Podcasts about ICU

🧭 REBEL Rundown 🔑 Key Points 🧩 Human Factors: The unseen behaviors, distractions and considerations critical in emergency medicine and the ICU, influencing patient care beyond just medical knowledge.🎯 System Design: Effective system design directly impacts team performance by creating environments that facilitate optimal decision-making. 🏥 Real-world Application: The application of human factors in healthcare leads to better team dynamics, reduced stress, and improved patient outcomes. 👷🏽‍️It’s Everyone’s Job: Building a culture of adaptability and openness to change can lead to better healthcare delivery, communication and interprofessional relationships🛠️ Practical Solutions: Start the conversation in departments for actionable and pragmatic changes to current healthcare environments to enhance practitioner efficiency and patient care quality. Click here for Direct Download of the Podcast. 👀Previously Covered and Related Content: REBEL EM: Titles Don’t Make LeadersREBEL MIND: Moving from Junior to Senior Leadership in Emergency CareREBEL MIND: The Dunning-Kruger EffectREBEL MIND: Growth vs Fixed Mindset 📝 Introduction Welcome back to Rebel MIND, the podcast where we sharpen the person behind the practitioner. MIND stands for Mastering Internal Negativity during Difficulty. This series emphasizes productivity, provider performance, and team optimization to ensure we are at our best during high-pressure situations. In this episode, host Dr. Mark Ramzy chats with special guests and master educators about the concept of human factors.Dr. Chris Hicks is an emergency physician and trauma team leader at St. Michael’s Hospital in Toronto, Assistant Professor in the Department of Medicine at the University of Toronto, and co-founder of Advanced Performance Healthcare Design, a physician-led simulation and design group. Dr. Andrew Petrosoniak is an emergency physician and trauma team leader at St. Michael’s Hospital, and Medical Director of the Unity Health Toronto Simulation Program. He’s an Assistant Professor at the University of Toronto where his research focuses on simulation for systems and design improvement and optimizing the care of the bleeding patient. Along with Dr. Hicks, he’s also President of Advanced Performance Healthcare Design, a consulting firm that works with high-performance teams and uses simulation to enhance and design better healthcare spaces Cognitive Question How can the integration of human factors improve decision-making and performance in emergency medicine and critical care environments? ️What are Human Factors? In the context of healthcare, human factors encompass the interplay between humans, the systems they work within, and the effectiveness of their interactions. It includes elements like communication, system design, environmental conditions, and behavioral patterns affecting individual and team decision-making processes. It’s the collective impact of individual behaviors, team dynamics, and the physical environment on performance and outcomes. The aim is to eliminate issues arising from human error by creating systems and environments that naturally guide and support optimal performance. 🏥How This Applies to the Emergency Department or ICU? Efficient integration of human factors in high-pressure settings like the Emergency Department (ED) or Intensive Care Unit (ICU) helps mitigate the risks associated with stressful and chaotic environments. By focusing on system designs that account for human behavior, healthcare professionals can reduce errors, enhance team coordination, and ultimately improve patient care. This is crucial as teams are often required to make rapid, life-saving decisions in these environmentsThe design of clinical spaces can either hinder or help efficient care. Poorly arranged equipment or cluttered workspaces increase stress and impede decision-making. Implementing structured design principles, such as dedicated equipment zones and clear visual cues, can streamline workflows and enhance team coordinationIt actually helps pave the way for more efficiency because you end up “working smarter instead of harder”.It speaks directly to the Daniel Kahneman’s theory of Type 2 Thinking – which is a slow, analytical cognitive process requiring deliberate thoughtWe’ll likely create a whole dedicated episode to this but if you want to read more ahead of time on it, check out his book Thinking, Fast and Slow ⏩Immediate Action Steps for Your Next Shift **Assess Your Environment**: Take note of any clutter, noise, or layout issues in your workspace that could hinder optimal performance. Identify problem areas that could be optimized.**Recognizable Hard-Stop** – Implement a “Stop-Point” Check for areas or issues that involve more than just patient safety (ie. workflow inefficiencies, sign-out, throughput, etc). Use predefined benchmarks during procedures to ensure clarity and efficiency.**Foster Open Communication** – Encourage an environment where every team member feels comfortable discussing their thoughts and decisions without fear of judgment.**Prototype Solutions** – Work with colleagues to identify problems and brainstorm quick, cost-effective solutions that could be tested in your department.**Role Clarity and Preparation** – Ensure roles are clearly defined and team members are prepared with necessary resources readily available during high-stakes scenarios.**Test and Refine** – Conduct quick pilot tests of new setups or processes during quieter times and gather feedback from your team. Conclusion Human factors play a critical role in shaping healthcare outcomes. Through structured system designs and attention to team dynamics, it is possible to reduce inefficiencies and enhance both patient care and provider well-being. It requires a shift in perspective from seeing design and systems as separate from human behaviors, to seeing them as intricately linked. By incorporating these principles, healthcare professionals can create environments that inherently support better, safer, and more effective patient care. 🚨 Clinical Bottom Line Incorporating human factors into healthcare isn’t just about preventing errors—it’s about creating an ecosystem where the healthcare team is empowered to perform at their best, even under the most challenging conditions. Implementing small, iterative changes can create a meaningful impact, paving the way for improved systems and processes. This starts by redesigning systems and environments with human factors in mind, which can significantly improve both the efficiency of care delivery and the safety of the healthcare environment. Further Reading Petrosoniak A, Hicks C. M&M rounds 2.0: the future of performance improvement. CJEM. Feb 2025PMID: 39979684Petrosoniak A, Hicks CDesign, build, train, excel: Using simulation to create elite trauma systems. International Anesthesiology Clinics. Publish Ahead of Print.Request the Article herePetrosoniak A, Hicks C, et al. Design Thinking-Informed Simulation: An Innovative Framework to Test, Evaluate, and Modify New Clinical Infrastructure. Simul Healthc. 2020 Jun 2020.PMID: 32039946Bleetman A, et al.Human factors and error prevention in emergency medicine. Emerg Med J. May 2012PMID: 21565880Hayden EM, et al.Human Factors and Simulation in Emergency Medicine. Acad Emerg Med. 2018 Feb 2018PMID: 28925571 Meet the Authors Mark Ramzy, DO Co-Editor-in-Chief Cardiothoracic Intensivist and EM Attending RWJBH / Rutgers Health, Newark, NJ Chris Hicks, MD, Med Co-Founder of Advanced Performance Assistant Professor of Emergency Medicine, University of Toronto, Canada Andrew Petrosoniak, MD, MSc Co-Founder and President of Advanced Performance Medical Director of Unity Health Toronto Simulation Program Showing Slide 1 of 3 The post REBEL MIND – Human Factors: The Hidden Architecture of Emergency & Critical Care Medicine appeared first on REBEL EM - Emergency Medicine Blog.

Send us Fan MailWhat if closing a PDA could be done at the bedside in under 10 minutes, without transporting a fragile preterm infant to the cath lab? Dr. Shyam Sathanandam, Chief of Cardiovascular Medicine at Nicklaus Children's Heart Institute, joins us to discuss the evolution of transcatheter PDA closure in extremely preterm infants. We cover how bedside procedures protect the most vulnerable neonates, which infants are most likely to benefit from closure, the learning curve and complication profile, and Dr. Sathanandam's vision of eventually training neonatologists to perform this procedure themselves.Dr. Shyam Sathanandam has consulting and compensation relationships with Abbott Laboratories and Medtronic, both relevant to topics discussed in this episode.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

High reliability organizations (HROs) reduce patient harm through frontline input, shared accountability, and collaboration in high-stakes clinical settings. Anand Iyer, M.D., associate chief medical officer, explains how he helped UAB meet HRO principles via a multidisciplinary titration task force focused on ICU medication safety. Learn how frontline feedback, simulation testing, EMR enhancements, and shared mental models helped reduce variability.

How untreated strep throat sent Ron into a coma the first time — in 2015What vasopressors are, why they saved his life, and why they cost What do you do when the love of your life is fighting for his life — and four kids are at home counting on you to hold everything together?Victoria Rosas is a former Dallas attorney, mom of four in a beautifully blended family, and one of the most quietly extraordinary women we've ever sat across from at the Moms Club.In 2022, her husband Ron — a former professional tennis player who competed for Notre Dame, played the pro tour, and coached their kids on the court — woke up feeling off. Within 24 hours, he was intubated. Within days, the medication saving his life was slowly taking something else: blood flow to all four of his limbs.Victoria was told multiple times he wasn't going to survive.He did. But what came next — nine surgeries, 70 hours in the operating room, nine weeks in Ohio, and coming home to a kindergartner and three kids on the verge of launching — is a story about what strength actually looks like when it has no other choice.

A broken heart is never just emotional—it can become deeply physical. Nurse practitioner Jessica Love shares her powerful journey from ICU nurse to patient after experiencing stress-induced cardiomyopathy, also known as "broken heart syndrome," during her clinical training. What began as subtle symptoms of fatigue and chest pressure quickly escalated into a life-threatening cardiac event, reshaping everything she thought she knew about stress, health, and healing.  Her recovery became a turning point, shifting her focus from treating disease in the ICU to preventing it through whole-person care. In this conversation with Dr. Michelle Robin and Bayleigh Soza, Jessica explores how chronic stress impacts the heart, why women's symptoms are often missed, and how nervous system regulation, awareness, and daily habits can transform long-term heart health.  Key Takeaways:   Broken heart syndrome can occur unexpectedly when chronic or emotional stress overwhelms the body, even in young and healthy individuals.   Stress often shows up physically before it is emotionally recognized, with symptoms like fatigue, shortness of breath, and reduced energy.   The heart and nervous system are deeply connected, meaning emotional regulation directly influences cardiovascular health and resilience.   Women's heart symptoms are frequently subtle and can be overlooked, making awareness of early warning signs especially important.   Daily practices like gratitude, movement, sleep, nutrition, and nervous system regulation can significantly support long-term heart health and prevention.   We couldn't highlight incredible stories like this without the support of our sponsor, CommunityAmerica Credit Union. Thank you for helping us promote connection, well-being, and stronger communities. If you're looking for trusted financial wellbeing resources, we invite you to connect with their team and take the next step toward greater financial confidence.  About Jessica Love:  Jessica Love, APRN, FNP-C, is a board-certified nurse practitioner specializing in a whole-person, root-cause approach to cardiometabolic health and nervous system regulation. She has a nursing background in critical care at a Level 1 trauma center and experience as a nurse practitioner in both inpatient and outpatient cardiology. Jessica blends conventional medicine with functional and lifestyle-based approaches to support long-term health and wellness. Her education and clinical experience allow her to support patients through personalized strategies including nutrition, movement, and lifestyle interventions.  Inspired by both professional experience and her own nearly fatal cardiac event, Jessica is deeply committed to helping others understand the mind-body connection and address the underlying drivers of chronic disease and inflammation. As a certified HeartMath Coach she incorporates nervous system regulation into her care, helping patients build resilience, reduce stress, and create an internal environment that supports overall well-being. Her goal is to help others repair, rebuild, and rebalance their health, fostering sustainable, meaningful shifts that promote lasting vitality and well-being.  Jessica enjoys traveling, gardening, cooking healthy meals, running, community, and spending time with her husband and her French Bulldog named Beau.  Connect with Jessica Love at:  https://rootedheartkc.com/   Connect with Dr. Michelle and Bayleigh at:  https://smallchangesbigshifts.com  hello@smallchangesbigshifts.com  https://www.linkedin.com/company/smallchangesbigshifts  https://www.facebook.com/SmallChangesBigShifts  https://www.instagram.com/smallchangesbigshiftsco  https://www.youtube.com/@smallchangesbigshiftsco    Thanks for listening!  Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page.  Do you have some feedback or questions about this episode? Leave a comment in the section below!  Subscribe to the podcast  If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can also subscribe in your favorite podcast app.  Leave us an Apple Podcasts review  Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts. 

