesthesiologist - triple-board certified in anesthesiology, critical care medicine and hospice and palliative medicine - and a well known researcher who has devoted her career to improving the delivery of effective and equitable palliative care, particularly to perioperative and critically ill populations.   Rebecca is an Associate Professor at Stanford University with appointments in both the Department of Primary Care & Population Health in the Palliative Care Section and the Department of Anesthesiology, Perioperative and Pain Medicine where she serves as Division Chief of Critical Care Anesthesia. Rebecca discusses how her early work in HIV paved the way for her career as both a researcher and as a palliative care physician.  She shares the story of David, one of her very first patients, who inspired her interest in palliative medicine.   She talks about the importance of honoring the emotive (rather than the cognitive) experiences of our patients as well as the importance of creating a space for patients and families to discuss their spiritual/religious beliefs, whatever they may be.For young physicians, Rebecca's career illustrates the importance of mentorship throughout one's career (and proves that you do NOT have to be mentored by people in your own field).  She also reflects upon the importance of knowing the culture of your medical community and being mindful of that culture when trying to conduct research or introducing an intervention. Beyond being a brilliant researcher, Rebecca is one of the most authentic and heart-centered human beings.  Get ready for both your emotive and cognitive sides to be inspired!Read more about Rebecca, including links to her publications, here.Read more about anesthesia and palliative medicine in the ASA Monitor here.   Read more about the Multicenter, Randomized Controlled Trial of Perioperative Palliative Care Surrounding Cancer Surgery for Patients and Their Family Members (PERIOP-PC) here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com.

#020 - Join host Dr. Red Hoffman as she interviews Dr. Preeti John, a surgeon triple board-certified in general surgery, surgical critical care and hospice and palliative medicine.  Preeti currently practices at the VA Maryland Healthcare System in Baltimore and is the Facility LSTDI (Life Sustaining Treatment Decisions Initiative) Director, coordinating all aspects of this Veterans Health Administration's quality improvement initiative in the in-patient and out-patient settings and intensive care units.  Preeti is also a healthcare ethics consultant and serves on the national Society of Critical Care Medicine (SCCM) Ethics Committee. She is editor of a widely acclaimed book titled ‘Being a Woman Surgeon – 60 Women Share Their Stories' and is on the editorial board of the American Medical Women's Association's ‘Literary AMWA' publication.  In this episode we review some of the details of LSTDI and the needs of veterans at the end of life.  We also discuss hospital ethics and how to become a healthcare ethics consultant.  Lastly, we talk about Preeti's first book about women surgeons and her upcoming book about pain management.   Read more about the VA Life-Sustaining Treatment Decisions Initiative here. Read more about Being A Woman Surgeon:  Sixty Women Share Their Stories here.  Learn more about the Healthcare Ethics Consultants-Certified Program here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare

#019 - Join host Dr. Red Hoffman as she interviews Dr. Janet Bull, chief medical officer of Four Seasons, a Hospice and Palliative Medicine organization in Western North Carolina.  Janet began her career as an obstetrician-gynecologist.   After witnessing the illness and death of a close friend, she left her practice and eventually began volunteering at Four Seasons.  Janet was instrumental in starting the Palliative Care program at Four Seasons as well as the Clinical Research Department.  She is a prolific researcher and has won multiple awards including the Sharon O. Dixon award and the Hastings Center Cuniff-Dixon award.  She also served as the president of the American Academy of Hospice and Palliative Medicine.  In this episode, she discusses the similarities between birth and death, how her surgical training influences her work in hospice and palliative care and the importance of play and staying true to oneself.  Tune in to learn more!Learn more about the Palliative Care Quality Collaborative here.Learn more about the Palliative Care Immersion Course here.  (Having done this course myself, I highly highly recommend it!)To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#018 - Join host Dr. Red Hoffman as she interviews Dr. Nancy Glass, who worked as a professor of both Anesthesiology and Pediatrics at Baylor College of Medicine as well as the Director of Pediatric Pain Management at Texas Children's Hospital.  She now is the Associate Medical Director of Houston Hospice.  Nancy was able to seamlessly integrate her training in pediatrics, pediatric critical care, pain management, anesthesiology and hospice and palliative medicine into the care of the some of the sickest children in the country.  