Podcasts about outpatient

Hear two post-fracture care specialists share their perspective on how to effectively transition patients' post-fracture osteoporosis care from the inpatient to outpatient setting. Dr. Aloiya Kremer will share her perspective on best practices for starting a post-fracture osteoporosis care program, while Jacqi Kernaghan will discuss what she has learned about the inpatient to outpatient integration from her work in a specialized osteoporosis clinic. Listeners will gain valuable insights into how to effectively manage patients after they leave the hospital to minimize the risk of subsequent fractures. Dr. Kremer and Ms. Kernaghan are paid consultants for Amgen.This episode is sponsored by Amgen.

Outpatient Direct Initiation of Injectable Buprenorphine in a Harm Reduction Agency and Primary Care Clinic: A Retrospective Case Series Journal of Addiction Medicine Initiating weekly long-acting injectable buprenorphine (LAIB) without prior sublingual buprenorphine (“direct-to-inject” or DTI) may reduce buprenorphine initiation barriers. In this case series, outpatient DTI outcomes are described. Of the 23 patients with available data, 19 (83%) had no withdrawal symptoms pre-DTI. Of the 20 patients with documented post-DTI withdrawal symptoms, 3 (15%) had no withdrawal, 12 (60%) had mild, 4 (20%) had moderate, and one (5%) patient had severe withdrawal. Thirty days post-DTI, 14 (58%) patients were retained on any buprenorphine formulation, and 11 (46%) patients were retained at 90 days. The median post-DTI buprenorphine treatment days were 77 (range: 9–90).  The majority of patients had no pre-DTI withdrawal symptoms, no or mild withdrawal symptoms post-DTI, and were retained on buprenorphine at 30 days post-DTI, with nearly half retained at 90 days. DTI is a promising buprenorphine initiation strategy, but further research is warranted.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

“My doctor says it's safe, but Google says it's not… what do I do?” It's the reality so many pregnant and breastfeeding moms face when they're given conflicting medication advice.  In this episode, consulting pharmacist Dr. Danielle Plummer and clinical pharmacist Dr. Tara Birch pull back the curtain on pregnancy medication confusion and why it happens. As Tara puts it, “Pharmacists need to be utilized more than they are. We are medication specialists.”  The core message is clear: every mom needs a pharmacist as part of her care team. From preconception through the postpartum period, pharmacists bring the medication expertise that is often missing and can prevent confusion, errors, and unnecessary risk. From the overwhelm of choosing a prenatal vitamin to navigating mixed messages from providers and “Dr. Google,” they walk through what's actually happening behind the scenes and how to make safer, more confident decisions. You'll hear why “there is no one-size-fits-all prenatal vitamin,” how postpartum needs can increase during breastfeeding, and why a truly collaborative care team leads to better outcomes for both mom and baby. If you've ever second-guessed a medication, felt confused by conflicting advice, or wished you had a clear, trusted voice guiding you, this conversation will change how you approach your care. What You'll Learn: - Why pharmacists are underused in maternal care - How to handle conflicting medication advice - How to choose the right prenatal vitamin - Why postpartum nutrition matters - The risks of relying on Google or AI for medication decisions - How collaborative care improves outcomes Expert Insights: - Pharmacists in Maternal Care: Pharmacists are medication experts but are often excluded from care teams. Including them improves safety and outcomes. - Conflicting Advice: Patients often receive mixed guidance from providers. Pharmacists help clarify evidence-based decisions. - Prenatal Vitamins: Not one-size-fits-all. Needs vary by diet, genetics, and symptoms. - Postpartum Nutrition: Nutrient needs may increase after delivery, especially during breastfeeding. - Gaps in Care: Hospital care is collaborative. Outpatient care is fragmented, creating safety risks. - Preconception Planning: Medication review before pregnancy can prevent first-trimester risks. Connect with Dr. Tara Birch: https://themotherbabypharmacist.com www.instagram.com/themotherbabypharmacist/ Phone/Text: 321-609-5424 Connect with Dr. Danielle Plummer: www.HGPharmacist.com linkedin.com/in/daniellerplummer

Virtual supervision is reshaping outpatient radiology — helping imaging centers cut costs, extend hours, and meet the new C M S permanent ruling on remote contrast oversight. Learn how real-world facilities are making it work. Learn more at https://www.contrast-connect.com/ ContrastConnect City: Las Vegas Address: Las vegas Website: https://www.contrast-connect.com/

Dr. Shelby Blankenship PT, DPT discusses a case study on a post ICU deconditioned patient due to cervical spine surgery complications. The episode covers assessment, treatment approach, progression, outcomes, and takeaways for similar cases. Want to make sure you stay on top of all things geriatrics? Go to https://MMOA.online to check out our Free eBooks, Lectures, & the MMOA Digest!

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/UKJ865. CME/NCPD/AAPA credit will be available until April 10, 2027.ChARTing New Ground in NHL: Practice-Changing Evidence, Real-World Experience, and Outpatient Delivery of Cellular Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb, Caribou Biosciences, Inc., Kite, A Gilead Company, Miltenyi Biomedicine, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/UKJ865. CME/NCPD/AAPA credit will be available until April 10, 2027.ChARTing New Ground in NHL: Practice-Changing Evidence, Real-World Experience, and Outpatient Delivery of Cellular Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb, Caribou Biosciences, Inc., Kite, A Gilead Company, Miltenyi Biomedicine, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/UKJ865. CME/NCPD/AAPA credit will be available until April 10, 2027.ChARTing New Ground in NHL: Practice-Changing Evidence, Real-World Experience, and Outpatient Delivery of Cellular Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb, Caribou Biosciences, Inc., Kite, A Gilead Company, Miltenyi Biomedicine, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/UKJ865. CME/NCPD/AAPA credit will be available until April 10, 2027.ChARTing New Ground in NHL: Practice-Changing Evidence, Real-World Experience, and Outpatient Delivery of Cellular Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb, Caribou Biosciences, Inc., Kite, A Gilead Company, Miltenyi Biomedicine, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/UKJ865. CME/NCPD/AAPA credit will be available until April 10, 2027.ChARTing New Ground in NHL: Practice-Changing Evidence, Real-World Experience, and Outpatient Delivery of Cellular Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb, Caribou Biosciences, Inc., Kite, A Gilead Company, Miltenyi Biomedicine, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/NCPD/AAPA information, and to apply for credit, please visit us at PeerView.com/UKJ865. CME/NCPD/AAPA credit will be available until April 10, 2027.ChARTing New Ground in NHL: Practice-Changing Evidence, Real-World Experience, and Outpatient Delivery of Cellular Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through educational grants from Bristol Myers Squibb, Caribou Biosciences, Inc., Kite, A Gilead Company, Miltenyi Biomedicine, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

What does it take to bring innovative embolization procedures like prostate artery embolization (PAE) and genicular artery embolization (GAE) into the outpatient setting? Dr. Kavi Devulapalli and Dr. Jerry Niedzwiecki share their experiences pioneering these treatments in office-based labs (OBLs), highlighting the clinical benefits, patient selection strategies, and workflow efficiencies that come with outpatient care. The conversation dives into real-world challenges, including reimbursement hurdles and the importance of advocacy and data collection through societies like OEIS. Gain practical insights on responsible practice, collaboration, and how building robust clinical evidence is key to advancing the field and securing patient access.

In this episode, Wake Radiology's President and Managing Partner Brent Townsend, MD and COO Parul Galloway discuss practical strategies to help mitigate patient access, workforce and other common challenges to successfully scale outpatient imaging. Together with Jason Weshler, VP of Outpatient Solutions at Siemens Healthineers, they explore how digitalization and AI-based tools, operational innovations, and advocacy efforts are shaping the future of patient-centered radiology care.This episode is sponsored by Siemens Healthineers.

In this episode, Wake Radiology's President and Managing Partner Brent Townsend, MD and COO Parul Galloway discuss practical strategies to help mitigate patient access, workforce and other common challenges to successfully scale outpatient imaging. Together with Jason Weshler, VP of Outpatient Solutions at Siemens Healthineers, they explore how digitalization and AI-based tools, operational innovations, and advocacy efforts are shaping the future of patient-centered radiology care.This episode is sponsored by Siemens Healthineers.

As federal oversight of risk adjustment and documentation practices intensifies, healthcare organizations are facing new scrutiny regarding how patient complexity is documented and reported. Recent guidance and enforcement activity from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has placed renewed focus on risk-adjustment accuracy, defensible documentation, and compliance across both Medicare Advantage (MA) and value-based payment models. During the next episode of Talk Ten Tuesday, Jason Jobes, a CDI expert, will discuss why outpatient clinical documentation integrity (CDI) programs are becoming increasingly important in this environment. He will explore how documentation practices, provider education, and governance strategies can help organizations accurately capture patient complexity while reducing audit exposure and protecting revenue.The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:·      POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.·      CDI Report: Cheryl Ericson will provide an update on all things CDI.·      The Coding Report: Christine Geiger will report on the latest coding news.·      News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

In this week's episode, Rex Nelson talks with a psychiatrist at the UAMS women's mental health clinic, Dr. Jessica Coker and the UAMS outpatient director of the women's mental health program, Dr. Shona Ray-Griffith, about women's mental health in Arkansas. Coker and Ray-Griffith talk about pregnancy planning, maternal mental health and postpartum mental health and how it impacts women in Arkansas. Podcast on Apple, Spotify, and YouTube, or visit arkansasonline.com/podcast23 for an exclusive subscription offer available only to podcast listeners Chapters (00:00:13) - Southern Fried Podcast(00:01:01) - The Women's Mental Health Program at UAMS(00:04:55) - Postpartum depression: Outpatient and inpatient care(00:07:58) - Mental health care: Between psychiatry and therapy(00:11:44) - Are Our Medications Safe During Pregnancy?(00:14:07) - How to manage mental health during pregnancy and postpartum?(00:15:49) - How to cope with pregnancy blues(00:18:07) - Should You Seek Mental Health Help after Having a Baby?(00:22:37) - UAMS Health System: A Big Picture(00:23:35) - UAMS doctor on access to care in Arkansas

Cardiology is shifting from inpatient to outpatient care. In this MedAxiom HeartTalk, host Melanie Lawson, MS, talks with Amy Brownell, MSN, FNP-C, FACC, cardiovascular service line director at Ascension Illinois Market about strategies for expanding ASCs and office-based labs while maintaining clinical quality. They also discuss operational and financial considerations that help health systems thrive in this changing landscape.