Send us Fan MailOpioid withdrawal dosing, intranasal breast milk, human milk fortification in Japan, neonatal dysphagia, and vaccine policy. A full week on the Incubator Journal Club.Ben opens with the Optimized NOW trial in JAMA: symptom-based dosing reduced time to medical readiness for discharge by nearly two and a half days in NOWS infants managed with Eat Sleep Console, and allowed 65% of pharmacologically treated infants to avoid scheduled opioids entirely.Daphna reviews a small RCT out of Turkey showing improved cerebral oxygenation and favorable vital sign trends after intranasal breast milk administration in preterm infants, adding to the growing tolerability data for this intervention.Ben then covers the JASMINE trial, a Phase 3 RCT in Japan showing significantly better weight gain velocity with an exclusive human milk diet in very low birth weight infants.Daphna closes with a retrospective cohort study on FEES-confirmed dysphagia in preterm infants. Of those who met criteria for evaluation, every single one had laryngeal penetration and 57% were aspirating.Ben and Eli close the week on the quiet dismantling of vaccine infrastructure in the US and what it means for the populations in your NICU.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailIn this episode, I sit down with my longtime friend and community member, Maria Jasanya. Based in Brooklyn, Maria is a nurse educator and medical writer who has mastered the art of balancing a traditional nursing career with multiple income streams.She shares her journey from wanting to be a nurse since elementary school to becoming a nurse residency coordinator, adjunct professor, and prolific freelance writer. We dive deep into how a curious mind and a willingness to say “yes” to new opportunities can lead to a fulfilling and diversified professional life.About Maria JasanyaMaria Jasanya, MSN, RNC, CNM, CLC, CNE, is a Nurse Educator, Adjunct Nursing Faculty, Certified Nurse Midwife and Nurse Freelance Medical Writer with extensive experience in nursing education, maternal–child health, and professional development. She obtained her BSN from CUNY Hunter College in 2007, MSN from SUNY Downstate Medical Center in 2012 and a post-MSN certificate from SUNY Stony Brook in 2019.Maria is passionate about mentoring nurses, advancing nursing education, self and patient advocacy and improving maternal and newborn health outcomes by applying evidence-based research. She has devoted herself to be a lifelong learner and encourages nurses to do the same! Key TakeawaysThe Power of Multiple Income Streams: We discuss how Maria manages her primary role as a nurse residency coordinator alongside being an adjunct professor at three different nursing colleges and a frequent contributor to major medical databases.The Art and Science of Writing: Maria explains how she transitioned into medical writing through our connection on LinkedIn. She now contributes to platforms like EBSCO's Dynamic Health and Relias, specializing in updating references, fact-checking, and writing nursing and continuing education content.Speaking into Existence: After taking a chance on her first podcast guest appearance, Maria discovered a new passion for speaking and now proactively uses LinkedIn to book future engagements.Advice for Nurses Seeking ChangeFollow Your Passion: Maria emphasizes that you shouldn't chase money; instead, chase your passion, and the multiple income streams will naturally follow.Ignore the “Marketable” Myth: You don't have to work in high-acuity areas like the ICU just to be marketable; there are endless opportunities in settings like school health, correctional nursing, and neuro rehab.Start Small and Take Risks: Growth happens when you are willing to be uncomfortable. Whether it's a small $25 project or a new credential like SEO, every step helps build your professional repertoire.Follow Maria on Socials!LinkedInWelcome to the Savvy Scribe Podcast, I'm so glad you're here! Before we start the show, if you're interested, we have a free Facebook group called "Savvy Nurse Writer Community"I appreciate you following me and listening today. I would LOVE for you to subscribe: ITUNESAnd if you love it, can I ask for a

What if one of the most toxic products in your home isn't your cleaning spray, your cookware, or your water bottle… but the lip gloss sitting in your purse right now? In this eye-opening and deeply alarming conversation, Darin Olien sits down with clean beauty innovator, attorney, and consumer advocate Laura D'Alamo to expose what may be one of the biggest blind spots in modern health and beauty. After surviving triple-negative breast cancer and a near-fatal battle with COVID, Laura embarked on a two-year investigation into the cosmetic industry that uncovered a startling regulatory gap surrounding lip products, microplastics, toxic ingredients, and consumer safety. Together, they explore how lip products are regulated as external-use cosmetics despite being chronically ingested, why 80–90% of lip products may contain microplastics, how outdated regulations fail to reflect modern usage patterns, and why ingredients banned in food can still legally appear in products applied directly to the lips. They also discuss the launch of the Lip Service Alliance, the future of food-grade lip care, and how consumers can drive industry-wide change through awareness and purchasing decisions.     What You'll Learn Why lip products may represent a major overlooked toxic exposure pathway How cosmetics regulations differ from food and pharmaceutical regulations Why lip products are treated as external-use products despite being ingested The hidden role of microplastics in lip glosses, lipsticks, and lip balms Why flavored lip products may increase chronic ingestion How lip tissue differs biologically from normal skin The shocking absorption rates associated with oral mucosal tissue Why titanium dioxide is banned in European food but still used in lip products How outdated usage assumptions fail to reflect modern beauty habits Why the fastest-growing lip product market is girls ages 9–17 The mission behind the Lip Service Alliance How consumers can influence change through their purchasing decisions     Chapters 00:00:04 – Welcome to SuperLife 00:00:33 – Sponsor: Manna Vitality and frequency-enhanced wellness 00:01:59 – Introducing Laura D'Alamo and today's hidden toxic threat 00:02:35 – Triple-negative breast cancer and Laura's life-changing diagnosis 00:02:42 – Surviving COVID in the ICU and a profound existential awakening 00:03:00 – The cosmetic regulatory blind spot that changed everything 00:03:49 – Lip products containing thousands of microplastics per application 00:04:14 – Titanium dioxide, food bans, and regulatory contradictions 00:04:50 – The creation of the Lip Service Alliance 00:05:20 – Building the first food-grade lip care alternative 00:05:38 – Laura's legal background and journey through clean beauty 00:07:10 – Creating one of the first modern clean deodorant brands 00:08:23 – Innovation, consumer behavior, and predicting market shifts 00:09:29 – Consulting global beauty brands and seeing industry patterns 00:10:06 – Cancer diagnosis, purpose, and personal transformation 00:11:34 – Chemotherapy, ICU survival, and reevaluating life's mission 00:13:15 – The moment everything clicked into focus 00:13:59 – Returning to law and studying cosmetic regulations 00:14:25 – Why cosmetic regulations rarely keep pace with innovation 00:15:00 – Outdated assumptions still shaping modern beauty products 00:16:02 – Regulations built around usage patterns from decades ago 00:16:49 – Why this is a global issue—not just a U.S. problem 00:17:13 – Discovering the biggest blind spot in beauty history 00:18:15 – The late-night realization that launched two years of research 00:19:16 – Lip products classified as external-use cosmetics 00:21:02 – Why lip products are inevitably ingested 00:21:37 – Food-flavored lip products and TikTok taste-test culture 00:22:58 – Regulatory frameworks largely ignoring ingestion 00:23:53 – The EU's outdated lipstick usage assumptions 00:24:49 – The lead-in-lipstick controversy revisited 00:25:16 – Modern beauty consumers layering multiple lip products 00:26:16 – Heavy metals, PFAS, plastics, and cumulative exposure 00:27:12 – The $14 billion lip industry explained 00:27:34 – Why ages 9–17 are the fastest-growing demographic 00:29:00 – The shocking microplastic content of many lip products 00:29:44 – Why "clean beauty" often creates consumer confusion 00:30:15 – Hidden plastics even inside clean-positioned products 00:32:24 – Titanium dioxide and the food-versus-cosmetics paradox 00:33:20 – Genotoxicity concerns and cancer-related research 00:34:08 – Why regulators continue allowing it in lip products 00:35:04 – "You may love your lip products—but do they love you back?" 00:35:26 – The biological difference between lip tissue and skin 00:36:34 – Lip tissue as a highly absorbent biological portal 00:37:52 – Why standard skin testing may be misleading 00:38:17 – Testosterone, nicotine, and oral absorption comparisons 00:39:08 – Chronic exposure through ingestion and absorption 00:40:12 – Common sense versus regulatory assumptions 00:41:13 – Why parents react differently when children are involved 00:42:25 – The disconnect between protecting children and protecting ourselves 00:43:19 – Plastic detox research and fertility improvements 00:44:12 – Chronic inflammation and long-term health implications 00:45:07 – Quick wins consumers can implement immediately 00:45:47 – Why Laura spent two years building solutions before speaking publicly 00:46:30 – Launching the Lip Service Alliance 00:47:14 – Consumer awareness as the first step toward change 00:48:10 – Voting with your wallet and shifting industry behavior 00:48:52 – New scientific publications currently in peer review 00:49:50 – Creating new testing models for lip-specific safety 00:50:10 – Lip tissue absorbing up to hundreds of times faster than skin 00:51:00 – Why flavoring products encourages ingestion 00:52:14 – Petroleum-derived ingredients and bioaccumulation concerns 00:54:03 – Creating YAM: a 100% food-grade lip care company 00:55:29 – Building completely plastic-free packaging solutions 00:56:47 – Bioavailable ingredients and supporting natural lip biology 00:58:02 – The "dual pathway" problem: ingestion and absorption 00:59:00 – Hidden solvents and natural flavor loopholes 01:00:07 – Developing future food-grade lip products 01:01:04 – Why food-safe colorants are often illegal in cosmetics 01:02:28 – Regulatory barriers blocking safer innovation 01:03:37 – Simple policy changes that could transform the industry 01:04:23 – Darin reflects on Laura's relentless mission 01:05:32 – Why food-grade ingredients may work better biologically 01:06:21 – Regulatory modernization still missing lip-specific reforms 01:07:07 – The frustration of slow-moving bureaucracy 01:07:36 – Europe's timeline for microplastic warnings and bans 01:08:44 – Why consumers cannot afford to wait until 2035 01:09:29 – The aerosol-can analogy and how industries can change 01:09:49 – The role of consumer awareness and public pressure 01:10:38 – Why many brands don't even realize what's inside their formulas 01:11:18 – Inflammation, chronic exposure, and final warnings 01:11:57 – Closing thoughts and the future of lip safety advocacy     Thank You to Our Sponsors Shakeology: Get 15% off with code DARINO1BODI at Shakeology.com. Manna Vitality: Go to mannavitality.com/ and use code DARIN12 for 12% off your order.     Join the SuperLife Community Get Darin's deeper wellness breakdowns — beyond social media restrictions: Weekly voice notes Ingredient deep dives Wellness challenges Energy + consciousness tools Community accountability Extended episodes Join for $7.49/month → https://patreon.com/darinolien     Find More from Laura DiGirolamo Website: https://yombeauty.com/  Instagram: @meetlauradigi Join: Lip Service Alliance     Find More from Darin Olien: Website: darinolien.com Instagram: @darinolien Book: Fatal Conveniences Platform & Products: superlife.com New Show: Roadmap to Happiness      Key Takeaway "The biggest health threats are often the ones hiding in plain sight. Lip products are uniquely positioned at the intersection of ingestion, absorption, and chronic exposure, yet most regulatory systems still treat them as if they simply sit on the surface of the skin. Whether or not every concern raised in this conversation proves true over time, one thing is undeniable: consumers deserve better science, better transparency, and better products. And when enough people demand change, industries always find a way to evolve."