She offers useful tips on how to speak to both sick children (and their parents) about death and dying and shares that children often know way more than we give them credit for.  She also talks about how to discuss code status with patients who are undergoing surgery and about the importance of surgeon-anesthesiologist communication to help provide the best patient care.  Lastly, she discusses her passion for narrative medicine and how it helps her to integrate her clinical experiences.  You can find Nancy's essay, What Did La Abuela See, here.You can follow Nancy on Twitter @nancyglass1.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#017 - Join host Dr. Red Hoffman and cohost Dr. Pringl Miller as they interview Dr. Geoff Dunn, the father of the Surgical Palliative Care Movement.  Geoff is a fourth generation surgeon, a second generation hospice medical director (his father was also both a surgeon and a hospice medical director!) and an artist.   Along with Dr. Bob Milch, Geoff is responsible for starting the integration of the concept of palliative medicine into the work of the American College of Surgeons (ACS), the largest surgical organization in the country.   As he shares in this episode, at the ACS Clinical Congress in 1997, he was invited by Dr. Tom Krizek to address a large gathering of surgeons during a symposium focused on physician-assisted suicide.  As he approached the microphone, Tom whispered to him, "You have ten minutes to change surgery... Don't mess it up!"  Geoff took this to heart and over the next two decades he worked tirelessly to integrate palliative medicine into surgical practice through chairing the  ACS Committee on Surgical Palliative Care, writing countless articles, editing  numerous books, speaking at numerous conferences, and - perhaps most importantly - never preaching!   As a lover of history, Geoff has tirelessly documented the history of the Surgical Palliative Care movement, most recently in a chapter of the Surgical Palliative Care textbook (link below).  As a lover of art and literature, Geoff has often utilized in his quest to better explain palliative medicine to surgeons, most memorably by comparing the Family Conference to a surgical procedure in which we "Prepare, Do and Close."  Despite all of his achievements, Geoff remains humble, heart-centered and human.  Listen and enjoy learning the history of the Surgical Palliative Care Movement!To read more by Geoff Dunn:Surgical Palliative Care-  Along with Anne Mosenthal, Geoff served as co-editor and also authored a chapter highlighting how surgeons have been involved in palliation since the beginning of the profession.  Surgical Clinics of North America- Geoff edited the 2011 edition focused on Surgical Palliative Care.  The 2019 edition, edited by Pringl Miller, can be found here.  Surgical Palliative Care:  A Resident's Guide- Geoff served as one of the co-editors of this extremely useful (and free) guide to providing palliative care to surgical patients.  In this article, Geoff discusses the history of surgical palliative care and the American College of Surgeons.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#016 - Join host Dr. Red Hoffman as she interviews Dr. Rick Greene, a surgical oncologist and a champion of palliative care for surgical oncology patients.  Rick currently serves as the medical director of the Cancer Data Registry at the Levine Cancer Institute in North Carolina.  As a past president (and founding member) of SAGES, past president of the Southeastern Surgical Society, past chair of the American College of Surgeons Commission on Cancer, past chair of the American Joint Committee on Cancer and past Chair of Surgery at Carolinas Medical Center, Rick can certainly be described as accomplished.  However, what is perhaps even more striking about Rick is how thoughtful and insightful he is, about both medicine and life.  In this episode, he shares his early experiences as a young surgeon aboard the USS Nimitz and discusses the influence of beshart (a Yiddish word which means inevitable or preordained) in his life.  Rick also offers his advice on how best to approach and talk about surgical complications.   Lastly, he discusses how important it is for surgeons to plan for life after surgery and recounts the necessity of always reinventing oneself (Rick is a writer and a radio host!) Articles discussed in the episode:Patient Loss: Surgeons Describe How They CopeThe Joys of Creative WritingCheck out The Recovery Room, a podcast hosted by Dr. Greene and supported by the American College of Surgeons here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#015 - Join host Dr. Red Hoffman as she interviews Dr. Anne Mosenthal, a trauma surgeon and one of the founding members of the American College of Surgeon's Surgical Palliative Care Task Force (now the Committee on Surgical Palliative Care, which she currently chairs).  Her name is synonymous with surgical palliative care in this country.  Anne, along with nurse Pat Murphy, wrote some of the earliest papers about how to incorporate  palliative care into the surgical and trauma intensive care units.   