In this episode of The ASHE Podcast, hosts Dr. Gonzalo Bearman and Dr. Priya Nori sit down with Dr. Lindsey Childs-Kean and Dr. Alexandra Yamshchikov to discuss their recent publication highlighting a curated bundle of the top 10 OPAT-related studies from 2024. Outpatient parenteral antimicrobial therapy (OPAT) remains a cornerstone of infectious diseases practice, with a growing body of research shaping how clinicians deliver safe and effective care outside the hospital setting. In this conversation, the authors break down the most clinically impactful OPAT publications of the year, offering key insights, emerging trends, and practical takeaways for providers. https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/bundle-of-the-top-10-opat-publications-in-2024/F22DABCC50AED0A66CA53840508B8BD8#article

Dr. John Mays, orthopedic surgeon with Willis-Knighton Bossier Orthopedics, joins Healthline 3 to discuss advances in hip and knee replacement surgery. These advances allow some patients to return home the same day and begin walking almost immediately following the procedure.

Dr. Centor discusses hyponatremia in the outpatient setting with Dr. Joel Topf.

What does it look like when an early-career clinician steps up to solve real barriers patients face — not just their pain?Wisconsin-based PT and Fellow-in-Training Rachel Beilfuss joins us to talk about her mission to integrate social determinants of health (SDoH) into everyday outpatient PT practice. As a Northwestern OMPT fellow with a clinical site at Marquette University, she's building systems to help clinicians screen, identify, and address the life factors that shape recovery and access.Rachel is also this year's FOMPT scholarship recipient, representing the next generation of OMPT clinicians who are redefining what comprehensive care looks like.In this episode, we dig into:???? Why SDoH screening belongs in musculoskeletal care???? How Rachel is building clinic workflows + resource guides???? Her experience as a Fellow-in-Training at Northwestern/Marquette???? The importance of advocating for patients' basic needs???? What early-career leadership looks like in AAOMPT???? How lifestyle, access, and equity affect rehab outcomes???? Why clinicians need support beyond biomechanics to serve patients fullyThis one is full of passion, practicality, and vision from one of the profession's rising voices.

In this episode of Between the Lines with FGI, hosts Marissa Lamperis Kastrinos and John Williams sit down with the tri‑chairs of the 2026 FGI Codes for Planning and Design of Outpatient Settings: Kevin Matuszewski, Collin Beers, and Jennifer Kuschinsky. Together, they explore the major updates shaping the 2026 FGI Outpatient Code and discuss how evolving clinical practices, advancing technology, and new models of care are transforming outpatient environments. The conversation also offers a behind-the-scenes look at the multiyear revision process and the collaboration that drives the development of the FGI Codes. Listeners will get an inside look at new chapters, clarified terminology, streamlined imaging requirements, and the growing role of flexible, multifunctional outpatient spaces designed to support the future of care.    Sponsored by: American Society for Health Care Engineering (ASHE): Optimizing health care facilities    Link to show notes: https://fgiguidelines.org/podcast/s3-e4-the-code-ahead-a-preview-to-the-2026-fgi-outpatient-code/   Take a deeper dive into the 2026 FGI Outpatient Code: An on-demand webinar is available at FGI University that breaks down the specific updates mentioned in this episode, plus additional context and practical takeaways, directly from the chairs of the Outpatient Document Group of the 2026 Health Guidelines Revision Committee (HGRC).    Earn CEUs Anytime with FGI University and Between the Lines with FGI:  Gain even more insight with the extended version of this episode while earning continuing education units (CEUs)! Head over to FGIUniversity.org our educational platform for the FGI Codes/Guidelines, and explore CEU- and HSW-approved audio courses designed to make earning credits effortless—perfect for learning on the go.   To make it even better, use promo code BTL10 at checkout to get 10% off any Between the Lines with FGI course and the on-demand webinar for the 2026 FGI Outpatient Code. Listen, learn, and save today.    AIA self-reporting: FGI is a registered provider of AIA-approved continuing education under Provider Number 38744124. All registered AIA CES Providers must comply with the AIA Standards for Continuing Education Programs. Any questions or concerns about this provider or this learning program may be sent to AIA CES (cessupport@aia.org). This learning program may be self-reported for LU credit through the AIA Continuing Education System. As such, it does not include content that may be deemed or construed to be an approval or endorsement by the AIA.  To receive AIA self-reported LUs, learners must complete and self-report two of these entire learning programs for 1 LU.  Learn more about AIA self-reporting LUs: https://fgiguidelines.org/aia-self-reporting-lus/  Connect with us on LinkedIn Author: Facility Guidelines Institute 

Hospital Shutdown, Ransomware Surge, Fortinet Failures A hospital doesn't cancel chemotherapy appointments because of a “technical issue.” They cancel them because they've lost operational control. This week, the University of Mississippi Medical Center shut down its entire network after a ransomware attack disrupted systems — including Epic. Clinics closed. Elective procedures paused. Outpatient services halted. Emergency operations activated. Leadership described the shutdown as precautionary. But here's the real question executives should be asking: Why was a full network shutdown necessary? If segmentation is validated… If identity governance is enforced… If lateral movement detection is operationalized… Why does the only safe option become “turn it all off”? In this episode of Security Squawk, we break down what this incident signals about containment confidence, governance maturity, and operational resilience — not just in healthcare, but across every industry that depends on uptime. And we zoom out. Because UMMC isn't happening in isolation. According to TechRadar, ransomware groups have reached an all-time high in 2025. The victim growth rate has doubled. Qilin and other affiliate-driven operators are scaling aggressively. This isn't random chaos. It's industrialization. More fragmentation. More specialization. More execution discipline on the criminal side. Healthcare, public sector, and critical infrastructure are being economically targeted because downtime equals leverage. When systems go dark, negotiation pressure spikes. Then we connect it to something many leaders are still underestimating: Fortinet exploitation patterns. Edge vulnerabilities. VPN credential harvesting. Reinfection cycles months after patches were released. The vulnerability itself isn't the story. The response maturity is. Attackers are repeatedly probing whether organizations: – Patch fast enough – Rotate exposed credentials – Reset trust boundaries after compromise – Validate segmentation integrity – Rebuild identity confidence When those governance steps are skipped, attackers come back. That's not a tooling failure. That's a leadership failure. This episode translates three headlines into one hard truth: Ransomware is no longer just a malware problem. It's a containment confidence problem. For CEOs: If you cannot isolate an intrusion without shutting down revenue operations, your resilience model is fragile. For IT Directors: Active Directory recovery is not a restore-from-backup event. It's a trust re-establishment event. For MSPs: Client environments are operating in a denser criminal ecosystem. Tool stacking without maturity validation will not scale. For Risk Leaders: Financial exposure is no longer limited to ransom. Revenue interruption, regulatory scrutiny, and reputational damage compound quickly — especially in healthcare. We also discuss: • Why attacker communication often signals a second phase • Why affiliate ransomware models are accelerating • Why segmentation validation will become a board-level metric • Why detection speed does not equal governance strength Security Squawk exists to translate cybersecurity chaos into business reality — without vendor spin and without hype. If you value that kind of analysis and want to support independent, executive-focused cybersecurity conversations, you can back the show at: buymeacoffee.com/securitysquawk Your support helps us keep this live, timely, and unfiltered. Because criminals are already running maturity audits. And they invoice in operational shutdown. The question is simple: If it happened to you tomorrow, could you contain it — or would you turn the lights off?

Dr. Erdei is a triple board certified physician (neonatology, pediatrics, and developmental-behavioral pediatrics!) who talks us through high risk infant clinic! There is no one-size-fits-all approach to NICU follow-up, so Dr. Erdei draws on her years of experience to share the set-up of her own clinic. We talk about common challenges like evaluating adequate growth, preterm formulas/fortifiers, feeding intolerance, neurodevelopmental assessments and her expert advice for helping babies thrive in their family unit once they go home!

A major change in outpatient cardiac care is underway. On this MedAxiom HeartTalk, host Melanie Lawson, MS sits down with David Kenigsberg, MD, FACC, FHRS, a clinical cardiac electrophysiologist based in Northern Broward County, Florida. Together, they unpack the shift toward performing ablation procedures in ambulatory surgical centers (ASCs) — why it's happening, how it improves patient access and cost-effectiveness.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-472 Overview: The transition from hospital to home is a valuable period for patients and clinicians. In this episode, we discuss which patients require follow-up, what should be reviewed during these appointments, and when follow-up should take place to help improve patient outcomes. Episode resource links: Anderson, T. S., Herzig, S. J., Marcantonio, E. R., Yeh, R. W., Souza, J., & Landon, B. E. (2024, April). Medicare transitional care management program and changes in timely postdischarge follow-up. In JAMA Health Forum (Vol. 5, No. 4, pp. e240417-e240417). American Medical Association. Anderson, T. S., Wilson, L. M., Wang, B. X., Steinman, M. A., Schonberg, M. A., Marcantonio, E. R., & Herzig, S. J. (2025). Medication Errors and Gaps in Medication Discharge Planning for Hospitalized Older Adults: A Prospective Cohort Study. Journal of general internal medicine, 1-10.   Balasubramanian, I., Andres, E. B., & Malhotra, C. (2025). Outpatient follow-up and 30-day readmissions: a systematic review and meta-analysis. JAMA Network Open, 8(11), e2541272-e2541272. Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-472 Overview: The transition from hospital to home is a valuable period for patients and clinicians. In this episode, we discuss which patients require follow-up, what should be reviewed during these appointments, and when follow-up should take place to help improve patient outcomes. Episode resource links: Anderson, T. S., Herzig, S. J., Marcantonio, E. R., Yeh, R. W., Souza, J., & Landon, B. E. (2024, April). Medicare transitional care management program and changes in timely postdischarge follow-up. In JAMA Health Forum (Vol. 5, No. 4, pp. e240417-e240417). American Medical Association. Anderson, T. S., Wilson, L. M., Wang, B. X., Steinman, M. A., Schonberg, M. A., Marcantonio, E. R., & Herzig, S. J. (2025). Medication Errors and Gaps in Medication Discharge Planning for Hospitalized Older Adults: A Prospective Cohort Study. Journal of general internal medicine, 1-10.   Balasubramanian, I., Andres, E. B., & Malhotra, C. (2025). Outpatient follow-up and 30-day readmissions: a systematic review and meta-analysis. JAMA Network Open, 8(11), e2541272-e2541272. Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