Brians Questions: I frequently work with dark wood, and need to mark the cuts.  Do you have a recommendation for a white pencil or pen that is fine tipped? Thank you for the great show and your time to produce it. -George What has been your favorite veneering project (or what project would you like to do with veneer) George Guys Questions: Hey guys, your recent talk about bandsaws made wonder if anyone is using anything cool for bandsaw infeed and out feed, im using roller stands and doing resaw cuts that are about 10' long. I also was curious how you guys would go about making a cabinet over a toilet not require filler strips? Maybe a scribed face frame? Great podcast lately, i really enjoy it. Tyler I'm making a bow front dresser and the bow will be made by gluing up 1/8th” bending play. The front of the drawers will be 1/16th” shop sawn cherry veneer. I'm planning on putting  1/32” backing veneer on the inside of the bow.  To make up the bow i will have a couple glue ups. The first glue up will be the 1/8th” bending ply and the 1/32” backing veneer. For ease of use, I plan to use unibond one for this glue up. The second glue up for the front piece of 1/16” cherry veneer I plan to use Unibond 800 to ensure there is no wood movement later, since the height of some of the drawers will be 10”.  My questions are: is 1/32 backing veneer ok seeing the front piece of veneer is 1/16”? And second: is using Unibond 800 a bad idea because it will only be for the front piece of veneer. Mike Huys Questions: Hi,  Love the show. I recently got into woodworking as part of my stress relief from my W2 job (ICU work) and have fallen in love with it. I have expanded my tool chest and have a makita track saw and recently noted there was a variable speed setting on it. What guide do you utilize to change that setting? I have had it on 6 since I got the saw and never even thought to change it. I did finally follow your advice and upgrade my blade with a CMT finish 36 tooth carbide blade and what a difference cutting through hardwoods. Thanks, Viyeka Anyway, i wanted to ask how you would go about cleaning mouse droppings on your wood. The cdc (because of the hantavirus scare) suggests using bleach and then wiping but it seems harsh on raw wood stock. I don't want the bleach to penetrate too deep. I was thinking of spraying with a soapy solution and then gently wiping it off all my wood. What do you think? —vaibhav from chicago

Send us Fan MailIn this fast-paced episode of Neo News, Eli and Ben tackle the rapidly shifting landscape of vaccine regulation and economics in the US. They discuss recent political maneuvers surrounding the Vaccine Injury Compensation Program (VICP) and how expanding liability could quietly push manufacturers out of the market entirely. The hosts also examine the FDA's recent hesitation to review Moderna's new mRNA flu vaccine, highlighting how these administrative roadblocks threaten the financial viability of developing novel vaccines—including critical immunizations for pediatric and neonatal populations. Tune in for a sharp analysis of how top-down policy changes might reshape everyday clinical practice!----1) https://thehill.com/policy/healthcare/5689850-kennedy-dismisses-vaccine-advisors/2) https://www.washingtonpost.com/opinions/2026/01/15/rfk-jr-vaccines-autism-vicp/3) https://www.nytimes.com/2026/02/18/health/fda-moderna-flu-vaccine-mrna.html4) https://www.nytimes.com/2026/02/16/health/rfk-vaccine-manufacturers.htmlSupport the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

"I've seen death in the face numerous times. I. I am going to do something going forward that is going to help people in a big way. And so I am. I am. I'm doing it." ~Ksenia MerckKsenia Merck joins the show to share her powerful story of love, loss, caregiving, creativity, and renewal. After caring for her elderly mother until her passing and then losing her beloved husband Bill to cancer, Ksenia Merck found herself navigating profound compound grief and the search for healing. Through her journey, she discovered the transformative power of creativity and art.Listeners will be deeply moved by Ksenia Merck's reflections on “re-lifing” herself. She shares her experience of illustrating and publishing Bill's unfinished novel "Ghost Flower," and her ongoing mission to build community and help others on the widowhood journey. This episode is full of wisdom, hope, and encouragement for anyone grieving or seeking new purpose after loss.Key takeaways:The traumatic experience of Bill's sudden illness, ICU stays, and the couple's recognition of shared PTSDThe inspiration and healing that came from illustrating and publishing "Ghost Flower," Bill's final unfinished manuscriptFinding comfort and connection through creativity, especially in times of griefThe significance of honoring one's own grief timeline and resisting outside pressure to “move on”Recognizing and appreciating signs from loved ones after their passing, especially through natureTrust yourself and your intuition to make the choices that feel right for you on your widowhood journey! You know what's best for YOU!You can find Ksenia and her book Ghost Flower at https://www.merckiipress.com/ksenia-merckStruggling with an identity crisis? Many widows find themselves wondering "Who Am I Now?" Get the latest workbook in the Widow 180 Workbook series, The Who Am I Now? Workbook at www.widow180.com/whoaminow  Be sure to join our Facebook group, Widow 180 The Community: https://www.facebook.com/groups/312036956454927Also follow us on Insta: https://www.instagram.com/widow_180/Check us out on YouTube at Widow 180: The Channel: https://www.youtube.com/channel/UC-DK_dl31qMilJ5cE6t9MVQFor more blog posts and resources go to www.widow180.comQuestions? Email me at jen@widow180.com

This week's topics include duration of dual anticoagulation following bypass grafting or stents, how has management of miscarriage changed, at home rehab after an ICU stay, and weight loss for atrial fibrillation.

In this episode, Dr Michelle Ossmann, nurse practitioner and socio-spatial scientist, explores hospitality in healthcare, ICU design, and evidence-based healthcare architecture. Dr. Ossmann is the global research director for MillerKnoll. Trained as a socio-spatial scientist and nurse practitioner, she leads the research team to investigate front-end innovation and back-end organizational outcomes across a range of place types. She serves in an advisory capacity for various Fortune 500 companies, health systems, and academic and professional programs, and publishes and presents widely. Dr. Ossmann received both her undergraduate and graduate degrees in nursing and her MBA from Emory University, and her PhD in Architecture from The Georgia Institute of Technology. For more information on research discussed on today's podcast, visit millerknoll.com. You can also connect with Dr. Ossmann on LinkedIn at https://www.linkedin.com/in/michelle-ossmann/, where she shares additional research and insights.

Send us Fan MailHow often are we missing dysphagia in our most vulnerable NICU patients? In this episode of Journal Club, Daphna reviews a retrospective cohort study from the Journal of Perinatology examining the incidence and risk factors of dysphagia confirmed by flexible endoscopic evaluation of swallowing (FEES) in very preterm and very low birth weight infants. Among infants showing persistent feeding difficulties at 38 weeks post-menstrual age, laryngeal penetration was detected in all infants who underwent FEES, and tracheal aspiration in nearly 60%. Ben and Daphna discuss whether we are naming dysphagia for what it is, whether earlier instrumental assessment could change outcomes, and what it means for families to finally understand why their baby is struggling to feed.----Incidence and factors associated with dysphagia in infants born very preterm or very low birth weight. Reynolds J, Suterwala M, Desai S, Chiruvolu A.J Perinatol. 2026 Apr 29. doi: 10.1038/s41372-026-02701-1. Online ahead of print.PMID: 42056238Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

The Triggering Scent: A Medical Thriller (The Abbey Roberts Series Book 1) by Jenny White https://www.amazon.com/Triggering-Scent-Medical-Thriller-Roberts-ebook/dp/B0GTX6ZT74 Beep….Beep…..Beep……. When the brilliant neurosurgeon, Dr. Mark Winston III operates on Abbey Roberts, he knows it will be a challenging procedure. But a drug addiction and withdrawal symptoms cause his hands to shake. Four hours into the operation, disaster occurs. Almost a year after the botched brain surgery, Abbey returns to work, in her comfort zone the ICU. But all is not well. She struggles to differentiate right from wrong, realizes her personality is different and has gaps in her memory she can't resolve. Living with her brain damage, she has to create her new world and at the same time hide her challenges. Then her worst nightmare walks through the ICU doors and she must work side by side with the man who almost killed her, twice. How can Abbey navigate the ethical minefield of treating patients while her tormentor operates just down the hall? When past and present collide, Abbey must decide if vengeance is worth risking everything.

The Chicks sit down with hospice nurse, educator, and best-selling author Julie McFadden for an honest and compassionate conversation about death, dying, and how embracing mortality can actually help us live more fully. Julie shares her journey from ICU nursing to hospice care, why education around death reduces fear, the importance of end-of-life planning, and insights from her best-selling book Nothing to Fear. Nothing to Fear by Julie McFadden Hospice Nurse Julie - Social Media Legal planning guides for end-of-life choices Hospice and Palliative Care Resources Educational Video Series on Actively Dying Learn more about your ad choices. Visit megaphone.fm/adchoices

A 52-year-old male with a history of alcohol use disorder is admitted to the ICU with acute pancreatitis. On day 3, the physical therapist is asked to perform a bedside evaluation. Which of the following findings would be the most appropriate indication to defer physical therapy intervention at this time? Find it all out in the podcast! Be prepared for the NPTE so that you can pass with flying colors! Check out www.ptfinalexam.com/podcast for more information and to stay up-to-date with our latest courses and projects. #Npte #PT #ptboards #crushtheNPTE #study #studygram #spt #ptstudent #ptlife #sptprobs #physicaltherapystudent #physicaltherapy #physio #physiotherapist #ptlife #ptstudentstudy

We discuss the interface between ED and ICU and why we have trouble understanding each other, with Dr. Namita Jayaprakash, dual-trained EM and critical care physician, and medical director of her ED. Learn more at the Intensive Care Academy! References

Send us Fan MailJapan has some of the best survival rates for extremely preterm infants in the world, yet feeding practices there look very different from what many of us are used to. In this episode of Journal Club, Ben reviews the JASMINE trial, a multicenter phase three randomized controlled trial evaluating an exclusive human milk diet compared to a standard cow milk-based diet in very low birth weight infants in Japan. Infants on an exclusive human milk diet gained weight significantly faster, reached full feeds six days sooner, and had fewer antibiotic days. Ben then sits down with first author Professor Katsumi Mizuno and Dr. Melinda Elliott, CMO of Prolacta Bioscience, to discuss the backstory and broader implications of this landmark trial.---Growth and safety evaluation in very low birth weight infants receiving an exclusive human milk diet: a phase III randomized control trial in Japan. Mizuno K, Miyazawa T, Kondo U, Nishikubo T, Yamamoto Y, Nakano Y, Hiroma T, Ikeda K, Murase M, Jimi H, Hokuto I, Miyata M.J Perinatol. 2026 Apr 27. doi: 10.1038/s41372-026-02695-w. Online ahead of print.PMID: 42045666Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailWhat does it take to turn a single struggling baby into a national standard of care? In this episode, Ben sits down with Professor Katsumi Mizuno (Showa Medical University) and Dr. Melinda Elliott (Chief Medical Officer, Prolacta Bioscience) to discuss the landmark Jasmine Trial, the first randomized controlled trial of an exclusive human milk diet (EHMD) in Japan. The results: significantly better weight and length gain, fewer antibiotic days, and improved feeding tolerance in very preterm infants. After an eight-year regulatory journey, Japan's Pharmaceuticals and Medical Devices Agency (PMDA) granted Prolacta's human milk-based fortifier PrimiFort drug-level designation, a global first, ensuring equitable, nationally reimbursed access for every preterm infant in the country. The conversation also looks ahead to the Fuji Trial and what Japan's precedent-setting decision could mean for Europe and the US.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

This is episode one of a two-part series. Flight nurse Dave Repsher and his wife Amanda — also a nurse — join host Jana Price on Nurse Converse to share one of the most powerful survival stories in nursing.On July 3rd, 2015, Dave was working a shift on a Flight for Life helicopter when it crashed 32 seconds after takeoff. Covered in jet fuel and on fire, he suffered burns over 90% of his body. The pilot did not survive. Doctors did not expect Dave to make it through the night.Almost a year later, he walked out of the hospital alive.Jump Ahead: 02:09 — Introducing Dave and Amanda Repsher02:53 — Dave's path into nursing: from ski bum to flight nurse04:29 — Amanda's path: raft guide, EMT, paramedic, ICU nurse05:58 — How Dave and Amanda met at an ACLS class06:43 — Setting the scene: July 3rd, 2015, the helicopter crash27:55 — The lifetime impact of small acts by nurses30:26 — Arriving at the burn unit in Denver and being let into the "tub room"34:18 — Severe inhalation injuries and renal failure35:42 — The everyday battle for survival37:28 — "The perfect storm of good"39:08 — Dave wakes up after five and a half months42:53 — Amanda fills in what really happened: emergent thoracotomy and SVC syndrome49:58 — Wrap-up and tease for part twoIn part one of this incredible two-part conversation, Dave and Amanda walk through the day of the crash, what those first hours in the burn unit looked like, and how Amanda fought to be part of his care team. They share the small moments from nurses — a phone call, a hand on a shoulder, a tech explaining each burn degree — that changed everything. Dave also opens up about what it was like to wake up after five and a half months and beg his wife to let him die, not knowing the medical crisis that had just nearly killed him.This episode is for every nurse who has ever wondered if the small things they do for patients and families actually matter. They do. Sometimes for a lifetime.Listen to part one now. Part two coming soon. Learn more at nurse.org/nurseconverse.For more information, full transcript and videos visit Nurse.org/podcastJoin our newsletter at nurse.org/joinInstagram: @nurse_orgTikTok: @nurse.orgFacebook: @nurse.orgYouTube: Nurse.org 