She championed the integrative model of palliative care, which relies upon the surgical team to utilize their primary palliative care skills.   She is the co-editor (along with Dr. Geoffrey Dunn) of the recently released textbook entitled Surgical Palliative.  Anne served as the Chair of Surgery at Rutgers New Jersey Medical Center for nine years (one of the first women in the country to chair a department of surgery) and recently transitioned into a new role as the Chief Academic Officer of Lahey Hospital and Medical Center.  In this episode, she shares her experience as a woman pursuing a career in surgery and notes the lack of female role models during her training.  She has been a champion for women in surgery, serving as a mentor to many and eventually winning the Association of Women Surgeon's Olga Jonasson Distinguished Member Award in 2018.   She also shares some tips about how to break bad news and how to discuss code status.  Lastly, she very graciously accepts all of my fan-girling!  As I tell her, many of us would not have the careers that we do if it were not for her leading the way.  Listen and learn from one of the very best!Articles mentioned:Trauma Care and Palliative Care: Time to Integrate the Two? (2003)Interdisciplinary model for palliative care in the trauma and surgical intensive care unit: Robert Wood Johnson Foundation Demonstration Project for Improving Palliative Care in the Intensive Care Unit (2006)Integrating palliative care in the surgical and trauma intensive care unit: a report from the Improving Palliative Care in the Intensive Care Unit (IPAL-ICU) Project Advisory Board and the Center to Advance Palliative Care (2012)To read more about or purchase the recently released Surgical Palliative Care (a must have!), click here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare

#014 - Join host Dr. Red Hoffman as she interviews Drs. Kate Aberger and David Wang, emergency medicine physicians who specialize in palliative care.  They are the editors of the recently released book, "Palliative Skills for Frontline Physicians," a collection of case-based vignettes which illustrate how to practically integrate palliative care into all fields of medicine, including surgery, emergency medicine, internal medicine and critical care, among others.  David and Kate discuss how to successfully integrate palliative medicine into the care of emergency room patients, the forces that make this integration difficult and the reality that this work cannot be done without the support of hospital administration.  Kate talks about her palliative care work during the COVID epidemic in New Jersey and David shares research conducted at his institution which showed that palliative care consults placed by ED physicians at admission resulted in decreased length of stay and lower overall hospital costs for patients.   Join us for another inspiring episode that proves that palliative medicine can be utilized successfully throughout the hospital, even in the basement (where it seems many EDs are located!). To learn more about the recently released Palliative Skills for Frontline Physicians, click here. To learn more about palliative care in the emergency department read this article by Dr. Wang.  To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#013 - Join host Dr. Red Hoffman as she interviews Dr. Gretchen Schwarze, a vascular surgeon, medical ethicist and prolific researcher known for her work focused on surgical buy-in and the best case/worst case scenario.  Gretchen is an endowed professor in the Division of Vascular Surgery, Department of Surgery, at the University of Wisconsin School of Medicine and Public Health.  She completed a fellowship in medical ethics at the MacLean Center for Medical Ethics.  She is a nationally recognized expert in surgical decision making, informed consent, advance directives and end-of-life care and her research focuses on improving communication between older patients and their surgeons so that patients can avoid unwanted treatment and make decisions that align with their values, preferences and goals.  Gretchen defines the concept of surgical buy-in and explores how this concept manifests differently for various patients and various procedures.  We discuss the ethics surrounding Do Not Resuscitate orders in the OR and the importance of clearly establishing the goals of surgery (prolonging life, improving quality of life, making a diagnosis or preventing a disability) before operating.  Finally, Gretchen explains the Best Case/Worst Case decision aid and notes the importance of both eliciting preferences and making recommendations when using this aid.  I learned so much from speaking with Gretchen; she helped me to articulate many of the ethical dilemmas I struggle with when taking care of many of my surgical patients. Articles mentioned:Surgeons Expect Patients to Buy-In to Postoperative Life Support Preoperatively A Framework to Improve Surgeon Communication in High-Stakes Surgical Decisions: Best Case/Worst Case"Best Case/Worst Case": A Qualitative Evaluation of a Novel Communication Tool for Difficult in-the-Moment Surgical DecisionsRisk Calculators and Decision Aids are Not Enough for Shared Decision MakingTo learn how to do Best Case/Worst Case, watch a ten minute video here.  To learn more about the Maclean Center Fellowship in Medical Ethics, click here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare

#012 - Join host Dr. Red Hoffman as she interviews Dr. Jack M. Zimmerman, a retired cardiothoracic surgeon who served as the chief of surgery at Church Hospital in Baltimore, Maryland and as an associate professor of surgery at Johns Hopkins.  Jack first developed his interest in surgical palliation during his surgical residency, when he learned of the Souttar, a tube meant to help patients with esophageal cancer.   He then went on to start one of the very first hospice programs in the United States.  Jack discusses his memories of training under Dr. Alfred Blalock and of how meeting Dr. Balfour Mount convinced him to invest his time in opening a hospice at Church Hospital.  For those interested in surgical history, this is a fascinating discussion!Read more about Dr. Zimmerman's work with the Souttar tube here.To learn more about Dr. Alfred Blalock and Dr. Vivien Thomas, watch Something the Lord Made here. To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#011 - Join host Dr. Red Hoffman as she speaks with surgeons Drs. Sara Scarlet, Pringl Miller and Kim Kopecky about surgical ethics, particularly those surrounding Do Not Resuscitate Orders in the operating room.   All three completed a fellowship in medical ethics and Drs. Miller and Kopecky are also fellowship-trained in Hospice and Palliative Medicine.  Dr. Scarlet served as the co-editor of the April 2020 issue of the AMA Journal of Ethics which focused on the relationship between surgeons and anesthesiologists.  Together, we review the basic principles of medial ethics, discuss why we seem to focus so much on autonomy and reflect upon how training in both ethics and palliative medicine have affected how we practice as surgeons.  We talk about some of the common challenges which exist within the surgeon-anesthesiologist relationship and ways in which we can better navigate our differences.  Finally, we review what the various societies have to say about upholding DNR orders in the OR (spoiler alert:  there are NO policies which insist that patients rescind their DNR orders before going to the OR) and talk about some tips and tricks that work when having these sometimes difficult and nuanced conversations.    To learn more about the Maclean Center Fellowship in Medical Ethics, click here.To read the AMA Journal of Ethics:  April 2020 Anesthesiologist-Surgeon Relationships, click here.Statements on DNR in the OR:American College of SurgeonsAmerican Association of AnesthesiologistsAssociation of Perioperative Nurses To learn more about the surgical palliative care community, visit us on twitter @surgpallcare

#010 - Join host Dr. Red Hoffman as she joins the long-running GeriPal Podcast to discuss all things surgical palliative care.  As is the tradition on the GeriPal podcast, Red gets serenaded by GeriPal co-hosts Drs. Eric Widera and Alex Smith, along with guest co-host Dr. Joe Lin.   They then go on to chat about the definition of surgical palliative care, the importance of building relationships between surgeons and palliative care providers and the common misconceptions that both disciplines have about each other.  They review a recent retrospective study of the utilization of palliative care in VA patients undergoing high-risk surgical patients and brainstorm various ways that palliative care may be better integrated into the world of surgery.  If you've never listened to the GeriPal Podcast, you are guaranteed to love these guys!Paper discussed:Palliative care and end-of-life outcomes following high-risk surgeryTo learn more about the GeriPal Podcast, check out their blog here or subscribe to their podcast here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare

#009 - Join host Dr. Red Hoffman as she interviews Dr. Ira Byock, nationally known author and speaker and the founder and chief medical officer of the Institute for Human Caring at Providence St. Joseph in Southern California.  Ira served as the president of the American Association of Hospice and Palliative Medicine as well as the Director of the Robert Wood Johnson Foundation's Promoting Excellence in End of Life Care, under which the Surgeons Palliative Care task force (now the Committee on Surgical Palliative Care) was created within the American College of Surgeons.  For those interested in the history of surgical palliative care, Ira is also known as the man who introduced surgeons Dr. Robert Milch to Dr. Geoffrey Dunn (both men went on to become leaders in the field of surgical palliative care).  Ira shares that seeing how poorly patients at the end of life were treated in his training hospital led him to develop a hospice program while still a resident physician.  He discusses that illness is fundamentally a personal issue (rather than a medical issue) and that by acknowledging this, surgeons can do their part in making certain that patients get the best care possible.  He is thoughtful, inspiring, generous with both his time and his experience, and a pure joy to talk to!Learn more about Ira here.Ira's books include:The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life Dying Well: Peace and Possibilities at the End of LifeThe Four Things that Matter MostLearn more about the Surgeons Palliative Care Workgroup here (includes PDFs of over two dozen articles written about surgical palliative care and published in the Journal of the American College of Surgeons.)To learn more about the surgical palliative care community, visit us on twitter @surgpallcare