How can patients receive more consistent interventional radiology care amid a national shortage of IR physicians? That question led Dr. Rick Daniels to develop a new outpatient practice model centered on recruiting independent IRs to provide long-term, fractional coverage for groups in need. In this episode of the BackTable Podcast hosted by Dr. Aaron Fritts, Dr. Daniels outlines the thinking behind this approach and how it aims to expand access to IR services in outpatient settings. --- SYNPOSIS The conversation examines the evolving landscape of IR practice, including the challenges associated with transitioning between practice settings and building sustainable outpatient service lines. Dr. Daniels walks through the development of his model, with particular attention to identifying and supporting outpatient embolization opportunities. The discussion also explores the consortium-style structure for independent IRs, emphasizing long-term alignment, professional autonomy, and scalability at a national level. Operational considerations such as technology partnerships, documentation workflows, and targeted marketing strategies offer a practical look at what it takes to make this model work. --- TIMESTAMPS 00:00 - Introduction03:49 - Evolution of an Independent IR Practice05:30 - Challenges and Opportunities in Outpatient IR09:58 - Building Service Lines and Marketing Strategies18:34 - Forming a National IR Group25:21 - Balancing Business and Healthcare25:37 - Evaluating and Correcting Site Performance28:16 - Expanding Geographical Reach30:45 - Recruitment and Retention Challenges38:07 - The Importance of Tech-Doc Teams42:35 - Future Goals and Recruitment Efforts45:58 - Conclusion

Learn about Seattle's mental health resources, from outpatient programs and telehealth services to crisis lines and community support groups. Understand how to find treatment options, work with insurance coverage, and access personalized care that fits your life. Read more at https://missionconnectionhealthcare.com/our-facilities/washington/outpatient-mental-health-services-seattle/ Mission Connection City: San Juan Capistrano Address: 30310 Rancho Viejo Rd. Website: https://missionconnectionhealthcare.com/

Why do nearly half of adults with mental illness go untreated, and how can intensive outpatient programs offer a powerful middle ground between weekly therapy and hospitalization with flexibility and proven results? Read more at https://missionconnectionhealthcare.com/virginia/outpatient-mental-health-center-in-arlington/ Mission Connection City: San Juan Capistrano Address: 30310 Rancho Viejo Rd. Website: https://missionconnectionhealthcare.com/

In this episode, Robert C. Rhoad, MD, Partner at OrthoCincy Orthopaedics & Sports Medicine, Hand, Wrist & Elbow Orthopaedic Surgery, shares how orthopedic care is shifting to outpatient, ASC, and office based settings. He discusses staying independent, expanding walk in and in office procedures, and the collaborations helping physician led groups innovate while preserving autonomy.

In this episode, Robert C. Rhoad, MD, Partner at OrthoCincy Orthopaedics & Sports Medicine, Hand, Wrist & Elbow Orthopaedic Surgery, shares how orthopedic care is shifting to outpatient, ASC, and office based settings. He discusses staying independent, expanding walk in and in office procedures, and the collaborations helping physician led groups innovate while preserving autonomy.

In this episode, Allison Roditi, Vice President of Orthopedics at Catholic Health, shares how the system is unifying employed and independent physicians, preparing for rapid outpatient growth, and navigating CMS policy changes. She discusses regional strategy, standardizing care and education, and building resilient orthopedic service lines centered on access, quality, and patient experience.

In this episode, Allison Roditi, Vice President of Orthopedics at Catholic Health, shares how the system is unifying employed and independent physicians, preparing for rapid outpatient growth, and navigating CMS policy changes. She discusses regional strategy, standardizing care and education, and building resilient orthopedic service lines centered on access, quality, and patient experience.

How do you know when weekly therapy isn't enough? We explore the critical signs that outpatient mental health care may no longer be sufficient and discuss the steps to transition to more intensive support. Learn more at https://missionconnectionhealthcare.com/mental-health/treatment-plans/when-outpatient-isnt-enough/ Mission Connection City: San Juan Capistrano Address: 30310 Rancho Viejo Rd. Website: https://missionconnectionhealthcare.com/

Kick off 2026 with the January episode of RAPM Focus, where RAPM Social Media Editor Alopi Patel, MD, converses with Josh Gleicher, MD, MSc, FRCPC, and Hermann dos Santos Fernandes, MD, PhD, following the September 2025 publication of their original research paper, “Outpatient continuous adductor canal block (CACB) for total knee arthroplasty: a double-blinded randomized placebo-controlled trial.” Dr. Gleicher is a staff anesthesiologist and regional anesthesia expert at Mount Sinai Hospital in Toronto, Canada. He completed his anesthesiology training and fellowship in regional anesthesia at the University of Toronto and holds a master's degree in quality improvement and patient safety. Dr. Gleicher has extensive experience leading clinical trials in acute postoperative pain, with multiple funded studies and recognized expertise in anesthesia research. He is also a co-developer of the ISAFE technique for adductor canal catheter placement. In his spare time, he enjoys skiing and spending time with his wife and three kids. Dr. dos Santos Fernandes is a specialist in anesthesiology and pain management, trained at University of São Paulo, where he also achieved his PhD and completed a post-doctorate program. He has fellowship training in regional anesthesia and medical education at Mount Sinai Hospital, University of Toronto, and holds multiple certifications, including the superior title in anesthesiology and European diploma in anesthesiology and intensive care. Currently, he is an assistant professor at the University of Toronto and a staff anesthesiologist at Mount Sinai Hospital, with research and clinical focus on regional anesthesia. A retired basketball player and aspiring tennis player, he likes to travel with the family in his free time. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

A legislative committee is reviewing the state's procedures when it comes to treating people with mental health problems after two high-profile killings in North Carolina. WRAL State Government reporter Paul Spetch shares why both cases highlight the gaps in mental health care and public safety procedures, as both the justice system and mental health care system are under strain. 