This is episode two of a two-part series. Part 2 of one of the most powerful survival stories in nursing. Host Jana Price welcomes back flight nurse Dave Repsher and his wife Amanda — also a nurse — to continue the story they started in part 1.After a helicopter crash left Dave with burns over 90% of his body, the fight to survive was only the beginning. In this episode, Dave and Amanda pick up where they left off and walk through the long road of recovery: a year of home dialysis, a kidney transplant from a stranger named Matt who has now become family, getting married in the ICU after 16 years together, and what life looks like on the other side of it all.Jump Ahead: 00:38 — Welcome back and recap of part 103:40 — Dave's decision to fight: "We can't be angry"08:05 — The power of hope and small acts from staff11:21 — A nurse-patient's plea: talk to your sedated patients12:45 — What separates new nurses from experienced ones15:20 — A year of home dialysis: "Dialysis keeps you alive, but it's no way to live"17:18 — Amanda's stress and the first 911 call from home17:51 — Finding humor and independence on a tricycle with a bell21:11 — The phone call: a donor named Matt23:13 — Choosing to know your donor — Matt becomes family25:56 — Married in the ICU after 16 years together28:02 — The documentary "D-Rep" and the milk-jug fuel system30:37 — A 2014 helicopter built to 1965 safety standards32:19 — Why military helicopters got safer after Vietnam but civilian ones didn't34:00 — Two federal laws in five years thanks to advocacy35:52 — "Dave was the least physically injured from the crash"37:57 — A company's staff who refused to fly without crash-resistant fuel systems40:03 — 85% of the non-military fleet had no crash-resistant fuel systems at the time of the crash41:23 — Life today: running a community ice rink in Colorado42:23 — Continued advocacy and burn survivor support44:32 — Closing thanks and where to find resourcesThey also share the advocacy work that came out of the crash. Dave's helicopter was brand new, but its fuel system was built to 1965 safety standards. The same fuel system has been described as no stronger than a milk jug. Together with the pilot's widow Karen, Dave and Amanda helped push two pieces of federal legislation through Congress to require crash-resistant fuel systems on newly manufactured helicopters. A medic recently texted them after walking away from a crash because of the very system they fought for.This is a conversation about hope, advocacy, and what it really means to make good come out of tragedy. Listen to part 1 now at nurse.org/nurseconverse.For more information, full transcript and videos visit Nurse.org/podcastJoin our newsletter at nurse.org/joinInstagram: @nurse_orgTikTok: @nurse.orgFacebook: @nurse.orgYouTube: Nurse.org 

Send us Fan MailCould putting a few drops of breast milk in a preterm infant's nose actually improve cerebral oxygenation? In this episode of Journal Club, Daphna reviews a randomized controlled trial from the European Journal of Pediatrics investigating the physiologic effects of intranasal expressed breast milk (EBM) administration in preterm infants. The study found that infants receiving 0.2 mL of fresh breast milk intranasally three times daily showed significantly higher cerebral oxygenation levels, along with more favorable trends in heart rate and respiratory rate, compared to controls. While time to full oral feeding and length of hospital stay were unchanged, the safety data is reassuring. Ben and Daphna discuss what outcomes we should even be measuring, and whether the evidence is already good enough to just do it.----Effect of intranasal breast milk administration on cerebral oxygenation, vital signs, and transition time to full oral feeding in preterm infants: a randomized controlled study. Yücel A, Küçükoğlu S, Konak M.Eur J Pediatr. 2026 Apr 16;185(5):272. doi: 10.1007/s00431-026-06922-6.PMID: 41986747Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

When Joshua Barbeau proposed to his girlfriend, Jessica Courtney Periera, she was already in the ICU. 10 years later, Joshua was still grieving her death. That's when he came across Project December. With just a short writing sample and a prompt, the program enabled him to make a chat bot of Jessica. Since then, the market for so-called “grief bots” has exploded. Millions of people are using AI to “talk” to the dead. The phenomenon has left cyberpsychologist Elaine Kasket asking the question: what happens when we rely on for-profit AI companies to help us manage something as deeply human as grief? And where's the line between comfort and self-destruction?This episode features Joshua Barbeau, and Elaine Kasket, with research from Jason Fagone's article “The Jessica Simulation”, written for the San Francisco Chronicle in 2021.

Delirium, pain, and prolonged ventilation can feel like “expected” bumps in perioperative care until you look closely at the data. We walk through four recent APSF In the Literature reviews and pull out what's actually actionable for anesthesia patient safety right now, with clear numbers and real-world implications.First, we dig into a randomized controlled trial of S-ketamine for elderly patients undergoing total hip or total knee arthroplasty under neuraxial anesthesia. With general anesthesia out of the equation, the study reports a notable drop in postoperative delirium, raising practical questions about when S-ketamine belongs in your plan and how you weigh neuroprotection alongside analgesia.Next, we shift to the ICU after cardiac surgery and examine evidence on dexmedetomidine sedation and duration of invasive mechanical ventilation. We talk through the key nuance: dexmedetomidine is associated with longer ventilation overall, yet may shorten ventilation time in patients with a high “sedation burden,” highlighting how stacking sedatives can change the outcome you're trying to optimize.We then move to labor and delivery with a large prospective cohort on pain during cesarean delivery with neuraxial anesthesia, including higher risk with urgent cases and epidural top-ups, plus an important signal on language and the need for interpreters. We close with a pediatric trial where EEG-guided sevoflurane titration reduces emergence delirium and speeds recovery in the PACU.Subscribe for weekly, evidence-focused anesthesia insights, share this with a colleague, and leave a review so more clinicians can find the latest perioperative patient safety updates.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/308-we-break-down-the-latest-evidence-on-safer-anesthesia-care/© 2026, The Anesthesia Patient Safety Foundation

Send us Fan MailOne infant is diagnosed with neonatal opioid withdrawal syndrome every 27 minutes, and rates are rising. In this episode of Journal Club, Ben and Daphna review the Optimized NOW randomized clinical trial, a landmark multicenter study published in JAMA. The trial compared symptom-based dosing,  a single opioid dose given when a withdrawal threshold is met against the traditional scheduled opioid taper in infants managed with Eat Sleep Console. The results are striking: symptom-based dosing reduced time to medical readiness for discharge by nearly two and a half days, and 65% of pharmacologically treated infants avoided scheduled opioid dosing entirely. Could this be the evidence-based approach that finally reshapes how we treat NOWS pharmacologically?----Symptom-Based Dosing for Neonatal Opioid Withdrawal: The OPTimize NOW Randomized Clinical Trial. Devlin LA et al HEAL Evaluation of Limited Pharmacotherapies for Neonatal Opioid Withdrawal Syndrome (HELP for NOWS) Consortium.JAMA. 2026 Apr 25:e265782. doi: 10.1001/jama.2026.5782. Online ahead of print. PMID: 42033722Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

This week on The Amish Inquisition, we're joined by Dr Penny Sartori, one of the world's leading researchers of Near‑Death Experiences (NDEs) and author of The Wisdom of Near‑Death Experiences. With over 20 years of clinical nursing experience — including a landmark five‑year ICU study — Penny brings rare scientific insight into what people report at the very edge of life. Are NDEs hallucinations, spiritual events, or evidence that consciousness survives death? What do people consistently describe when their brain is clinically shutting down? And why do these experiences transform lives so profoundly? We explore: The core patterns of Near‑Death Experiences across cultures What patients report when the brain is supposedly “offline” Veridical perception — cases where people saw or heard things they shouldn't have been able to How NDEs challenge materialist models of consciousness The transformative after‑effects: personality shifts, values, intuition, worldview The big question: What do NDEs reveal about the nature of consciousness itself? Whether you're sceptical, curious, or deeply invested in the mystery, Penny Sartori brings clinical data, human stories, and decades of research to one of the most profound questions we can ask. Join us live, get involved in the chat, and bring your questions. Follow Penny here:  https://www.drpennysartori.com/ https://www.instagram.com/drpennysartori/ https://x.com/DrPennySartori _____________________________ Follow us here: https://allmylinks.com/the-amish-inquisition Sign up for the newsletter, join the community, follow us online, and most importantly share links!  Producer Credits for Ep 424:   Producers - TBC _______________________________   Leave us a voicemail: 07562245894 Message us here....follow, like, subscribe and share. (comments, corrections, future topics etc). We read out iTunes reviews if you leave them. Website - http://www.theamishinquisition.com/ Join the Element server: https://matrix.to/#/%23the-amish-inquisition%3Amatrix.org Subscribe to the Newsletter: Drop us an email and let us know Get your Merch from: The Amish Loot Chest - https://teespring.com/en-GB/stores/amish-inquisition-loot-chest Email - theamishinquisition@gmail.com Buy us a Coffee - https://www.buymeacoffee.com/theamishguys Twitch - https://www.twitch.tv/theamishinquisition Rumble - https://rumble.com/c/c-1347401 Twitter - https://twitter.com/amishinqpodcast Facebook - https://www.facebook.com/amish.inquisit.3 Instagram - https://www.instagram.com/theamishinquisition/?hl=en Bitchute - https://www.bitchute.com/channel/0fNMZAQctCme/ YouTube - https://www.youtube.com/channel/UCmv8ucrv5a2KpaRWyBWfBUA Find out how to become a Producer here - http://www.theamishinquisition.com/p/phil-1523918247/   Become a Producer! The Amish Inquisition is 100% supported by YOU.  NO Ads, NO Sponsorship, NO Paywalls. We really don't want to suckle at the teat of some faceless corporate overlord. But that is only avoidable with your help! Join your fellow producers by donating to The Amish Inquisition via the PayPal button on our website, simply donate whatever you think the show is worth to you. If you find the podcast valuable, please consider returning some value to us and help keep the show free and honest.