#008 - Join host Dr. Red Hoffman and co-host Dr. Mackenzie Cook as they interview Dr. Sharmila Dissanaike, professor and Peter C. Canizaro chair of surgery at Texas Tech University Health Sciences Center.   They have a wide-ranging discussion about leadership, wellness, disaster ethics and the role of social media in academic medicine.  Sharmila shares some of her journey to becoming a chair of surgery, discusses the importance of maintaining a growth mindset and emphasizes the need for all of us to maintain an interest in the nuance of our current situation, rather than on searching for black and white answers.  Once again, we also talk about the benefit of being a "spork" (neither a spoon nor a fork!). Join us for a great conversation!Resources discussed in the episode:Ethical Framework for the Allocation of Resources in the Event of Shortages by the American College of Surgeons Committee on EthicsEthics of PPE Allocation by the American College of Surgeons Committee on EthicsACS-MacLean Center Surgical Ethics FellowshipTo learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#007 - Join host Dr. Red Hoffman and cohost Dr. Mackenzie Cook as they interview Dr. Karen Brasel, Professor of Surgery in the division of Trauma, Critical Care and Acute Care Surgery, as well as the Program Director of the general surgery residency, the Vice-Chair for Education and the Assistant Dean of Graduate Medical Education, all at OHSU School of Medicine in Portland, Oregon.   Karen is a national leader in both surgical education and surgical palliative care and has authored or co-authored over 250 papers.  Under her leadership, the general surgery residency at OHSU is the only surgical residency in the country which requires all trainees to spend one month on a palliative care service.  Join us as we discuss the benefits of being a "spork" (neither a spoon nor a fork), family presence during resuscitation and the ethics surrounding the idea of futility.  CAPC (Center to Advance Palliative Care) features the IPAL (Integrating Palliative Care into the ICU) toolkit on their website.  Many organizations maintain CAPC memberships; to find if your organization is a member, go online and type in your email here. Papers discussed:Palliative care in the trauma ICU by Drs. Katie O'Connell and Ron MaierRead about the Geriatric Trauma Outcome Score here and here.TQIP Best Practices for Palliative Care can be found here. To learn more about the surgical palliative care community, visit us on twitter @surgpallcare

#006 - Recorded on March 20, 2020. Join host Dr. Red Hoffman, cohost Dr. Mac Cook and guest Dr. Katie O'Connell (acute care surgeon and director of surgical palliative care at Harborview Medical Center in Seattle, WA) as they discuss the Covid-19 pandemic and the various roles that surgical palliative care may play throughout this public health crisis.  They compare notes on the responses of their various institutions and commiserate about the shared sense of anxiety, boredom and identity distress that many surgeons throughout the country are currently feeling.  They also talk about the importance of making sure that all of patients have updated advance directives, the use of telemedicine at end of life, ethical dilemmas in the time of resource scarcity and various resources (listed below) that may help all surgeons deliver primary palliative care to our patients.  Thanks to Mac and Katie for a thoughtful, honest discussion and for the reminder that we all have an important role to play during this difficult time.  Resources discussed in this episode:Elective Surgery Acuity Scale by Dr Sameer Siddiiqui at St. Louis University.Covid-Ready Communication Skills published by Vital Talk- an invaluable resource to help guide your conversations with patients and families.Covid-19 Response Resources provided by Center to Advance Palliative Care (CAPC).  Beyond communication tips, CAPC is providing- free of charge- symptom management protocols so that all surgeons are armed with the tools needed to provide excellent primary palliative care to our patients.  Ventilator Allocation Guidelines provided by NY State Task Force on Life and Law and NY State Department of Health.  These guidelines provide an excellent introduction to the ethical considerations necessary when resources are limited.  Rationing Life Saving Treatments in the Setting of COVID Pandemics: A Podcast with Doug White and James Frank by GeriPal Podcast.  This discussion of public health ethics manages to be both very nuanced and very understandable.  Well worth a listen.  Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 published on Friday, March 20, 2020 by the Society of Critical Care Medicine.  To learn more about the surgical palliative care community, visit us on twitter @surgpallcare