 Season 6 episode 18 rebecca  j...and therapy - 1_8_26, 10.27 AMThu, Jan 08, 2026 10:40AM • 57:28SUMMARY KEYWORDSemotional metabolization, existential threat, destabilizing changes, social media, information overload, Venezuela crisis, racial identity, colonization, anti-blackness, white privilege, immigration policies, historical context, white supremacy, interdependence, narrative controlSPEAKERSSpeaker 3, Speaker 1, Speaker 2 Jenny  00:30I think something I'm sitting with is the impossibility and the necessity of trying to metabolize what's going on in our bodies. Yeah, and it feels like this double bind where I feel like we need to do it. We need to feel rage and grief and fear and everything else that we feel, and I don't think our nervous systems have evolved to deal with this level of overwhelm and existential threat that we're experiencing, but I do believe our bodies, Yeah, need space to try to do that, yeah,yesterday, I was sitting at, I don't know what's gonna happen to people anyway, Rebecca  01:45Pretty good. I'm okay. It like everyone. I think there's just a lot of crazy like and a lot of shifting to like, things that we could normally depend on as consistent and constant are not constant anymore. And that is like, it's very, 02:11I don't even have a word I want to say, disconcerting, but that's too light. There's, it's very destabilizing to to watch things that were constants and norms just be ripped out from underneath. People on like, every day there's something new that used to be illegal and now it's legal, or vice versa. Every day there's like, this new thing, and then you're having to think, like, how is that going to impact me? Is it going to impact me? How is it going to impact the people that I care about and love? Yeah, Danielle  02:52Jenny and I were just saying, like, maybe we could talk about just what's going on in the world right now, in this moment. And Jenny, I forgot how you were saying it like you were saying that we need to give our bodies space, but we also need to find a way to metabolize it so we can take action. I'm paraphrasing, but yeah, Rebecca  03:30And I would agree, and something else that I was thinking about too is like, what do you metabolize? And how do you metabolize it? Right? Like, in terms of what's happening in Venezuela, I have people that I count very dear to me who feel like it was a very appropriate action, and and people who are very dear to me who feel like absolutely not. That's ridiculous, right? And so, and I'm aware on that particular conversation, I'm not Venezuelan. I'm not I'm very aware that I stand on the outside of that community and I'm looking in on it, going, what do I need to know in order to metabolize this? What do I not know or not understand about the people who are directly impacted by this. And so I, like, I have questions even you know about some of the stuff that I'm watching. Like, what do you metabolize and how do you come to understand it? And in a place where it's very difficult to trust your information sources and know if the source that you're you're have is reliable or accurate or or complete in it, in its detail, it feels those are reasons why, to me, it feels really hard to metabolize things i. Jenny  05:06There's this like rule or like theory thing. I wish I could remember the name of it, but it's essentially like this, this graph that falls off, and it's like, the less you know about something, the more you think you know about it, and the more confident you are. And the more you know, the less confident you are. And it just explains so well our social media moment, and people that read like one headline and then put all these reels together and things talking about it. And on one hand, I'm grateful that we live in an age where we can get information about what's going on. And at the other end, like, you know, I know there, there's somewhere, some professor that's spent 15 years researching this and being like it is. There's so much here that people don't know and understand. And yeah, it feels like the sense of urgency is on purpose. Like that we just have to like it feels like people almost need to stay up to date with everything. But then I also wonder how much of that is whiteness and this idea of like, saviorism and like, if I'm just informed, then I'm doing my duty and like what I need to do and and what does it look like to slow down and be with things that are right in front of US and immediate, without ignoring these larger, transnational and global issues. Yeah, it feels so complicated. Rebecca  06:55I do think the sense of urgency is on purpose. I think that the overwhelming flood of information at this time is not just a function of like social media, but I think, I think the release of things and the timing of things is intentional, I think, and so I think there's a lot of Let's throw this one thing in front of you, and while you everybody's paying attention to that, let's do 10 other things behind closed doors that are equally, if not more, dangerous and harmful than the thing that we're letting You see up front. And so I think some of that is intentional. So I think that that sense of almost flooding is both about social media, yes, but it's also about, I think some of this is intentional, on purpose, flooding Jenny  08:01I think it's wise to ask those questions and try to sort of be paying attention to both what is being said and what is not being said. Rebecca  08:16Yeah, it may makes me think, even as you named Venezuela like my understanding is that that happened either the day of or the day before Congress was supposed to explain why they had redacted the Epstein files, and it just the lengths that they will go to to distract from actually releasing the files and showing the truth about Trump and Epstein and everyone else that was involved is, Speaker 2  08:52well, yeah, yeah, yes. And there's something in me that also wants to say, like it what happened around Venezuela might be 09:32and its natural resources is not a small thing. And then I was reminded today by someone else, this is also not the first time this country has done that. It might be the first time it was televised to the world, but so I don't Yes on the distraction. And I agree with you times 1000 10:09hard about this moment, is that there's all this stuff that's happening that's like absolutely we would be looking at, how do you possibly put any of that in any sense of order that it makes any sense? Because, yes, the FC, I mean, it's horrific. What we're talking about is likely in those files, and if they are that intent on them not coming out, if it's worse than what we already know, that's actually scary. Danielle  10:44Yeah, I agree that this isn't new, because this is it feels like, you know, Ibram X kendi was like, talking about, hey, like, this is what I'm talking about. This is what I'm talking about. And it feels as though, when we talk, I'm just going to back up, there's been this fight over what history are we teaching, you know, like, this is dei history, or this is, you know, critical race history. But in the end, I think we actually agree on the history more than we think. We just don't disagree on where we should take it. Now, what I think is happening is that, and you hear Donald J Trump talk about the Monroe Doctrine, or Vance talk about Manifest Destiny, or Stephen Miller, these guys talk about these historical things. They're talking about the history of colonization, but from a lens of like, this was good, this was not a mistake. Quote, slavery was not necessarily a bad thing. You have like Doug Wilson and these other Christian nationalists like unapologetically saying there was slavery. It's been throughout all time. This was, quote, a benefit people, you know, you have Charlie Kirk saying, you know, in the 1940s like pre civil rights movement, quote, I think he said, quote, black people were happier. He has said these things. So in my, in my mind, yes, they, they're they're saying, like, we don't want X taught in schools. But at the same time, they actually, we actually kind of agree on history. What we don't agree on is what we should do with it, or or who's in com, who's in control. Now, I think what they're saying is, this was history. We liked it, and we don't like the change in it, and we're just gonna keep doing it. I mean, they literally have reinstated the Monroe Doctrine, which is so racist, it's like, and manifest destiny is like, so fucked up to, like, put that back in place, like Rebecca said, I'm not, I'm not negating the murder that just happened in Minneapolis, but this concept that you you can tell who's human and that these resources belong to us, the only person human in the room, then, is the White man. I don't know. Does that make sense? It Rebecca  13:24makes me think of you know, when you talk about sort of identity formation, or racial identity formation, when you are talking about members of the majority culture and their story is, is this manifest destiny? Is this colonization and and the havoc and the harm that that they engaged in against whole people groups in order to gain the power? Do they, sort of, on a human level, metabolize the their membership in that group, and what that group has done the heart the and that it's come by its power by harming other people, right? And so in order to sort of metabolize that you can minimize it and dismiss it as not harmful. So that's the story, that slavery is not a bad thing, and that black people are happier under slavery, right? You can deny it and say that it didn't happen, or if it did, it wasn't me. That's Holocaust deniers, right? That didn't happen. I think what we're looking at now is the choice that some of the powers that be are making in order to metabolize this is to just call what is evil good, to just rewrite. Not the facts, but the meaning that that we draw from those facts. And then to declare, I have the right to do this, and when I do this, it makes me more powerful, it makes me a better leader, and it establishes rules and norms about right versus wrong. I think they're rewriting the meaning making as a way to kind of come to terms with what what they've done. And so I think that statement by the Vice President about you no longer have to apologize for being white in this country is actually about more than an apology. That was that is now, a couple of weeks later, after watching what happened in Venezuela, watching what happened in Minneapolis, watching what they're doing about Greenland, you go like, that's just a statement that we're going to do whatever the heck we want, and you cannot stop us, and we will do it without apology, and we will make you believe. We will craft a narrative that what is wrong is actually right, Jenny  16:43it just, it's, it's wild to me that our last time, or two times ago that we were talking, I was talking about Viola liozo, who was the white woman who drove black people during the bus boycott and was murdered, and the what feels like is being exposed is the precarity of white privilege, like it is Real. It exists, and so long as white people stay within the bounds of what is expected of them, and Renee good did not and I think that that is it Rebecca  17:36exposes what's already true, that I think racism and race are constructs to protect the system, and so if, no matter what your melanin is, if you start to move against the system, you immediately are at risk in a different way, and yet still not in the same way. You know, like there are already plenty of people who have died and been disappeared at the hands of ice. What happened is not new. What is new is that it did happen to a white woman, and it reveals something about where we are in the fulcrum, tip, I think, of of power and what's happening? 18:30because I think the same, like you said, is true during the Civil Rights Movement, right that in there, they're really they're most of their stories we don't know. There's a handful of them that we know about these, these white the people who believe themselves to be white, to quote on history codes, who were allies and who acted on behalf of the Civil Rights Movement and who lost their life because of it. There's probably way more than we know, because, again, those are stories that are not allowed to be told. But it makes me wonder if, if the exposure that you're talking about Jenny is because we were at some sort of tipping point right, in a certain sense, by the time you elect Obama in oh eight, you could make the argument that something of racial equality is beginning to be institutionalized in the country, right? I'm not saying that he solved everything and he was this panacea, but I'm saying when the system, when the people in the system, find a way to bring equilibrium. That's the beginning of something being institutionalized, right? And, and, and did that set off this sort of mass panic in the majority culture to say that that cannot happen? Mm. Yeah, and and, so there is this backlash to make sure that it doesn't happen, right? And to the extent that it's beginning to be institutionalized, that means that some members of the majority culture have begun to agree with the institutionalism of some kind of equilibrium, some type of equity, otherwise you wouldn't see it start to seep into the system itself, right? And it means that there are people who open doors, there are people who left Windows cracked open there, you know, there are, right? I mean, somebody somewhere that had the key to the door, left it unlocked, so, so that, so that a marginalized community could find an entrance, right? And and so it does make me think about, are we? Are we looking at this sort of historical tipping point? And what's being exposed is all these people are the majority culture who are on the wrong side of this argument. We need you to get back in line. I mean, if you read ta nehisi Coates book, eight years in power, he makes a sort of similar argument that that's what happened around reconstruction, right? You have the Emancipation Proclamation being signed, slavery is now illegal in the United States, and there's this period during reconstruction where there's mass sort of accomplishment that happens in the newly freed slave community. And then you see the rise of the Ku Klux Klan and the very violent backlash. This is not going to happen. We're not. We're not. And when, when I say what happened during Reconstruction, is like again, the beginning of the institutionalizing of that kind of equilibrium and equity that came out of the Emancipation Proclamation. Right? My kids were part of a genealogy project a few years back, and one of the things that they uncovered is they have a ancestor who was elected to this 22:27and while he was in office, he was instrumental in some of the initial funding that went to Hampton to establish Hampton University, right? And