Peer support can feel like the missing link in addiction care, not because it replaces medicine, but because it makes recovery feel possible when someone is scared, ashamed, or shutting down. I'm Dr Casey Grover, and I sit down with Mark Ehrenkranz, a certified peer recovery specialist who does bedside work across a thousand-bed hospital, from the ED and ICU to behavioral health. Mark brings decades of recovery experience, plus the clarity that comes from having lived through relapse, depression, and the brutal way substance use disorder can hijack decision-making.We get practical about what peer recovery specialists actually do: building trust quickly, sharing just enough personal story to invite radical honesty, translating brain science into plain language, and helping patients move from crisis to a realistic next step. We also talk about the real-world barriers, including stigma in medical settings, limited funding for peer teams, and how different states handle certification and reimbursement. If you've ever searched for recovery coaching, peer recovery support services, sober support, or how to get help for addiction, this conversation maps the terrain with honesty and hope.We also go straight at the “one path” problem. AA helps many people, but it can feel dogmatic to others, so we discuss multiple pathways like SMART Recovery, CBT/DBT, secular and Buddhist recovery, online communities, and medication for opioid use disorder support spaces. Mark shares his “Navy SEAL Recovery” approach to nervous system regulation: one-minute diaphragmatic breathing, humming to stimulate the vagus nerve, and small doses of intentional discomfort to build resilience. If you care about compassionate, evidence-informed addiction treatment that respects individual fit, you'll leave with tools you can use today.Subscribe, share this with someone who needs it, and leave a review so more people can find the show.To learn more about Mark's work: https://www.go-humans.com/To contact Dr. Grover: ammadeeasy@fastmail.com

"The Doctor Is Not Always Right"  Hein Van Eck is a healthcare actuary by training, a breed of thinker who sits at the intersection of data, ethics, and human behavior. He started in insurance in South Africa, was handed his career-defining job after answering a single ethical question correctly, and has spent the last 20 years on the provider side watching an industry transform in real time. He moved to Dubai in 2014 and hasn't stood still since.  As CEO of Mediclinic Middle East, Hein oversees six hospitals, 27 clinics, 4,000 babies born annually, and a workforce of doctors recruited from around the world not by headhunters, but by hospital directors who fly to the UK in winter specifically to sit across a candidate and ask: would I feel comfortable if this person treated my family?  That detail tells you everything about how he leads.  This conversation goes places most healthcare interviews don't. Hein talks honestly about the agency problem at the heart of modern medicine doctor has the knowledge, patient consumes, insurer pays and what happens when that system breaks down. He explains why Ozempic and Mounjaro might genuinely extend lives, not just shrink waistlines. He reveals an AI model that predicts, with 95% accuracy, which patient won't show up to their appointment. And he shares his vision of what a hospital looks like in ten years: a theatre complex, an ICU, and almost everything else happening at home.  If you think Dubai healthcare is second-tier, this conversation will change your mind.    Timestamps:  0:00 -  20 years at one company in Dubai: why Hein never needed to leave   2:00 - From actuary to hospitals: the agency problem at the heart of healthcare   5:00 - Post-Covid consumerism: why visits per person have doubled from four to eight a year   9:00 - Peptides, Ozempic, and the traffic light system: green, amber, and outright quackery  14:00 - Insurance, self-pay, and the moral dilemmas that arise every single day   21:00 - Collaborative management without consensus: how he leads 4 million patient interactions   25:00 - The mentor, the one ethical question, and how Hein got the job   28:00 - Payment cycles: 20 days in South Africa, 100+ days in the UAE and the hidden cash flow crisis   34:00 - How Mediclinic recruits doctors: hospital directors on planes, not recruiters on LinkedIn   40:00 - Spencer's spinal fusion story and the one doctor who made it human   47:00 - Hospitals as healthcare malls and why the big scary hospital is disappearing   52:00 - AI that predicts no-shows with 95% accuracy and ambient AI that frees doctors to look up   56:00 - In ten years, a hospital will be a theatre and an ICU and everything else happens at home   1:02:00 - The blue chair in every boardroom: every decision tested against what's best for the patient   1:07:00 - Quickfire: the biggest lie in healthcare, what scares him about AI, and the hardest truth about technology adoption    Follow Spencer Lodge on Social Media: https://www.instagram.com/madeindubaipodcast/?hl=en  https://www.facebook.com/profile.php?id=61586194260076  https://www.instagram.com/spencer.lodge/?hl=en   https://www.tiktok.com/@spencer.lodge   https://www.linkedin.com/in/spencerlodge/   https://www.youtube.com/c/SpencerLodgeTV   https://www.facebook.com/spencerlodgeofficial/    Follow Hein Van Eck on Social Media: https://www.linkedin.com/in/hein-van-eck-a632881a/  https://www.linkedin.com/company/mediclinic-middle-east/  https://www.instagram.com/mediclinicme/?hl=en 

How can changing the way we breathe lower stress and blood pressure? Why is touch so important for premature babies and ICU patients? And what can our organs teach us about staying healthy? Dr Giulia Enders, author of the multimillion-selling Gut, returns with a new book, Organ Speak — an exploration of the lungs, skin, immune system, muscles and brain, and the extraordinary ways our organs work together to keep us alive and well. In this episode, she joins science communicator Dr Emma Yhnell to discuss how exercise really works, the hidden sophistication of the immune system, why humans evolved to sleep and dream, and whether AI can ever compete with the complexity of the human brain. Dr Giulia Enders is a physician and author. Her new book, Organ Speak: What it Really Means to Listen to Our Bodies, is available online and in stores now. Dr Emma Yhnell is an academic and science communicator. Learn more about your ad choices. Visit podcastchoices.com/adchoices

I was honored to share time in studio with Ryan and Sarah Woodland recently, and I'm proud to call Ryan a member of LoCo Think Tank, and a friend.  In the 3+ years I've known Ryan, he's grown his Woodland Home Marketplace from a $500K business into a ~$2MM / year and profitable operation - and largely worked himself out of a role for the company.  And - he's been developing his skills acquired from decades of contracting, fix and flips, and custom home building - and has been building his systems to manage a 56-unit luxury patio home semi-custom production build project.   Sarah is co-founder of Woodland Family Homes, but spends most of her time in brokerage at Orr Land Company - which was founded by her grandfather.  She met Ryan when she was living in California - but was preparing to move back to NoCo - but decided to stay a while - and soon brought Ryan back to his deep family roots in NoCo going back to the 1800's.  Ryan and Sarah trace their journey of passion for community and real estate - and business - and the journey of this family legacy project.   Not to miss in this episode is a LoCo Experience story from Ryan's firefighting days in California, during EMS training - when a dirty needle from a regular customer poked him in the elbow - and caused a systemic infection that put him in the ICU and almost killed him.  So - please tune in - and enjoy - my conversation with Ryan and Sarah Woodland.

Send us Fan MailThe NICU is one of the loudest environments a newborn will ever experience, yet it is also where the most vulnerable infants spend their earliest, most developmentally critical days. In this Tech Tuesday episode, Ben and Daphna sit down with Gabby Daltoso and Sophie Ishiwari, co-founders of the Sonura Beanie. Their device tackles two pressing NICU challenges at once: harmful noise exposure and disrupted parental connection. By embedding a low-pass filtration system tuned to the acoustic environment of the womb into standard hospital beanies, Sonura attenuates high-frequency alarms while preserving the frequency of the human voice. Parents can also send recordings of songs, stories, and their heartbeat directly to their infant at the bedside. With a feasibility trial underway at Penn Medicine and the University of Pennsylvania President's Innovation Prize secured, Gabby and Sophie are just getting started.To learn more, visit www.sonuracare.comSupport the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

In this powerful and deeply personal episode of Hard Parking, host Jhae Pfenning welcomes longtime friend and fishing partner Brice Chaidez for his first time on the show. Nearly 11 months after a severe motorcycle accident in Mesa, Arizona that left him in the ICU, Brice opens up about waking up with no memory, his military service, the long recovery road, and how the crash transformed his life and perspective.Raw, honest, and full of resilience — this conversation highlights the power of friendship and community in the face of life-altering challenges.Referenced:NYC woman falls into open manhole tragedy • ABC7 NYSupport Brice's recovery: GoFundMeTimestamps:00:00 - Welcome & Episode Intro03:10 - Brice Chaidez joins the studio08:45 - The day of the motorcycle accident15:20 - Waking up in the ICU24:30 - Military service & life before37:15 - Recovery journey and life changes52:40 - Friendship, fishing stories & memories1:08:50 - Moving forward with new perspective1:35:45 - Closing thoughtsEnjoy the episode and don't forget to subscribe for more real conversations from the Hard Parking crew.ContactEmail: info@hardparking.comWebsite: www.hardparking.comPatreon: patreon.com/hardparkingpodcastInstagram: https://www.instagram.com/hardparkingpod/YouTube: youtube.com/@HardParking

Imagine being a speech therapist and waking up in an ICU, unable to speak, swallow, or move your head and neck. That's what happened to Vanessa Abraham, MS, CCC-SLP, seven years ago when she was paralyzed by the pharyngeal-cervical-brachial (PCB) variant of Guillain-Barre. In this episode, she shares the full story from ventilator, tracheostomy, G-tube, and eye gaze boards through her path to eventually rebuilding her voice, her ability to swallow, and her clinical practice.  We cover: The PCB variant of Guillain-Barre and what recovery actually looks like How Vanessa found the Neubie, which turned out to be the missing link in her recovery The ways she uses electrical stimulation on the head and neck in her speech-language pathology practice, and how she dials in for swallowing and vocal cord function Polyvagal theory, why the body can't heal in a state of fight-or-flight, and how Vanessa uses the Master Reset Her frameworks for working with children with autism, adults with neurodegenerative conditions, and people experiencing PICS (post-intensive care syndrome) Vanessa is now one of the first SLPs in the world using the Neubie and has become a passionate educator through her book Speechless, her various talks and appearances, and her clinical practice. Her story is a very powerful pain-to-purpose conversation.  

Patrick responds directly to listeners, offering guidance on spirituality, relationships, and daily challenges through heartfelt exchanges and practical wisdom. Questions range from Catholic teaching on end-of-life care and feeding tubes to the nuances of physical attraction in marriage, and the risks parents might encounter in family court or when trusting neighbors. Faith, experience, and a willingness to address the tough stuff keep the conversation real and, at times, unexpectedly moving. Irene – Why hasn’t anyone spoken out against the CCP in China electing bishops? (00:28) Judy (email) – If there’s a problem with a Catholic school, I would go to the bishop. Maria (email) – Should I let my daughter babysit for a family that practices yoga? Maria - I am a single woman in my 40s. How much physical attraction do I need to find a holy spouse? (10:34) Paul (email) - How do I go about finding a spiritual director? (22:58) Tim - I had to talk my wife into marrying me. (26:47) Rose – Is it a sin if you can't concentrate during the Rosary? (29:22) Ted - You said you are not a spiritual advisor, but I think you are to me. I say you are my spiritual advisor when people ask where I get my advice from. Should I not say that anymore? (33:50) Mary – My father is in the ICU. Does the Catholic Church approve of putting someone on a feeding tube? (40:46) Matt - No Christian legal expert would help me because they didn’t want to get involved in family court. (46:53)

Tonight on America at Night with McGraw Milhaven: Dr. William Hylton and Attorney Joel Faxon join the show to discuss a developing lawsuit filed after a man reportedly died while under the care of a telehealth ICU doctor. They examine the legal and medical questions surrounding virtual healthcare, patient safety, and the growing role of telemedicine in critical care environments. Later, author Mary-Lisa Gavenas joins the program to discuss her book “Selling Opportunity: The Story of Mary Kay.” Gavenas explores the rise of the iconic beauty company, the business strategy behind its success, and the lasting cultural impact of Mary Kay Ash and her entrepreneurial vision. Learn more about your ad choices. Visit podcastchoices.com/adchoices

#229 - He was face down in the ocean, paralyzed, and running out of time. Patrick Yalon went out for a routine surf at San Francisco's Ocean Beach and never came back the same person and he's honest about how close he came to not coming back at all.We talk through the full arc: the low-tide wipeout that breaks his neck, the foggy scramble that ends with his friend finding him blue in the water, and the CPR that brings him back. From there it's ICU uncertainty, brutal nerve pain, and a nine-and-a-half-hour spinal fusion from C3 to C5 with titanium hardware. Patrick doesn't skip the dark parts: identity loss, depression, and the exhausting question of whether his body will ever work the way it used to.Then the story pivots from survival to purpose. Patrick chooses a wildly specific goal for spinal cord injury recovery and resilience: Moab 240, one of the toughest ultramarathons in the world. He lines up just months after the accident, grinds out 144 miles in 2024, then travels to Thailand to keep healing through daily Muay Thai training, time in the mountains, and a search for meaning and faith. He also shares why helping others with similar accidents matters so much, and how finishing Moab 240 in 2025 through storms, mud, lightning, and sleep deprivation becomes a shared victory with the friend who saved his life.Patrick is writing a memoir called Still Here and continues raising money and awareness for people impacted by spinal cord injuries. Subscribe to The Human Adventure, share this with someone who needs a reason to keep showing up, and leave a review if Patrick's story hits home.To follow along with Patrick's journey you can give him a follow on Instagram @bodiezepha415. For those runners out there on Strava just search for Patrick Yalon.To learn more about me and see clips from past, present, and future shows give me a follow on Instagram @humanadventurepod.Want to be a guest on The Human Adventure? Send me a message on PodMatch, here: https://www.podmatch.com/hostdetailpreview/journeywithjakeXploreum connects you with authentic wilderness expeditions led by trusted local experts. Browse real adventures, book directly with experienced guides, and get $200 off your first trip using code HumanAdventure2026 at xploreum.io/humanadventure. 