#005 - Join host Dr. Red Hoffman as she interviews Dr. Diane Meier, a professor of Geriatrics and Palliative Medicine, as well as well as a professor of Medical Ethics, at Mount Sinai School of Medicine in New York City (listen for NYC ambulances in the background!)   Diane is the founder of the Center to Advance Palliative Care (CAPC) as well as a recipient of the MacArthur Foundation Fellowship (also known as a "genius grant.")  She shares about the early days of CAPC and describes some of the educational offerings available through a CAPC membership (go online and type in your email to see if your organization is a member!).   Diane also discusses the importance of tailoring your message for your audience and reminds us to be thoughtful about our language, particularly when we are attempting to define palliative care.  I learned so much about communication from speaking with her!  Enjoy!Learn more about CAPC here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#004 - Join host Dr. Red Hoffman and co-host Dr. Mackenzie Cook as they interview Dr. Zara Cooper, associate professor of surgery at Harvard Medical School, Kessler Director of the Center for Surgery and Public Health at Brigham and Women's Hospital and a prolific researcher in the field of surgical palliative care.  Zara shares how she first became interested in the field of surgical palliative care, the importance of maintaining curiosity when talking to both patients and fellow surgeons, and the need to make certain that future research in palliative care helps to drive policy change.  Zara manages to be incredibly smart, remarkably insightful and refreshingly approachable all at the same time, which makes for a great interview!Learn more about the Center for Surgery and Public Health here.Zara's articles discussed in this episode:Resident education and management of end-of-life care: the resident's perspective Racial variation in the use of life-sustaining treatments among patients who die after major elective surgeryEnd-of-life care intensity for physicians, lawyers, and the general publicRecent New York Times articles on dying at home:https://www.nytimes.com/2019/12/11/health/death-hospitals-home.htmlhttps://www.nytimes.com/2019/09/03/well/live/is-dying-at-home-overrated.htmlhttps://www.nytimes.com/2018/01/06/opinion/sunday/hospice-good-death.htmlTo learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#003 - Join host Dr. Red Hoffman as she interviews Jonathan Bartels, a palliative liaison nurse at the University of Virginia and the founder of The Pause, a 30-second to one-minute period of silence meant to honor both the patient and the treatment team after a death occurs.  Jonathan discusses his work in both trauma and palliative care (they are not as different as people think!) as well as his work with the Compassionate Care Initiative.  As the son and brother of surgeons, he brings a unique perspective to his career as a nurse and offers his opinion on how surgeons may better integrate the principles of palliative medicine into their daily work.  Read more about Joan Halifax here.  Learn more about The Being with Dying program here.  To learn more about The Pause:Check out Jonathan's website.  Download the App (available for IPhone and IPad).To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#002 - Join host Dr. Red Hoffman as she interviews Dr. Robert Milch, one of the pioneers of the Surgical Palliative Care movement.  Bob discusses the early days of the American College of Surgeon's Surgical Palliative Care Task Force, his career with Hospice Buffalo and what he learned through helping to set up hospice programs throughout the world.  He also shares how some of the giants of surgery, including Dr. Olga Johannson and Dr. James Cameron, were early supporters of the surgical palliative care movement.  Finally, he reminds us of the importance of taking the time to both read and reflect as we work with critically ill and dying patients.  Books mentioned in this episode:Mortal Lessons: Notes on the Art of Surgery by Richard Selzer, MDHow We Die: Reflections on Life's Final Chapter by Sherwin Nuland, MDIntoxicated by My Illness and Other Writings on Life and Death by Anatole BroyardTo learn more about the surgical palliative care community, visit us on twitter @surgpallcare.

#001 - Join host Dr. Red Hoffman and co-host Dr. Matt Nielsen for the premiere episode of The Surgical Palliative Care Podcast as they interview Dr. Balfour Mount, the father of Palliative Care in North America.  Bal discusses his early days as a urologic oncologist, his work with Dame Cicely Saunders, his palliative care pilot project at the Royal Victoria Hospital and his experiences as a surgeon providing palliative care to his patients.   Prepare to be inspired!To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.