so that's the kind of institutionalized equity that starts to happen in this moment, and then this massive violent backlash, the rise of the Ku Klux, Klan, the black codes. We this is not going to happen. We're not doing this right. And so it does make me wonder if what we're actually looking at the exposure that you're talking about, Jenny is like the beginning of the this sort of equilibrium that could happen when you when things start to get institutionalized and and the powers that be going No way, no How, no dice, not doing that. Danielle  23:21I think that's true, and especially among immigrant communities. I don't know if you know, at the beginning, they were saying, like, we're just going after the violent criminals, right? And this morning, I watched on a news source I really trust, a video of a Somali citizen, a US citizen, but as a Somali background, man pulled over by ice like he's an Uber driver in Minneapolis. And they like, surrounded him, and he's like, wait a minute, I thought you were going after the violent criminals. And they're like, Well, you know, like, Are you a US citizen? He's like, Well, where's your warrant? And they're like, we're checking your license plate. He's like, well, then you know who I am. And then they want him to answer, and they keep provoking and they're like, Oh, you have a video on us. And he's like, Oh, you have a GoPro. He's like, I thought you were just going after violent criminals, you know? And they're like, no, we want to know if you're a US citizen. So in a sense, you know, there was all this rhetoric at the beginning that said, we you have to do it the right way. And I remember at the very beginning feeling afraid for Luis like, oh, man, shit, we did this the right way. I don't know if that's really guarantee. I don't think that's a guarantee of any guarantee of anything. And it's not doing well paying all the bills like it's expensive to become a citizen. It is not easy. Paying all the bills, going to the fingerprints, get in the test, hiring a lawyer, making sure you did it. Like cross, all your T's dot, all your eyes, just to get there and do it. And then they're saying, you know, and then they're saying, Well, prove it. Well, what do you have on your record? Or people showing up after having done all that work? They're showing up to their swearing in to be US citizens. And they're saying, Sorry, nope. And they're like, taken by ice. So you can see what you're saying. Rebecca first, it says violent criminals. Yeah, and you know, you have to have like, an FBI fingerprint background check. You had to do this, like, 10 years ago. Whenever Luis became a citizen, that's like, serious shit, you get your background check. So by the time you're into that swearing in, they know who you are, like you're on record, they know who you are, so they've done all that work. So this is not about being a criminal. This is about there's somebody successful that's possibly not white, that has done all the right things, paid all the fees, has the paperwork, and you don't like them because they're not white. And I think that's directly related to anti blackness. Rebecca  25:40Yeah. Say more about the anti blackness, because we started this conversation talking about Somalis and and Somalis are only the latest target of ice, right? It started with people of Latino descent. So how does that for you come down to anti blackness? Oh, for me, Danielle  26:02I see it as a as a projection. I can't tolerate my feelings about, quote, people of color, but let's be more specific about black people, and I can't tolerate those feelings. And for a time, I think we were in this sliver of time where it was not quite it was still like gaining social momentum to target black folks, but it was still a little bit off limits, like we were still like, oh, it's the criminals. Oh, it's these bad, bad guys. I know it's just the Latinos or, Oh, it's just this, this and this and this. But then if you notice, you start watching these videos, you start noticing they're like, they're grabbing, like, Afro Latinos. They're like, they're like, pushing into that limit, right? Or Puerto Rican folks they've grabbed, who are US citizens? So now you see the hate very clearly moving towards black folks. Like, how does an untrained $50,000 bonus ice agent know if, quote, a black person, quote, you know, if we're talking in the racial construct, has a Somali background or not, right? Right? It actually feels a little bit to me like grooming, right? Rebecca  27:24I I've asked myself this question several times in the past couple of years, like, and if, and I think some of the stuff that I've read like about the Holocaust, similar question, right? Was like, is racism really the thing that is that is driving this or is it something else, like at the at the heart of it, at the end of the day, are you really driven by racialized hate of someone that is different than you? Or is that just the smoke screen that the architects of this moment are using because you'll fall for it, right? And so I do think like you start with the criminals, because that's socially acceptable, and then you move very quickly from the criminals to everybody in that ethnic group, right? And so you see the supreme court now saying that you can stop and frisk somebody on the basis of a surname 28:22or an accent, Rebecca  28:26right? And it feels very much like grooming, because what was socially acceptable was first this very small subset, and now we've expanded to a whole people group, and now we've jumped from one country to another, which is why I think you know MLK is quote about injustice anywhere is a threat to justice everywhere. If you're going to come for one subset, you will eventually come for everyone, until the only subset is those in power versus those that aren't. Danielle  29:05Or just, let me just ask you this question then, so you got he's enforcing immigration bans on certain countries. Guess who the where the majority of those countries are located, Africa. Now, why didn't he do that with Latin the Latin America? It's very interesting, Rebecca  29:29and my fear is that it's coming right again. It's socially acceptable in this country to be anti black. Everyone understands that, and then you move from anti black to anti everybody else. And what you say is this, this people group is closer to black than white, and for that reason, they're out too, which is also not a new argument in this country. Jenny  29:58It makes me think of someone you. To this illustration, then I will not get it probably exactly how it is, but it was basically like if I have a room of 10 people, and I need to control those 10 people, I don't need to control those 10 people. I need to make a scapegoat out of three of them, and then the other seven will be afraid to be that scapegoat. And I feel like that is a part of what's going on, where, viscerally, I think that, again, like white bodies know, like it is about race and it's not about race, like race is the justification of hatred and tyrannical control. And I really love the book by Walter Rodney, how Europe underdeveloped Africa. And he traces like what Europe, and I would include the US now has done to the continent of what is so called Africa, and it didn't in the end, that it was used to create race and racism in order to justify exploitation and of people and resources. And so it's like, yeah, I think at the end of the day, it's really not about race, and it is because of the way in which that's been used to marginalize and separate even from the construction of whiteness, was to try to keep lower socioeconomic whites from joining with formerly enslaved black people and indigenous people to revolt against the very few people that actually hold power, like there are way more people that lack power. But if, if those in power can keep everyone siloed and divided and afraid, then they get to stay in power. Danielle  32:01That's where I come back to history. And I feel like, I feel like these guys like JD Vance and Stephen Miller love our history and hate the parts of it that are leading towards liberation. For people, they love that they love the colonization. They talk about it. They've there's a fantasy. They're living in, this fantasy of what could be, of what was for one set of people, and that was white men. And they're enacting their fantasy on us in some ways, you know, I think the question of, you know, Jenny, you always deal with bodies, and, you know, you're kind of known for that shit, I think, I think, just like, but the question of, like, who has a body when, when? Like, when does the body count? You know, like, when does it matter? And it feels like that's where race becomes really useful, 33:09because it gets to say, like, you know, like, that white lady, that's not really, that's not really a murder, you know. Or, you know, George Floyd, like, Nah, that's not really it, you know, just com, and they knew there's so many other lynchings and murders. Like, we can't cover them all. I just think it's just speaks to, like, who, you know, another way to say it'd be like, who's human and who's not. Jenny  33:42And like I sent you. Danielle, there was a post yesterday that someone said, those white lives matter. People seem to be really silent right now. And it just exposes, like the the hypocrisy, even in that and the, I think, the end of not the end, because racial privilege is still there, but, but this moment is exposing something, I think, as you're naming Rebecca, like it feels like this really scary tipping, and maybe hopeful tipping, where it's like there's enough, maybe fear or grasping of power, that there's enough desperation to execute a white woman, which historically and now, I think it says something about where we are in this moment. And I don't know exactly what yet, but I think it's, it's very exposing. Rebecca  34:43Yeah, but my what floats across my mind when you say that is really what has been the narrative or trajectory for white women? Because I think if you start to pull on stories like Emmett Till. 35:01Soul, and you realize what has been done in the name of protecting white women that doesn't actually feel like protection, right, right? And so, so again, you almost have this sense of like white femininity being this pawn, right? And you and you can have this narrative that that sounds like it's protection, sounds like it's value, but really it's not right. I only pull that out and use it when it when it gives me permission to do what I really want to do, right? 35:43And so in this moment. Now, you know, I mean, Emmett Till died because he was accused of looking inappropriately at a white woman, right? More recently, that incident with the the bird watcher in Central Park, right? I mean, his freedom is is under threat because of a white woman and, and then how do we go from that to ice killing a white woman and, and what like you said? What does that actually say about the value of white women, Was it, was it ever really recognized by the powers that be, right? Or is that like a straw man that I put up so I can have permission to do whatever I want? Jenny  36:36Absolutely, yeah, I think the trope of protecting white womanhood. It's it's always given women privilege and power, but that is only in proximity to white men and performing white womanhood. And you know, as you were talking about, the rise of lynchings, it did begin after reconstruction, and it really coincided with the first movie ever shown in theaters, which was Birth of a Nation they showed, yeah, white men in blackface, sexually assaulting a white woman, and the absolute frenzy and justification that that evoked was, we're protecting our white women, which was really always about protecting racial and class privilege, not the sovereignty of the bodies of white women, Rebecca  37:33right, right? And so we're back to your original thought, that what now is exposed, you know, with what happened in Minnesota is it's not really about protecting her and she's expendable. She is, quote, a domestic terrorist 37:56now so that we can justify what we're doing, Jenny  38:15which I think subconsciously at least white bodies have always known like there is something of I am safe and I am protected and I am privileged, so long as I keep performing whiteness. Rebecca  38:39I mean, the thing that scares me about that moment is that now we've gone Danielle from the criminals to the brown skinned citizens to white women who can be reclassified and recast as Domestic Terrorists if you don't toe the line, right? They're coming for everybody, because, because now we have a new category of people that ice has permission to go after, right? And again, it reminds me, if you look back at the black codes, which, again, got established during that same time period as you're talking about Birth of a Nation, Jenny, it became illegal for black people to do a whole host of things, to congregate, to read all kinds of things, right to vote, and in some states, it became illegal for white people to assist them in accomplishing any of those tasks. I Yeah, Danielle  39:53I mean, it's just the obliteration of humanity like the. Literal like, let me any humanity that can you can connect with your neighbor on let me take that away. Let me make it illegal for you to have that human share point with your neighbor. I really, that really struck me. I think it was talking about the the Minnesota mayor saying they're trying to get you to see your neighbor as like, less than human. He's like, don't fall for it. Don't fall for it. And I agree, like, we can't fall for it. I'm mean, it's like that. I Jenny  40:45don't know if you know that famous quote from Nazi Germany that was, like, they came for the Jews. And I didn't say anything because I wasn't a Jew. They, you know? And we've seen this, and we've all grown up with this, and the fact that so many people collectively have been like, well, you know, I'm not a criminal, well, I'm not an immigrant, well, I'm not, and it's like it this beast is coming for everybody, Rebecca  41:13yeah, well, and I, you know, I think That as long as we have this notion of individualism that I only have to look out for me and mine, and it doesn't matter what happens to anyone else. That is allowed the dynamic that you're talking about Jenny is allowed to flourish and until we come to some sense of interdependence until we come to some sense of the value of the person sitting next to me, and until we come to some sense of, if it isn't well with them, it cannot possibly be well with me. That sort of sense of, Well, I'm not a criminal, I'm not a Jew, so I don't have to worry about it is gonna flourish. 