In this hard-hitting episode of the PFC Podcast, Dennis sits down with Doug, a cardiothoracic ICU physician, for a no-fluff deep dive into ACLS with a heavy focus on pulseless VT and VFib in austere, military, and prolonged field care environments.From deciding when CPR is worth it under fire or in a mass casualty scenario, to running a lean team code with minimal personnel, nailing high-quality BLS, working the H's and T's under chaos, post-ROSC pitfalls, antiarrhythmics, and the gut-wrenching decision of when to call it — this conversation delivers practical, experience-based wisdom you won't find in standard ACLS class.Whether you're a medic, PA, physician, or team leader operating far from a hospital, this episode gives you the mental framework and tactical edge to give your teammate the best possible shot at survival.Key Takeaways:Scene safety and triage realities — when not to start CPRHow one knowledgeable person can effectively run an entire code by delegating roles (CPR rotations, timer, airway, meds, defibrillator)Prioritizing actions in resource-limited environments: early high-quality CPR + epi > everything elseWhen and how to practically apply the H's and T's (especially hypovolemia, acidosis, hypoxia, and tension pneumo)Post-ROSC critical care: preventing rearrest, airway management, sedation, and treating the “two patients” (heart + brain)Amiodarone vs Lidocaine — when to use whatRealistic termination of resuscitation guidelines, the difference between witnessed vs unwitnessed arrest, and the value of objective outside input (telemedicine)The power of bringing the team in for closure when the fight is overChapters00:00 – Intro & Welcome00:57 – Can you really do CPR in the field? Safety, triage, and mass casualty realities02:57 – Running a code with minimal trained personnel – how one leader directs chaos06:02 – Essential team roles: CPR rotation, AED/pads, airway, access, and early epi09:08 – Making the H's and T's actually useful (hypovolemia, acidosis, hypoxia, tension physiology)16:53 – Post-ROSC care: Preventing rearrest, airway security, sedation, and neuroprotection20:41 – Antiarrhythmics – Amiodarone vs Lidocaine, dosing, and post-arrest infusions22:53 – The hard call: When to terminate resuscitation (witnessed vs unwitnessed, resources, hypothermia exception)28:19 – Emotional reality of coding teammates and giving families/teammates closure33:21 – Final pearls: Telemedicine, ultrasound/video for handoff, STEMI considerations, and medevac prep36:03 – Closing thoughts & resourcesFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

Father Lance Harlow joins Patrick to discuss Devotion to Mary The inspiration behind the book on Mary (8:51) Difference between Devotion and Worship? How does humility keep devotion to saints focused on God? (12:54) Why should we go to Mary in order to love Jesus better? How does Mary draw us to Jesus? Laurene - My devotion to Mary has been a growing process. I haven't always understood devotions because I thought they were distractions with my relationship to Christ. I'm gradually coming out of that now. (20:31) Break 1 Gosia - Miracle with my devotion. My mom lived in Poland. Found out she was in ICU. She had been bleeding and didn't know where from. Went to chapel and begged Mary to save my mom. Next day, found out they didn't know what happened. All tests were normal. Blamed it on lab error. It's increased my devotion to Mary. (24:39) Laurene - My devotion to Mary has been a growing process. I haven't always understood devotions because I thought they were distractions with my relationship to Christ. I'm gradually coming out of that now. Email about a good approach to receiving Mary (31:47) What is a Consecration? Yesenia - I'm a Mexican American catholic. What about the phenomenon of apparitions? She has been a diplomat for the human race and has appeared so many places. Could you talk about that? (39:32) Break 2 (41:30) Laurel - Could you explain the Miraculous medal of Mary? (45:27) Sophia - Getting past the fear to get to pray the Rosary. I experienced what I prayed for after 54 day novena. I've been trying to developed my devotion again, but it's hard to do it. How do I get to that again? Resources: Vermont Catholic https://www.vermontcatholic.org/ The Echo of God eBook https://visitationproject.org/collections/november/products/the-echo-of-god-ebook-1?srsltid=AfmBOooOYljhNHKvqzYBErsRXjASsusLBqymauQPfzAjR9FGjOxQ1Ctr

Palliative care in multiple sclerosis spans the disease course, from early screening and support after diagnosis to symptom management and quality‑of‑life optimization in midstage disease, and end‑of‑life care in advanced MS. This episode outlines a staged approach to palliative care, highlights the roles of neurology and primary care teams, and discusses tools such as patient‑reported outcomes and symptom scales to support ongoing assessment of patients and care partners. In this episode, Katie Grouse, MD, FAAN, speaks with Penelope Smyth, MD, FRCPC and Janis M. Miyasaki, MD, MEd, FRCPC, coauthors of the article "Palliative Care in Multiple Sclerosis" in the Continuum® April 2026 Multiple Sclerosis and Related Disorders issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California, San Francisco in San Francisco, California. Dr. Smyth is the director of the Division of Neurology in the Department of Medicine at the University of Alberta in Edmonton, Alberta, Canada. Dr. Miyasaki is a professor in the Division of Neurology in the Department of Medicine at the University of Alberta and the zone clinical department head for Clinical Neurosciences at Alberta Health Services in Edmonton, Alberta, Canada. Additional Resources Read the article: Palliative Care in Multiple Sclerosis Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full episode transcript available here Dr Grouse: With the new treatments for MS, people might be saying palliative care is not relevant at all. It's about giving up hope and hopelessness. But this article covers why palliative care is important for your patients and families throughout their illness trajectory. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Grouse: This is Dr. Katie Grouse. Today, I'm interviewing Drs Penelope Smyth and Janis Miyasaki about their article on palliative care in multiple sclerosis, which appears in the April 2026 Continuum issue on multiple sclerosis. Welcome to the podcast, and please introduce yourselves to our audience.  Dr Smyth: Thank you, Katie. I'm Penny Smyth. I am a neurologist at the University of Alberta, a professor in neurology, and a clinical multiple sclerosis specialist.  Dr Miyasaki: Hi, Katie. Thanks for having us. I'm Janis Miyasaki. I am a movement disorder neurologist primarily who also provides neuropalliative care at the University of Alberta in Edmonton, Canada.  Dr Grouse: It's so great having you today to talk with us about your article. I thought this article was really a wonderful take on the topic. I learned a lot, and I'm really hoping all of our listeners will take advantage of this article and take advantage of all the learning they can get from reading about this topic. So, I wanted to start with a more general question, which is, what is the key message from this article that you're hoping your readers will take away?  Dr Smyth: In terms of key takeaways, I think it's our hope that neurologists will come away from reading this article with, really, an expanded understanding of what palliative care is and how that might be applicable to them in their care for their patients with MS along a continuum of treating people with MS, that there can be components of palliative care and strategies that can be integrated early after diagnosis in, really, anywhere along the continuum of caring for people with MS. We've called that kind of mid-stage. And then there are particular needs for people with MS and their care partners in late-stage or severe MS and end of life that might require different palliative care strategies. I think we kind of have maybe a bit of a bias sometimes in thinking of palliative care as more directed towards those that are near end-of-life. But in fact, it's a much expanded concept.  Dr Miyasaki: And I'll just add that we also discuss a palliative approach, that palliative care skills and philosophies can be used by generalists---in this case, neurologists who are providing care to people with MS---and that adopting certain skills and communication techniques can help us better address our patients' and their families' symptoms. And also to keep in mind that for most people with neurologic illness, the unit of care is not only the patient, but it's the patient and the family, however that family looks.  Dr Grouse: Now, Penny, I'm curious, how are early-stage and mid-stage multiple sclerosis palliative care strategies different from, say, a typical evaluation and counseling that a neurologist would give, say, an MS specialist or even a general neurologist?  Dr Smyth: Thank you, Katie. That's a great question, and something that actually I learned in writing this piece with Janice and from her as a neuropalliative care expert. I think in terms of early strategies around palliative care that can be helpful to the general neurologist in their office, palliative care is about holistic support for patients and their care providers spiritually, emotionally, physically. There are components of palliative care and symptom management and making sure that the patient is at the center of the care, as well as support for their care partners with their holistic approach of relief of suffering as well as offering hope. When I started this piece, I was thinking that many of us neurologists, I think, often informally utilize many of these components already when we're dealing with patients early on after diagnosis in terms of communication, counseling, and education; going through their fear of an uncertain future; spiritual well-being; and then connecting them with supports for adaptive coping strategies. And then as well in mid-stage, which is really around what we can do in symptom management and improving quality of life, with screening tools and patient-reported outcome measures. However, I have to say that there are many unmet needs for people with MS and their care partners that they identify that are clearly not being met by us neurologists in this day and age. So even though we may be incorporating some of these strategies, I don't think we're meeting the mark all the time and hitting the target, especially in our busy office practices, in various ways. Dr Grouse: Given that, at a high level, what are some important early-stage MS palliative care concepts that we should be keeping in mind when we are counseling patients in these stages of the disease? Dr Miyasaki: An important concept to keep in mind for neurologists dealing with early-stage MS patients is that for us, we feel successful that we have made a diagnosis. And yet for the patient, it is taking away that hope. Maybe it's not MS. Maybe I just have a numb hand and it's gonna go away. And for us to appreciate that while we make this diagnosis multiple times a week---or, for MS specialists multiple times a day---for this person, it is the first time, the first experience, and it shakes their entire foundation of who they are as a person, how they will perform all the tasks and roles that they have in society, in their professional lives, in their family structures, and in their close, intimate relationships. As physicians, we may be overwhelmed by acknowledging that. I feel that it's important for us to understand the needs that our patients have and to allow them to have their feelings. You know, feelings can feel messy and time-consuming, and yet when we fully see our patients, I feel that this is the best of medicine. And it certainly is, in terms of palliative care, the principle that we seek. We accept all of the patient, the joy and the sorrow, the anger and the frustration. We accept it all, and we try to determine what will serve this person who is suffering in front of us now.  Dr Smyth: There's another piece to this, which came up as Janice and I were writing together. We were talking about offering a prognosis to a patient as to how they would do, and this was something that I thought deeply about, because I said, we always communicate how uncertain the prognosis is and how we can't predict the future. And then she said to me, well, what about offering a roadmap to a person with MS soon after diagnosis as to how you're gonna determine how they do over the next couple of years? Which are really important years in terms of determining how patients are doing on their disease-modifying therapies, whether they're having progression or not, and things. It's a pivotal time. So, if you can offer a roadmap to a person with MS and say, look, this is when we will be following you up. This is how we will be following you with MRI and biomarkers if you have that available, and this is how we will determine how responsive you are and then how we move forward from there. Dr Grouse: Really important concepts. And the roadmap certainly makes a lot of sense to me and something that, apart from just being useful to the patient for so many reasons to help set expectations, you know, is useful for us to better partner with the patient so they understand this is sort of how we do things and everyone's sort of expectations are met. So, I think those sound like really great goals and things to keep in mind. Now, we talked about early-stage MS palliative care concepts. How does that change as you get into the mid-stage of the disease?  Dr Smyth: Yeah. So, this is reflecting the fact that the course of MS is so different and the experience of MS is so different person to person. And so, what do we do as neurologists when we follow these people long-term over years and decades of living with their MS as their needs evolve, as their symptoms evolve, and as their disability evolves? Well, really, this is about the time of getting into, what are the symptoms that they're struggling with, what are the causes of their suffering at various points? And then how do we identify that, maybe with use of patient-reported outcome measures, screening scales, things like that. And then how do we direct symptomatic management to the specific symptoms that are causing distress to the patient? As well as trying to improve their quality of life in various ways, treating their comorbidities, making sure to check on exercise, healthy living, and that kind of thing.  Dr Grouse: Now getting into, I think, topics that we're more used to thinking about when we think about palliative care: a lot of us, I think, are really unsure of the right time to discuss advanced care directives in the course of multiple sclerosis, and I think that's not helped by the fact that many of us are just, in general, not terribly comfortable talking about those types of things in general. What is your advice to questions like this?  Dr Smyth: And this is something that, again, Janice and I had to come together on, because there is no universal accepted time for when is the right time in multiple sclerosis to discuss advanced care directives and goals of care. And in fact, when they have looked at it in the literature, different things have come out. It has come out that neurologists can be uncomfortable discussing this. There's unique challenges to people with MS in that they have a diagnosis at a young age with an uncertain trajectory of how their course of disease is going to go. And many of these things lead care providers to be somewhat hesitant as to when is the right time, as well as, there were identified barriers within patients themselves as to when the right time might be to discuss. In that, you know, some of the coping strategies might be, as identified by some of the qualitative studies that have been done on this, around the fact that they would prefer to focus on the present rather than the future. In some studies expressed an ambivalence as to when they thought the right time might be, as well as some negative experiences that they might have had from providers trying to discuss these things in their previous experience. So, I went back to looking at the European guidelines for palliative care in MS, who suggested when a person might have severe MS---which they define as walking with bilateral aids for at least twenty meters or an EDSS of six or higher---or trigger-based, when there has been a change in the patient's status, when there's been a decline in some way or progression. Now, this is a little different, actually, than what we offer other people with neurologic diseases, and I don't know if that's the right answer. And this is where I'm going to turn it over to Janice, because I think we could learn something, as neurologists who treat people with MS, from our palliative care specialists.  Dr Miyasaki: I think of advanced care planning in a very different way. I think what a lot of the patients were expressing in the studies was that being asked about advanced care planning signaled to them in some way that they have reached this point in their illness where things aren't going so great and I anticipate that you may run into complications. Whereas in our movement disorder clinic, one of our fellows did a study looking at capacity for decision-making. And even in people who scored normally on the Montreal Cognitive Assessment, they had impairments in some of the domains of decision-making. And so, our philosophy in movement disorders at least---and some of our patients are quite young who have multiple system atrophy, they could be in their forties---we take the philosophy that everyone over the age of decision-making capacity, which is generally eighteen, should have some goals of care established. And how I introduce it in my clinic is, you know, for the young resident, you want the full-meal deal, because the likelihood of the resident surviving the ICU admission is very high. And then when we look at me, who… I am older, the likelihood of surviving an ICU admission is considerably lower. And so, the appropriate goals of care might be that I am willing to go to the ICU, and if things go well, then they can continue. But if things are not going well, they can have a discussion with my personal directive or power of attorney to talk about what the goals of care should be. And then the other aspect is sometimes having the conversation with family is really important because most of our families in hospital express an uncertainty. Am I doing the right thing? And they want to do the right thing for their loved ones. And most people actually say, if you ask them, I don't want to burden my family with making decisions that are going to tear at their hearts. So, then we can't actually make good informed decisions for our loved ones unless we have clear conversations. I think it does speak to our superstitious beliefs that if we talk about death, it's going to happen. But I hope the listeners will take my word for it, it really doesn't. And someone had a really good saying about the advanced directive. They're kind of like evening clothes. You should take them out every once in a while and make sure they still fit. And so, when you normalize it in this way, it helps people to just say, oh, yeah, it's once a year. Dr. Miyasaki is gonna ask me about how do I feel about those goals of care. And then it doesn't have this portent of, oh, I'm not doing well. Instead, it's just, this is what we should all be doing for our sake and for our family's sake.  Dr Smyth: Now, one thing that I have to add on to this is that it is important to try to establish advanced care directives before patients experience cognitive decline, because then that can make it a much more challenging conversation and brings nuances of challenge into the interactions, which, you know, are hard.  Dr Grouse: And Penny, I'm glad you brought that up, because I was really struck by that point too when reading this article, how easy it is to miss the subtle signs that cognitive changes are happening. I think it's just- it's a good kind of segue into that topic in general, but it is such an important link to, you know, making sure that you get those advanced directives at a time when the patient's really able to express and understand what they're talking to you about. Now, on the topic of the cognitive screenings, what's a good way to do this type of screening, and why is this type of screening so particularly important in the case of multiple sclerosis?  Dr Smyth: Yeah. Thank you, Katie. I think that it's important for our listeners to think about and recognize when we see our patients with MS because it is one of the invisible symptoms that people with MS can live with and may not be apparent on regular conversation in the office. So, it's important to deliberately ask about subjective challenges in cognition. Ask the partner about how they're doing in terms of their cognition in various ways. As well as asking them and exploring then, how are they doing in their professional roles if they're working or in their surroundings? How are they coping on a daily basis on a cognitive level in addition to a physical level? We know that cognitive issues are actually the biggest contributor for not working and are a huge driver of disability in MS in terms of functioning, even more than physical decline in many ways. So, it is important for us neurologists to keep top of mind and to think about and deliberately attend to. There are screening tests that we can do in the office. The easiest for us, which measures the verbal processing speed, is the SDMT test, which is a ninety-second test matching symbols and numbers. It's easy to do. You can train a MOA to do it before you see the patient and things like that, and it just gives you an idea as to where the patient is at. And usually they're having difficulties if they're greater than two standard deviations below the norm for their age, or if there's a significant drop of four or eight points, and that might signal to you that there might be more going on. You can explore it, and then if you do have this available, the ability to refer for neuropsychological testing if there's questions. But often we can't get it with the MoCA score, unfortunately.  Dr Grouse: Talking about all these concepts, I think they all sound great. I think a lot of us hearing this will naturally say, "Yes, these are absolutely things we should be incorporating in the care of these patients." What I wondered about was, certainly we're all very busy, it is really hard to find time for a lot of these things. We don't always have access to specialists who can help us with some of these conversations. How can we find time, and how can we work this into the care of our patients effectively and still make time for all the other things we have to talk about, and make sure that we're seeing all of our other patients and staying on time and all of those things?  Dr Miyasaki: Yes. I think that's the challenges of dealing with people who actually, over time, their care needs increase, is huge in neurology. I can't think of a single subspecialty where care actually gets easier. It's constantly getting harder. You know, having come from private practice, I completely understand my colleagues' challenges in the community. Some of the ways that other groups have managed this when they don't have government or university support in their center is actually to look at not-for-profits. There are a lot of not-for-profits that can help in terms of wayfinding for social services, explaining to the patients and the family what is available to them. And in fact, some of them can also provide some cognitive supports, as well as point them in the way of day programs. And many of them have very established caregiver support groups, as well as patient support groups for various stages of their illness. So, I think it requires for the individual or small or even a large group practice to be inventive, to look in your community and see what resources are available and free for your patients in order to establish that loose team without boundaries to help your patients. Of course, for those in academic centers, I know that times are tight for all of us, and if you haven't established a team, it is a challenge; and then learning how to write a business plan or a briefing note for your institution and to learn how to speak the love language of administrators, is really key to putting forward the needs of our patients. Which, compared to heart attack patients or hips and knees, they are very rare, and yet our patients can result in significant cost to the healthcare system. So, we do have an opportunity to make the case that putting a little bit of investment in the ambulatory setting can result in significant cost savings to the system when it comes to acute care hospitalization.  Dr Smyth: So, I was thinking, Janis, as you were talking about that, when you were talking about not-for-profit groups, it's really the MS societies in various countries that are very active in this and have a lot of resources available, especially for care partners.  Dr Grouse: Those are really great tips. Thank you for bringing those up as potential other resources we can take advantage of. I wanted to ask specifically about physician-assisted death and assisted suicide, which certainly does come up, especially in later-stage parts of the disease. How can palliative care specialists be helpful when patients do express interest in these types of interventions?  Dr Miyasaki: As you know, Katie, in Canada, we've had a legislative right to access to what we call medical assistance in dying. When the legislation passed, one of my other colleagues and I felt that these were the only conversations we were having with our patients. In all this experience, I have sort of developed in my mind a framework of people who are what we call MAID-curious. They want to know what their rights are and how it would look, when they feel the time is close, for them to exercise that right. And then there are those who are fearful of future suffering. And some of them may have a very unrealistic view of what the future will look like. And this may be in particular for multiple sclerosis because many of the public's view is based on what treatment was like thirty years ago. It may not be informed by more recent treatment where patients actually do quite well, and the majority never get to progressive MS. And so, to explore and be open to that request is the first thing that is important. And then if the person has unresolved symptoms that, traditionally, we can't care for, the palliative care specialist can be very helpful because they just have inventive ways of looking at things. They look at it outside the box, and they have a different toolkit available to them. I would not want all neurologists to just send all these patients requesting physician-assisted death to their palliative care colleagues. But I think for those who are having unaddressed symptoms, it can be very helpful. Certainly, if there is an acute event in the hospital, then this is a time of crisis. And often hospitals will have an in-hospital palliative care team who can come and speak to the patient about what is going on and address some of their needs. And I would also like to emphasize the importance of spiritual care, because for many of our patients, they are not just having the physical suffering, they are also having the spiritual suffering of hopelessness or of feeling that they are a burden or that they just are not seen because a lot of the symptoms in MS are invisible. To have that understanding by a spiritual care counselor is really helpful for the people to feel understood and to reduce some of that suffering.  Dr Grouse: That's a really great point, I think, to end on, and I think it really ties in a lot of the themes that we've been talking about today. Thank you so much for coming to talk with us today. It's been such a pleasure having you both here. Dr Smyth: Thank you. Dr Miyasaki: Thank you, Katie. Dr Grouse: Again, today I've been interviewing Drs Penelope Smyth and Janis Miyasaki about their article on palliative care in multiple sclerosis, which appears in the April 2026 Continuum issue on multiple sclerosis. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Brian's got a shiny new commercial certificate, Ben just logged 25 hours in three days in a flying potato over Florida, and somehow nobody declared an emergency — so naturally, it's time to talk about flying like a professional even when nobody's paying you to. From sterile cockpit discipline to weight and balance on every single flight (yes, everyone), the crew runs through a practical list of habits that separate polished pilots from the yank-and-bank crowd. Plus: a listener who went from ICU nurse to CFII at 54, a fuel tank horror story that will make you check yours right now, and Mark prepares to hand a large sum of money to some people in the Czech Republic who have definitely sent him pictures of his actual airframe. Probably.Mentioned on the show:* Time Building Mafia: https://volare.aero/timebuildingmafia* The Calm Cockpit Podcast: https://calmcockpit.com/* TL Sparker: https://www.tl-ultralight.cz/en/ultralight-aircraft/sparker* 0W3 - Hartford County Airport - Churchville Maryland: https://www.airnav.com/airport/0w3* PHKO - Ellison Kona airport: https://www.airnav.com/airport/phko* SISKIND: Do Easy: How Fast Can You Take Your Time? https://www.youtube.com/watch?v=Oqsg-iW3KBw