42:09Yesterday, I jumped42:12on Facebook for a second, and somebody that I would consider a dear friend had a lengthy Facebook post about how in favor he was of the President's actions in Venezuela, and most of his rationale was how this person, this dictator, was such a horrible person and did all of these horrible things. And my first reaction was, like, very visceral. I don't, I can't even finish this post like, I just, I mean, this is very visceral, like, and, and I don't want to talk to you anymore, and I'm not sure that our 20 plus years of friendship is sufficient to overcome how, how viscerally I am against the viewpoint that you just articulated, and I find myself, you know, a day later, beginning to wonder, Where is there some value in his perspective as a Latino man, what, what is his experience like that, that he feels so strongly about the viewpoint that he feels? And I'm not saying that he's right. I'm saying that if we don't learn to pause for a second and try to sit in the shoes of the other person before dismissing their value as a human. We will forever be stuck in the loop that we're in, right? I don't you know, I don't know that I will change my opinion about how much as an American, I have problems with the US president, snatching another leader and stealing the resources of their country. But I'm trying to find the capacity to hear from a man of Latino descent the harm that has been done to the people of Venezuela under this dictator, right? And I have to make myself push past that visceral reaction and try to hear something of what he's saying. And I would hope that he would do the same. I. Danielle  45:06I don't have words for it. You know, it just feels so deep, like it feels like somewhere deep inside the dissonance and also the want to understand, I think we're all being called, you know, Rebecca, this moment is, you know, this government, this moment, the violence, it's, it's, it's extracting our ability to stay with people like and it's such a high cost to stay with people. And I get that, I'm not saying it isn't, but I think what you're talking about is really important. Rebecca  45:57like you said, Jenny earlier, when you were talking about like, the more you know about something, the less confident you are, right? It's like, I can name, I am not Venezuelan, right? I can name I don't even think I know anybody who's from Venezuela, and if I do, I haven't taken the time to learn that you're actually from Venezuela, right, right? And I don't know anything about the history or culture of that country or the dictator that that was taken out of power. But I have seen, I can see in my friend's Facebook post that that's, it's a very painful history that he feels very strongly about. I so mostly that makes me as a black American, pause on how, on how much I want To dismiss his perspective because it's different than mine. Jenny  47:22I yeah, it also makes me think of how we're so conditioned to think in binaries and like, can there be space to hold the impossible both and where it's like, who am I to say whether or not people feel and are liberated or not in another country? I guess time will tell to see what happens. But for those that are Venezuelan and that are celebrating the removal of Maduro like can that coexist with the dangerous precedent of kidnapping a leader of a foreign country and starting immediately to steal their resources and and how do we Do this impossible dance of holding how complex these these experiences are that we're trying to navigate Rebecca  48:29and to self declare on national TV that like you're the self appointed leader of the country until, until whenever right some arbitrary line that you have drawn that you will undoubtedly change six times. I mean the danger of that precedent. It is I don't have vocabulary for how problematic that is. Danielle  48:57I don't mean to laugh, but if you didn't believe in white supremacy before, I would be giving you a lesson, and this is how it works, and it's awesome. Jenny  49:10And like you're saying, Rebecca, like I love books are coming to me today. There's another one called How to hide an empire and it Chase. It tracks from western expansion in what is now known as the United States to imperialism in the Philippines, in Puerto Rico, like in all of these places where we have established Dominion as a nation, as an empire, and what feels new is how televised and public this is, that people are being forced to confront it, hopefully in a different way, and maybe there can be more of this collective like way to psych it. This isn't what I'm supporting, because. I think for so long, this two party system that we've been force fed has a lot of difference when it comes to internal politics in the United States, but when it comes to transnational and international politics, it's been pretty much very similar for Democrats and Republicans in terms of what our nation is willing to do to other nations that we are conditioned not to think about. And so I think there's a hope. There's a desire for a hope for me to be like, Okay, can we see these other nations as humans and what the US has always done since the beginning. Rebecca  50:45you know, there's what actually happened, and then there's the history book story that we tell about what happened, right? And it like, it like what Danielle said. It appears to me that white supremacy is just blatantly at play, right? Like they're not hiding it at all. They're literally telling you, I can walk I can walk into another country, kidnap its leader and steal its resources. And I will tell you, that's what I'm doing. I will show you video footage of me intercepting oil tankers. I right like, and I will televise the time, place and location of my meeting with all the oil executives to get the oil um and and I'd like to be able to say that that is a new moment in history, and that what feels different is that we've never been so blatant about it, but I'm not sure that's true, right? I would love to have a time machine and be able to go back in some other point in time in American history and find out what they printed on the front page of the newspaper while they were stealing Africans from Africa or all the other while they were committing genocide against all the Native American tribes and all the other places and countries and people groups that the United States has basically taken their people and their resources. And so I don't know if this is different. I don't because, because the history books that I read would suggest that it is that right, but I don't. You can't always trust the narrative that we've been taught. Right? When I think there's an African proverb but as long as history is told by the lion, it will always favor the lion. Jenny  52:55I love you. Really good to be with you. Love you. Bye. Bye. See You Bio: Jenny - Co-Host Podcast (er):I am Jenny! (She/Her) MACP, LMHCI am a Licensed Mental Health Counselor, Somatic Experiencing® Practitioner, Certified Yoga Teacher, and an Approved Supervisor in the state of Washington.I have spent over a decade researching the ways in which the body can heal from trauma through movement and connection. I have come to see that our bodies know what they need. By approaching our body with curiosity we can begin to listen to the innate wisdom our body has to teach us. And that is where the magic happens!I was raised within fundamentalist Christianity. I have been, and am still on my own journey of healing from religious trauma and religious sexual shame (as well as consistently engaging my entanglement with white saviorism). I am a white, straight, able-bodied, cis woman. I recognize the power and privilege this affords me socially, and I am committed to understanding my bias' and privilege in the work that I do. I am LGBTQIA+ affirming and actively engage critical race theory and consultation to see a better way forward that honors all bodies of various sizes, races, ability, religion, gender, and sexuality.I am immensely grateful for the teachers, healers, therapists, and friends (and of course my husband and dog!) for the healing I have been offered. I strive to pay it forward with my clients and students. Few things make me happier than seeing people live freely in their bodies from the inside out!Rebecca A. Wheeler Walston, J.D., Master of Arts in CounselingEmail: asolidfoundationcoaching@gmail.comPhone:  +1.5104686137Website: Rebuildingmyfoundation.comI have been doing story work for nearly a decade. I earned a Master of Arts in Counseling from Reformed Theological Seminary and trained in story work at The Allender Center at The Seattle School of Theology and Psychology. I have served as a story facilitator and trainer at both The Allender Center and the Art of Living Counseling Center. I currently see clients for one-on-one story coaching and work as a speaker and facilitator with Hope & Anchor, an initiative of The Impact Movement, Inc., bringing the power of story work to college students.By all accounts, I should not be the person that I am today. I should not have survived the difficulties and the struggles that I have faced. At best, I should be beaten down by life‘s struggles, perhaps bitter. I should have given in and given up long ago. But I was invited to do the good work of (re)building a solid foundation. More than once in my life, I have witnessed God send someone my way at just the right moment to help me understand my own story, and to find the strength to step away from the seemingly inevitable ending of living life in defeat. More than once I have been invited and challenged to find the resilience that lies within me to overcome the difficult moment. To trust in the goodness and the power of a kind gesture. What follows is a snapshot of a pivotal invitation to trust the kindness of another in my own story. May it invite you to receive to the pivotal invitation of kindness in your own story. Listen with me…Kitsap County & Washington State Crisis and Mental Health ResourcesIf you or someone else is in immediate danger, please call 911.This resource list provides crisis and mental health contacts for Kitsap County and across Washington State.Kitsap County / Local ResourcesResourceContact InfoWhat They OfferSalish Regional Crisis Line / Kitsap Mental Health 24/7 Crisis Call LinePhone: 1‑888‑910‑0416Website: https://www.kitsapmentalhealth.org/crisis-24-7-services/24/7 emotional support for suicide or mental health crises; mobile crisis outreach; connection to services.KMHS Youth Mobile Crisis Outreach TeamEmergencies via Salish Crisis Line: 1‑888‑910‑0416Website: https://sync.salishbehavioralhealth.org/youth-mobile-crisis-outreach-team/Crisis outreach for minors and youth experiencing behavioral health emergencies.Kitsap Mental Health Services (KMHS)Main: 360‑373‑5031; Toll‑free: 888‑816‑0488; TDD: 360‑478‑2715Website: https://www.kitsapmentalhealth.org/crisis-24-7-services/Outpatient, inpatient, crisis triage, substance use treatment, stabilization, behavioral health services.Kitsap County Suicide Prevention / “Need Help Now”Call the Salish Regional Crisis Line at 1‑888‑910‑0416Website: https://www.kitsap.gov/hs/Pages/Suicide-Prevention-Website.aspx24/7/365 emotional support; connects people to resources; suicide prevention assistance.Crisis Clinic of the PeninsulasPhone: 360‑479‑3033 or 1‑800‑843‑4793Website: https://www.bainbridgewa.gov/607/Mental-Health-ResourcesLocal crisis intervention services, referrals, and emotional support.NAMI Kitsap CountyWebsite: https://namikitsap.org/Peer support groups, education, and resources for individuals and families affected by mental illness.Statewide & National Crisis ResourcesResourceContact InfoWhat They Offer988 Suicide & Crisis Lifeline (WA‑988)Call or text 988; Website: https://wa988.org/Free, 24/7 support for suicidal thoughts, emotional distress, relationship problems, and substance concerns.Washington Recovery Help Line1‑866‑789‑1511Website: https://doh.wa.gov/you-and-your-family/injury-and-violence-prevention/suicide-prevention/hotline-text-and-chat-resourcesHelp for mental health, substance use, and problem gambling; 24/7 statewide support.WA Warm Line877‑500‑9276Website: https://www.crisisconnections.org/wa-warm-line/Peer-support line for emotional or mental health distress; support outside of crisis moments.Native & Strong Crisis LifelineDial 988 then press 4Website: https://doh.wa.gov/you-and-your-family/injury-and-violence-prevention/suicide-prevention/hotline-text-and-chat-resourcesCulturally relevant crisis counseling by Indigenous counselors.Additional Helpful Tools & Tips• Behavioral Health Services Access: Request assessments and access to outpatient, residential, or inpatient care through the Salish Behavioral Health Organization. Website: https://www.kitsap.gov/hs/Pages/SBHO-Get-Behaviroal-Health-Services.aspx• Deaf / Hard of Hearing: Use your preferred relay service (for example dial 711 then the appropriate number) to access crisis services.• Warning Signs & Risk Factors: If someone is talking about harming themselves, giving away possessions, expressing hopelessness, or showing extreme behavior changes, contact crisis resources immediately.Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that.Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that.Rebecca A. Wheeler Walston, J.D., Master of Arts in CounselingEmail: asolidfoundationcoaching@gmail.comPhone:  +1.5104686137Website: Rebuildingmyfoundation.comI have been doing story work for nearly a decade. I earned a Master of Arts in Counseling from Reformed Theological Seminary and trained in story work at The Allender Center at The Seattle School of Theology and Psychology. I have served as a story facilitator and trainer at both The Allender Center and the Art of Living Counseling Center. I currently see clients for one-on-one story coaching and work as a speaker and facilitator with Hope & Anchor, an initiative of The Impact Movement, Inc., bringing the power of story work to college students.By all accounts, I should not be the person that I am today. I should not have survived the difficulties and the struggles that I have faced. At best, I should be beaten down by life‘s struggles, perhaps bitter. I should have given in and given up long ago. But I was invited to do the good work of (re)building a solid foundation. More than once in my life, I have witnessed God send someone my way at just the right moment to help me understand my own story, and to find the strength to step away from the seemingly inevitable ending of living life in defeat. More than once I have been invited and challenged to find the resilience that lies within me to overcome the difficult moment. To trust in the goodness and the power of a kind gesture. What follows is a snapshot of a pivotal invitation to trust the kindness of another in my own story. May it invite you to receive to the pivotal invitation of kindness in your own story. Listen with me… Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that. Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that.