Welcome to this episode of the Legal Nurse Podcast! In this episode, Pat Iyer and Tracey Kapper dive into the transformative power of video marketing through the lens of their newly released books, "AI-Powered Video for LNC's" and its companion workbook. Listeners are invited behind the scenes as Pat Iyer shares her journey from nervously recording presentations with outdated technology to becoming a seasoned video creator, offering invaluable tips for overcoming common obstacles like stage fright, equipment overload, and noisy backgrounds. Tracey Kapper, on the other hand, recounts her recent entry into video production, driven by the need to stand out in a crowded legal consulting field, and discusses the challenges and rewards of video challenges that pushed her out of her comfort zone. The conversation explores both practical and emotional strategies for getting started with videos, highlighting the importance of consistent practice, learning to edit, and adapting to evolving technologies. They address the significance of creating concise, engaging content tailored to the needs and language of legal professionals. They also discuss current tools such as AI-powered teleprompters, free editing programs, and platforms like Loom and Canva that make video production accessible to beginners and professionals alike. Throughout the episode, they emphasize authenticity and the willingness to experiment, urging legal nurse consultants to start, even if their early videos feel awkward. They offer guidance on leveraging AI for topic research, the nuances of protecting expert witness credibility, and maximizing visibility through platforms like LinkedIn, YouTube, and Instagram. Whether you're new to video or looking to refine your process, this episode is packed with actionable insights, relatable stories, and encouragement to embrace video in your professional journey. What You'll Learn in This Episode on Overcoming Video Anxiety with AI Tools and Practical Editing Tips Here are 5 discussion questions answered in the podcast: What were the initial challenges faced by Speaker A and Speaker B when they started creating videos, and how did they overcome them? How has video content changed the way legal nurse consultants and related professionals market themselves to attorneys? What are some advantages and drawbacks of using AI tools, such as ChatGPT and AI-generated videos, for content creation as discussed in the episode? In what ways can participating in video challenges help professionals become more comfortable with video marketing? How important are editing skills for producing effective marketing videos, and what editing tools did the speakers recommend? Listen to our podcasts or watch them using our app, Expert.edu, available at legalnursebusiness.com/expertedu. Get the free transcripts and also learn about other ways to subscribe. Go to Legal Nurse Podcasts subscribe options by using this short link: http://LNC.tips/subscribepodcast. https://youtu.be/DzwiSe6xptQ Your Presenter for Overcoming Video Anxiety with AI Tools and Practical Editing Tips Pat Iyer Pat Iyer is a seasoned legal nurse consultant and business coach, renowned for her expertise in guiding new legal nurse consultants to successfully break into the field. As the host of the Legal Nurse Podcast, Pat addresses critical challenges that legal nurse consultants face, such as difficulty in landing clients and a lack of response from attorneys. Through her insightful episodes, she emphasizes the importance of effectively communicating one's value to potential clients. With a wealth of experience, Pat has empowered countless consultants to overcome these hurdles and thrive in their careers. Connect with Pat Iyer by email at patiyer@legalnusebusiness.com Tracey Kappers IV sedation nurse expert, legal nurse consultant, scuba diver, and travel enthusiast. I began my career in high-acuity trauma ICU, cardiac critical care nursing, and recovery room with experience in GI endoscopy and procedural sedation recovery. I now work with attorneys through TKO Consulting, reviewing medical records and translating complex clinical details into clear timelines and insights that support case strategy. My work focuses on identifying what happened clinically, what should have happened, and where breakdowns occurred in patient care. With a background spanning ICU trauma care, procedural sedation, and outpatient recovery, I bring a practical clinical perspective to legal cases involving medical injury. When she is not on this podcast, she is scuba diving in some of the world's most memorable waters or spending time with her family and planning her next travel adventure. Connect with Tracey Kappers by email at traceykappers@tkoLNCconsulting.com

Send us Fan MailEvery neonatologist has built a protocol or written a guideline, and most have done it completely alone. In this episode, Ben sits down with Dr. Christina Muffy Sollinger (UC Davis) and Dr. Sarvin Ghavam (CHOP), the co-founders of NeoGuide, a national collaborative dedicated to connecting clinicians around the shared work of clinical guidelines and practice pathways. Born from a single email that broke a listserv and generated over 120 responses overnight, NeoGuide has grown into a structured community offering a seminar series on topics like transfusion medicine and HIE management, and a curriculum series focused on implementation science. Muffy and Sarvin discuss how to build consensus without promoting cookie-cutter medicine, the moral distress of clinical uncertainty, and their vision for a living repository of institutional pathways. Whether you are at a level four academic center or a small rural NICU, you shouldn't have to start from scratch.To learn more, visit NeoGuide.org Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

This week on Critical Care Time we take a slight departure from our usual content and turn an eye towards sustainability in the ICU. What low-hanging fruit exists in your ICU in the fight against medical waste? Why reach for a nebulizer when HFAs are so much more convenient? We had a great chat with Dr. Stephanie Maximos and Dr. Hari Shankar where we unpack this emerging concept and discuss options to take great care of your patients AND be mindful of waste and excess in your ICU! Listen, learn and let us know what you think!! Hosted on Acast. See acast.com/privacy for more information.

Send us Fan MailCerebral oxygenation, staffing economics, delivery room scoring, neurodevelopmental prognostication, and public health — a full week on the Incubator Journal Club.Ben walks through the NIRTURE trial, a single-device RCT testing cerebral oximetry-guided care in infants born under 29 weeks. The intervention dramatically reduced the burden of cerebral hypoxia and hyperoxia compared to standard care. Secondary clinical outcomes were neutral and neurodevelopmental follow-up is still pending. The question of whether stabilizing cerebral oxygenation actually moves the needle for these babies remains unanswered.Daphna covers a brief communication from the Journal of Perinatology on what happens to billing and productivity when NICUs shift to 24-hour in-house attending coverage. Clinical FTE went up, work RVUs went down — and the reason is counterintuitive. Attendings present overnight were weaning babies faster. Better care, less revenue. The coding system was not built to capture that.Ben then pairs the 5-minute Apgar with umbilical artery pH in very preterm infants using EPICE cohort data. When both are low, risk is highest. When they compete, the Apgar wins.Daphna rounds out Journal Club with a systematic review showing that combining EEG and brain MRI outperforms either tool alone for neurodevelopmental prognostication in preterm infants.The week closes with Ben and Eli on the sweeping domestic and international public health funding cuts — and what they mean for the vulnerable populations in your NICU.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

In this episode, Dr. Cindra Kamphoff shares the story behind Hank's Hope, a project inspired by her father's 51-day fight in the ICU and the "win wall" her family created to capture small victories each day.   Cindra explores why celebrating small wins is essential for building confidence, resilience, and hope. Drawing from performance psychology and confidence research, she explains how focusing on progress—not perfection—helps train your brain to recognize growth and build belief in yourself.   In This Episode: Why small wins matter The difference between "the gap" and "the gain" How celebrating progress builds confidence Simple ways to track your daily wins Power Phrase: "Confidence grows when we acknowledge our progress, not just our perfection."   Learn more about Hank's Hope at Mentally Strong Kids: mentallystrongkids.org/hanks-hope/

In August 2024, 26-year-old Conor Hylton checked into Bridgeport Hospital in Connecticut. Overnight, he was transferred to critical care, where he died.It was only after his passing that his family found out that Conor was treated at what's known as a “tele-ICU.” His story shines a light on a practice that's been around for decades despite a lack of substantial research about its outcomes.A tele-ICU is a hospital unit where patient care is handled off-site by remote doctors, nurses, or specialists. Up to a third of ICU beds in the U.S. are in tele-ICUs. That's according to a study from the American Hospital Association.In Wisconsin, as of May 1, critical care physicians are no longer physically present in the ICUs of a few Ascension satellite hospitals. They remain available via video call to help bedside nurses and on-site hospital medicine doctors, known as hospitalists, who do not specialize in critical care.These facilities do present an opportunity to expand and improve the health care people receive. But what are the risks of replacing in-person care in the most critical, life or death moments?Find more of our programs online. Listen to 1A sponsor-free by signing up for 1A+ at plus.npr.org/the1a.See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

What happens when your brain is a literal ticking time bomb and nobody tells you until it goes off? Meet Martin. At 16, he was just a normal kid until a rare brain malformation (AVM) ruptured, sending him into a month-long coma where he "tripped balls" to a Lil Wayne soundtrack provided by the ICU staff. But the rupture was only the beginning. After a grueling months long recovery he got hit with a second rupture, a brain infection, and a medical error so bad he was left with "Sunken Bone Flap Syndrome". A condition where atmospheric pressure literally pushed his scalp into his brain. It's a story about hitting rock bottom multiple times and finding the "gains" every single time you climb back out.Follow Sickboy: Instagram: https://www.instagram.com/sickboypodcastTiktok: https://www.tiktok.com/@sickboypodcastDiscord: https://discord.gg/expeUDN

In this episode, I sit down with Pierre Mousseau — entrepreneur, keynote speaker, and author of From the Ashes: A Father's Journey Through Grief, Grace, and Faith. This is one of the most extraordinary, raw, and spiritually powerful conversations this show has ever had. Pierre grew up with a severely alcoholic and mentally abusive father, was molested at 11, slept on the streets at 17, and was kicked out of his home at 19. He built himself into an entrepreneur, a husband, and a father. And then his son Parker — sweet, joyful, endlessly loving Parker — was taken from him at 21 years old after a catastrophic bowel emergency, five surgeries, and seven weeks in the ICU. Pierre made the decision to remove him from life support. Five months later, with his company collapsing and the grief unbearable, Pierre got into his car at full speed aimed at a maple tree. He should have died that day. He didn't. What follows is one of the most extraordinary stories of faith, forgiveness, and divine intervention you will ever hear — from the church he walked into while still hating God, to the deacon whose homily that Sunday was about losing a child, to the moment in the shower when something held him and everything changed. This episode will stop you in your tracks. And it will remind you to hug your kids today. Timeline Summary [0:00] Introduction to the Dad Edge mission and the movement to raise leaders of families and communities [1:02] Pierre's childhood — alcoholic and abusive father, bullied at school, Spider-Man comics as his only escape [5:33] Moving in with a drug-addicted uncle at 17, sleeping on the streets, and nobody noticing he was gone [7:44] Being molested at 11 — and the family that never did anything about it [8:31] Driving four hours to see his dying father determined to tell him everything — and what actually happened instead [10:41] Saying "I forgive you" at his father's bedside — and still carrying the hatred for years after [15:51] Introducing Pierre — entrepreneur, speaker, and author of From the Ashes [17:30] Who Parker was — how he loved, what made him extraordinary, and the boy who still believed in Santa Claus at 14 [21:30] The phone call from the hospital — and the doctor who said "I don't know what happened but his bowel is pink" [23:33] Seven weeks in the ICU, ICU delirium, and the decision Pierre had to make [25:39] "I felt like I murdered my child" — the guilt that followed Pierre for years [32:18] The hardest decision he has ever made — and why he couldn't keep Parker alive for himself [38:02] Five months after Parker's death, the company collapsed — and on a Saturday morning Pierre got in his car to end his life [39:09] Heading for a maple tree at full speed — and what stopped him [40:44] Eleven months of hating God — and the Sunday morning he suddenly drove to church [41:21] Walking into mass on the homily about losing a child — and sobbing until the woman beside him put her hand on his shoulder [43:52] Meeting Deacon Curtis, the grief retreat, Parker's orange tag, and the text that said "I think Parker is trying to tell you something" [47:30] In the shower in March 2025 — the purple light, the arms that held him, and the love that changed everything [51:14] Strength is not pushing through — strength is vulnerability, asking for help, and being willing to say "this sucks" [52:38] The keynote at the convent and the woman with a cane who walked up at the end without one [56:47] The man in the steam room bashing his kids — and what Pierre said that silenced the room Five Key Takeaways Forgiveness is not a feeling — it's a decision you make before the feeling follows. Pierre said the words at his father's bedside before he was ready. The release came years later. Grief and guilt will destroy you if you carry them alone. The bravest thing Pierre did wasn't surviving the worst moments — it was finally saying "I need help" and meaning it. Strength is not pushing through. Strength is vulnerability. Strength is allowing yourself to cry, to feel, to say this is hard, and to ask for another man to come alongside you. You never know when the moments will be gone. Cherish the ordinary ones — the arcade nights, the couch cuddles, the conversations that start after midnight. Parker would tell you that. God meets you in your most broken moment — not when you've cleaned yourself up. Pierre was still hating God when he walked through that church door. It didn't matter. Links & Resources Dad Edge Business Boardroom: https://thedadedge.com/boardroom From the Ashes by Pierre Mousseau: Available on Amazon, Barnes & Noble, Christian Books, and Walmart Episode Link & Resources (Episode 1476): https://thedadedge.com/1476   Closing If there's one message from this episode that stands out, it's this: hug your kids today. Not tomorrow. Today. Pierre Mousseau lost the most loving person he had ever known. And what he has done with that loss — the book, the keynotes, the moment in the steam room, the woman who walked without her cane — is one of the most beautiful things we have ever witnessed on this show. Don't let another day go by without telling the people who matter most that you love them. Go out and live legendary.