Ambar La Forgia is an assistant professor in the Management of Organizations group at the University of California, Berkeley Haas School of Business. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. A. La Forgia. From Patients to Consumers — The Corporatization of Ambulatory Care. N Engl J Med 2026;394:1-3.

CardioNerds (Dr. Colin Blumenthal, Dr. Kelly Arps, and Dr. Natalie Marrero) discuss anti-arrhythmic drugs in the management of atrial fibrillation and atrial flutter with electrophysiologist Dr. Andrew Epstein. We discuss two major classes of anti-arrhythmic drugs, class IC and class III, as well as digoxin. Dr. Epstein explains their mechanisms of action, indications and specific patient populations in which they would be particularly helpful, efficacy, adverse side effects, contraindications, and key drug-drug interactions. We also elaborate on defining clinical trials and their clinical implications. Given the large burden of atrial fibrillation and atrial flutter in our patient population and the high prevalence of anti-arrhythmic drug use, this episode is sure to be applicable to many practicing physicians and trainees. Audio editing by CardioNerds academy intern, Grace Qiu.  Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Atrial Fibrillation PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Anti-arrhythmic drugs should not be thought of as an alternative to ablation but, instead, should be considered an adjunct to catheter ablation.   Class IC anti-arrhythmic drugs, flecainide and propafenone, are highly efficacious for acute cardioversion and a great option for patients with infrequent episodes of AF who do not have a history of ischemic heart disease.    Class III anti-arrhythmic drugs like ibutilide, sotalol, and dofetilide, are highly effective for acute conversion; however, they require hospitalization for close monitoring during initiation and dose titration given the risk of prolonged QT.   Amiodarone should not be used as a first line agent given its toxicities, prolonged half-life, large volume of distribution, and drug-drug interactions.   Dr. Epstein notes that, “All drugs are poisons with a few beneficial side effects,” when highlighting the many adverse side effects of anti-arrhythmic drugs, particularly amiodarone, and the importance of balancing their benefit in rhythm control with their side effect profile.   Notes Notes: Notes drafted by Dr. Natalie Marrero. What are the Class IC anti-arrhythmic drugs and what indications exist for their use?   Class IC anti-arrhythmic drugs are anti-arrhythmic drugs that work by blocking sodium channels and, thereby, prolonging depolarizing.   Class IC anti-arrhythmic drugs include flecainide and propafenone.   Class IC anti-arrhythmic drugs are good agents to use in patients that have infrequent episodes of AF and do not want daily dosing as these agents can be used by patients when they feel palpitations and desire acute conversion back to sinus rhythm (“pill in the pocket” approach).    What are the adverse consequences and/or contraindications to using a class IC agent?  Class IC anti-arrhythmic agents are contraindicated in patients with a history of ischemic heart disease based on increased mortality associated with their use in these patients in the CAST trial.   Given the results of the CAST trial, providers should screen annually for ischemia via a functional stress test in patients on these drugs at risk for coronary disease.   These drugs can increase 1:1 conduction of atrial flutter and, therefore, require concomitant use of a beta blocker.   These agents are generally well-tolerated without any organ toxicities; however, they can precipitate heart failure in patients with cardiomyopathies, cause sinus node depression, and unmask genetic arrythmias such as a Brugada pattern.   What are the class III agents and what are indications for their use?   Class III agents are drugs that block the potassium channel, prolonging the QT, and include Ibutilide, Sotalol, and Dofetilide.    Class III agents can be considered in patients with or without a history of ischemic heart disease that desire effective acute chemical cardioversion and are willing to go to the hospital for close monitoring during dose initiation and titration.   Other specific circumstances in which one can use these agents, specifically Ibutilide, are in patients with recurrent atrial fibrillation and Wolf Parkinson White (due to slowed conduction via the accessory pathway).  What are the adverse consequences and/or contraindications to using a class III agent?  Ibutilide, Sotalol, and Dofetilide prolong the QT and increase the risk of torsade de pointes, which is why they require ECG monitoring in-patient during drug initiation and dose titration.    These agents are generally well-tolerated.   Sotalol should be avoided or used cautiously in patients with left ventricular dysfunction, while dofetilide can be used and has dose-response beneficial effects in patients with left ventricular dysfunction.   Both sotalol and dofetilide are renally cleared with specific creatinine clearance cutoffs (CrCl < 20 for dofetilide and CrCl

In this episode, Mark Makhinson PharmD, Senior Director of Outpatient Pharmacy at Mount Sinai Health System, discusses how digital innovation, AI driven workflows, and a modern patient facing platform are reshaping specialty pharmacy, improving access, streamlining operations, and enhancing outcomes across the health system.

Let's wrap the year with a look back on the challenges, developments, and momentum that the physical therapy profession encountered in 2025. Alliance Physical Therapy Partners CEO Richard Leaver talks with Team Rehab CEO Nick Weber, in this final episode of the year.In this episode, you'll join the conversation about:Outpatient PT industry health and developmentsOptimization and technology adoptionOutlook and priorities for 2026To learn more about us, visit our website at https://www.allianceptp.com/

   “It's not enough to build a system and then exit stage left when you realize it's broken. The ‘I'm sorry' is not the work — it's only the acknowledgment that work needs to be done. After the apology, you must actually do the repair. And what I see from her is the language of accountability without the actions that would demonstrate it. That's insufficient for real change.” Danielle (01:03):Well, I mean, what's not going on? Just, I don't know. I think the government feels more and more extreme. So that's one thing I feel people are like, why is your practice so busy? I'm like, have you seen the government? It's traumatizing all my clients. Hey Jeremy. Hey Jenny.Jenny (01:33):I'm in Charlottesville, Virginia. So close to Rebecca. We're going to soon.Rebecca (01:48):Yeah, she is. Yeah, she is. And before you pull up in my driveway, I need you to doorbell dish everybody with the Trump flag and then you can come. I'm so readyThat's a good question. That's a good question. I think that, I don't know that I know anybody that's ready to just say out loud. I am not a Trump supporter anymore, but I do know there's a lot of dissonance with individual policies or practices that impact somebody specifically. There's a lot of conversation about either he doesn't know what he's doing or somebody in his cabinet is incompetent in their job and their incompetency is making other people's lives harder and more difficult. Yeah, I think there's a lot of that.(03:08):Would she had my attention for about two minutes in the space where she was saying, okay, I need to rethink some of this. But then as soon as she says she was quitting Congress, I have a problem with that because you are part of the reason why we have the infrastructure that we have. You help build it and it isn't enough to me for you to build it and then say there's something wrong with it and then exit the building. You're not equally responsible for dismantling what you helped to put in place. So after that I was like, yeah, I don't know that there's any authenticity to your current set of objections,I'm not a fan of particularly when you are a person that in your public platform built something that is problematic and then you figure out that it's problematic and then you just leave. That's not sufficient for me, for you to just put on Twitter or Facebook. Oh yeah, sorry. That was a mistake. And then exit stage leftJenny (04:25):And I watched just a portion of an interview she was on recently and she was essentially called in to accountability and you are part of creating this. And she immediately lashed out at the interviewer and was like, you do this too. You're accusing me. And just went straight into defensive white lady mode and I'm just like, oh, you haven't actually learned anything from this. You're just trying to optically still look pure. That's what it seems like to me that she's wanting to do without actually admitting she has been. And she is complicit in the system that she was a really powerful force in building.Rebecca (05:12):Yeah, it reminds me of, remember that story, excuse me, a few years ago about that black guy that was birdwatching in Central Park and this white woman called the cops on him. And I watched a political analyst do some analysis of that whole engagement. And one of the things that he said, and I hate, I don't know the person name, whoever you are, if you said this and you hear this, I'm giving you credit for having said it, but one of the things that he was talking about is nobody wants you to actually give away your privilege. You actually couldn't if you tried. What I want you to do is learn how to leverage the privilege that you have for something that is good. And I think that example of that bird watching thing was like you could see, if you see the clip, you can see this woman, think about the fact that she has power in this moment and think about what she's going to do with that power.(06:20):And so she picks up her phone and calls the cops, and she's standing in front of this black guy lying, saying like, I'm in fear for my life. And as if they're doing anything except standing several feet apart, he is not yelling at you. He hasn't taken a step towards you, he doesn't have a weapon, any of that. And so you can see her figure out what her privilege looks like and feels like and sounds like in that moment. And you can see her use it to her own advantage. And so I've never forgotten that analysis of we're not trying to take that from you. We couldn't if we tried, we're not asking you to surrender it because you, if you tried, if you are in a place of privilege in a system, you can't actually give it up because you're not the person that granted it to yourself. The system gave it to you. We just want you to learn how to leverage it. So I would love to see Marjorie Taylor Greene actually leverage the platform that she has to do something good with it. And just exiting stays left is not helpful.Danielle (07:33):And to that point, even at that though, I've been struck by even she seems to have more, there's on the continuum of moral awareness, she seems to have inch her way in one direction, but I'm always flabbergasted by people close to me that can't even get there. They can't even move a millimeter. To me, it's wild.Well, I think about it. If I become aware of a certain part of my ignorance and I realize that in my ignorance I've been harming someone or something, I believe we all function on some kind of continuum. It's not that I don't think we all wake up and know right and wrong all the time. I think there's a lot of nuance to the wrongs we do to people, honestly. And some things feel really obvious to me, and I've observed that they don't feel obvious to other people. And if you're in any kind of human relationship, sometimes what you feel is someone feels as obvious to them, you're stepping all over them.(08:59):And I'm not talking about just hurting someone's feelings. I'm talking about, yeah, maybe you hurt their feelings, but maybe you violated them in that ignorance or I am talking about violations. So it seems to me that when Marjorie Taylor Green got on CN and said, I've been a part of this system kind of like Rebecca you're talking about. And I realized that ignoring chomp hyping up this rhetoric, it gets people out there that I can't see highly activated. And there's a group of those people that want to go to concrete action and inflict physical pain based on what's being said on another human being. And we see that, right? So whatever you got Charlie Kirk's murderer, you got assassination of Dr. Martin Luther King all throughout history we've seen these, the rhetoric and the violence turns into these physical actions. And so it seems to me like she had some awareness of what her contributing to that, along with the good old orange guy was doing contributes to violence. It seems to me like she inched in that direction.Rebecca (10:27):Yeah, like I said, I think you're right in that inching, she had my attention. And so then I'm waiting for her to actually do something substantive more than just the acknowledgement that I have been in error. And and I think part of that is that I think we have a way of thinking that the acknowledgement or the, I'm sorry, is the work, and it is not the, I'm sorry, is the acknowledgement that work needs to be done. So after you say, I'm sorry, now let's go do the work.Danielle (11:10):I mean our own therapeutic thing that we all went through that we have in common didn't have a concept for repair. So people are coming to therapy looking for a way to understand. And what I like to say is there's a theory of something, but there's no practical application of it that makes your theory useless in some sense to me or your theology, even if your ology has a theology of X, Y, Z, but you can't actually apply that. What is the use of it?Jenny (11:43):And I think that's best case scenario, and I think I'm a more cynical person than you are Danielle, but I see what's happening with Taylor Green and I'm like, this actually feels like when a very toxic, dangerous man goes to therapy and learns the therapy language and then is like it's my boundaries that you can't wear that dress. And it's like, no, no, that's not what we're doing. It's just it's my boundary that when there isn't that actual sense of, okay, I'm going to be a part of the work, to me it actually somehow feels potentially more dangerous because it's like I'm using the language and the optics of what will keep me innocent right now without actually putting any skin in the game.(12:51):Yeah, I would say it's an enactment of white womanhood. I would say it's intentional, but probably not fully conscious that it is her body moving in the way that she's been racially and gendered(13:07):Tradition to move. That goes in some ways maybe I can see that I've enacted harm, but I'm actually going to replicate the same thing in stepping into now a new position of performing white womanhood and saying the right things and doing the right things. But then the second an interviewee calls me out into accountability, I'm going to go into potentially white psychosis moment because I don't actually know how to metabolize the ways in which I am still complicit in the system. And to me, I think that's the impossibility of how do we work through the ways that these systems live in our bodies that isn't clean. It isn't pure, but I think the simplicity of I was blind now I see. I am very skeptical of,Rebecca (14:03):Yeah, I think it's interesting the notion that, and I'm going to misquote you so then you fix it. But something of like, I don't actually know how to metabolize these things and work them through. I only know this kind of performative space where I say what I'm expected to say.Jenny (14:33):Yeah, I think I see it as a both, and I don't totally disagree with the fact of there's not something you can do to get rid of your privilege. And I do think that we have examples of, oh goodness, I wish I could remember her name. Viola Davis. No, she was a white woman who drove, I was just at the African-American History Museum yesterday and was reminded of her face, but it's like Viola ela, I want to say she's a white woman from Detroit who drove down to the south during the bus boycotts to carpool black folks, and she was shot in the head and killed in her car because she stepped out of the bounds of performing white womanhood. And I do think that white bodies know at a certain level we can maintain our privilege and there is a real threat and a real cost to actually doing what needs to be done to not that we totally can abdicate our privilege. I think it is there, and I do think there are ways of stepping out of the bondage of our racial and gendered positions that then come with a very real threat.Rebecca (16:03):Yes. But I think I would say that this person that you're referring to, and again, I feel some kind of way about the fact that we can't name her name accurately. And there's probably something to that, right? She's not the only one. She's not the first one. She's not the last one who stepped outside of the bounds of what was expected of her on behalf of the Civil Rights Movement, on behalf of justice. And those are stories that we don't know and faces and names we cannot, that don't roll off the tip of our tongue like a Rosa Parks or a Medgar Evers or a Merley Evers or whoever. So that being said, I would say that her driving down to the South, that she had a car that she could drive, that she had the resources to do that is a leveraging of some of her privilege in a very real way, a very substantive way. And so I do think that I hear what you're saying that she gave up something of her privilege to do that, and she did so with a threat that for her was realizing a very violent way. And I would also say she leveraged what privilege she had in a way that for her felt like I want to offer something of the privilege that I have and the power that I have on behalf of someone who doesn't have it.(17:44):It kind of reminds me this question of is the apology enough or is the acknowledgement enough? It reminds me of what we did in the eighties and nineties around the racial reconciliation movement and the Promise Keepers thing and all those big conferences where the notion that the work of reconciliation was to stand on the stage and say, I realize I'm white and you're black, and I'm sorry. And we really thought that that was the work and that was sufficient to clear everything that needed to be cleared, and that was enough to allow people to move forward in proximity and connection to each other. And I think some of what we're living through 40, 45 years later is because that was not enough.(18:53):It barely scratched the surface to the extent that you can say that Donald Trump is not the problem. He is a symptom of the problem. To the extent that you could say that his success is about him stoking the fires that lie just beneath the surface in the realization that what happened with reconciliation in the nineties was not actually repair, it was not actually reconciliation. It was, I think what you're saying, Jenny, the sort of performative space where I'm speaking the language of repair and reconciliation, but I haven't actually done the work or paid the cost that is there in order to be reconciled.Danielle (19:40):That's in my line though. That's the continuum of moral awareness. You arrive to a spot, you address it to a certain point. And in that realm of awareness, what we've been told we can manage to think about, which is also goes back to Jenny's point of what the system has said. It's almost like under our system we have to push the system. It's so slow. And as we push the system out and we gain more awareness, then I think we realize we're not okay. I mean, clearly Latinos are not okay. They're a freaking mess. I think Mother Fers, half of us voted for Trump. The men, the women are pissed. You have some people that are like, you have to stay quiet right now, go hide. Other people are like, you got to be in the streets. It's a clear mess. But I don't necessarily think that's bad because we need to have, as a large group of people, a push of our own moral awareness.(20:52):What did we do that hurt ourselves? What were we willing to put up with to recolonize ourselves to agree to it, to agree to the fact that you could recolonize yourself. So I mean, just as a people group, if you can lump us all in together, and then the fact that he's going after countries of origin, destabilizing Honduras telling Mexico to release water, there is no water to release into Texas and California. There isn't the water to do it, but he can rant and rave or flying drones over Venezuela or shooting down all these ships. How far have we allowed ourselves in the system you're describing Rebecca, to actually say our moral awareness was actually very low. I would say that for my people group, very, very low, at least my experience in the states,Rebecca (21:53):I think, and this is a working theory of mine, I think like what you're talking about, Danielle, specifically in Latino cultures, my question has been when I look at that, what I see as someone who's not part of Latino culture is that the invitation from whiteness to Latino cultures is to be complicit in their own erasure in order to have access to America. So you have to voluntarily drop your language, drop your accent, change your name, whatever that long list is. And I think when whiteness shows up in a culture in that way where the request or the demand is that you join in your own eraser, I think it leads to a certain kind of moral ignorance, if you will.(23:10):And I say that as somebody coming from a black American experience where I think the demand from whiteness was actually different. We weren't actually asked to participate in our own eraser. We were simply told that there's no version of your existence where you will have access to what whiteness offers to the extent that a drop is a drop is a drop. And by that I mean you could be one 16th black and be enslaved in the United States, whereas, so I think I have lots of questions and curiosities around that, about how whiteness shows up in a particular culture, what does it demand or require, and then what's the trajectory that it puts that culture on? And I'm not suggesting that we don't have ways of self-sabotage in black America. Of course we do. I just think our ways of self-sabotage are nuanced or different from what you're talking about because the way that whiteness has showed up in our culture has required something different of us. And so our sabotage shows up in a different way.(24:40):To me. I don't know. I still don't know what to do with the 20% of black men that voted for Trump. I haven't figured that one out yet. Perhaps I don't have enough moral awareness about that space. But when I look at what happened in Latino culture, at least my theory as someone from the outside looking in is like there's always been this demand or this temptation that you buy the narrative that if you assimilate, then you can have access to power. And so I get it. It's not that far of a leap from that to course I'll vote for you because if I vote for you, then you'll take care of us. You'll be good and kind and generous to me and mine. I get that that's not the deal that was made with black Americans. And so we do something different. Yeah, I don't know. So I'm open to thoughts, rebuttals, rebukes,Jenny (25:54):My mind is going to someone I quote often, Rosa Luxembourg, who was a democratic socialist revolutionary who was assassinated over a hundred years ago, and she wrote a book called Reform or Revolution arguing that the more capitalism is a system built on collapse because every time the system collapse, those who are at the top get to sweep the monopoly board and collect more houses, more land, more people. And so her argument was actually against things like unions and reforms to capitalism because it would only prolong the collapse, which would make the collapse that much more devastating. And her argument was, we actually have to have a revolution because that's the only way we're going to be able to redo this system. And I think that for the folks that I knew that voted for Trump, in my opinion, against their own wellness and what it would bring, it was the sense of, well, hopefully he'll help the economy.(27:09):And it was this idea that he was just running on and telling people he was going to fix the economy. And that's a very real thing for a lot of people that are really struggling. And I think it's easier for us to imagine this paternalistic force that's going to come in and make capitalism better. And yet I think capitalism will only continue to get worse on purpose. If we look at literally yesterday we were at the Department of Environmental Protections and we saw that there was black bags over it and the building was empty. And the things that are happening to our country that the richest of the ridge don't care that people's water and food and land is going to be poisoned in exponential rates because they will not be affected. And until we can get, I think the mass amount of people that are disproportionately impacted to recognize this system will never work for us, I don't know. I don't know what it will take. I know we've used this word coalition. What will it take for us to have a coalition strong enough to actually bring about the type of revolution that would be necessary? IRebecca (28:33):Think it's in part in something that you said, Jenny, the premise that if this doesn't affect me, then I don't have any skin in this game and I don't really care. I think that is what will have to change. I think we have to come to a sense of if it is not well with the person sitting next to me, then it isn't well with me because as long as we have this mindset that if it doesn't directly affect me that it doesn't matter, then I think we're always sort of crabs in a barrel. And so maybe that's idealistic. Maybe that sounds a little pollyannaish, but I do think we have to come to this sense of, and this maybe goes along with what Danielle was saying about the continuum of moral awareness. Can I do the work of becoming aware of people whose existence and life is different than mine? And can that awareness come from this place of compassion and care for things that are harmful and hurtful and difficult and painful for them, even if it's not that way? For me, I think if we can get there with this sense of we rise and fall together, then maybe we have a shot at doing something better.(30:14):I think I just heard on the news the other day that I think it used to be a policy that on MLK Day, certain federal parks and things were free admission, and I think the president signed an executive order that's no longer true, but you could go free if you go on Trump's birthday. The invitation and the demand that is there to care only about yourself and be utterly dismissive of anyone and everyone else is sickening.Jenny (30:51):And it's one of the things that just makes me go insane around Christian nationalism and the rhetoric that people are living biblically just because they don't want gay marriage. But then we'll say literally, I'm just voting for my bank account, or I'm voting so that my taxes don't go to feed people. And I had someone say that to me and they're like, do you really want to vote for your taxes to feed people? I said, absolutely. I would much rather my tax money go to feed people than to go to bombs for other countries. I would do that any day. And as a Christian, should you not vote for the least of these, should you not vote for the people that are going to be most affected? And that dissonance that's there is so crazy making to me because it's really the antithesis of, I think the message of Jesus that's like whatever you do to the least of these, you are doing to me. And instead it's somehow flipped where it's like, I just need to get mine. And that's biblical,Rebecca (31:58):Which I think I agree wholeheartedly as somebody who identifies as a Christian who seeks to live my life as someone that follows the tenets of scripture. I think part of that problem is the introduction of this idea that there are hierarchies to sin or hierarchies to sort of biblical priorities. And so this notion that somehow the question of abortion or gay rights, transgendered rights is somehow more offensive to scripture than not taking care of the least of these, the notion that there's such a thing as a hierarchy there that would give me permission to value one over the other in a way that is completely dismissive of everything except the one or two things that I have deemed the most important is deeply problematic to me.Danielle (33:12):I think just coming back to this concept of I do think there was a sense among the larger community, especially among Latino men, Hispanic men, that range of people that there's high percentage join the military, high percentage have tried to engage in law enforcement and a sense of, well, that made me belong or that gave my family an inn. Or for instance, my grandfather served in World War II and the Korean War and the other side of my family, the German side, were conscientious objectors. They didn't want to fight the Nazis, but then this side worked so hard to assimilate lost language, didn't teach my mom's generation the language. And then we're reintroducing all of that in our generation. And what I noticed is there was a lot of buy-in of we got it, we made it, we made it. And so I think when homeboy was like, Hey, I'm going to do this. They're like, not to me,To me, not to me. It's not going to happen to me. I want my taxes lowered. And the thing is, it is happening to us now. It was always going to, and I think those of us that spoke out or there was a loss of the memory of the old school guys that were advocating for justice. There was a loss there, but I think it's come back with fury and a lot of communities and they're like, oh, crap, this is true. We're not in, you see the videos, people are screaming, I'm an American citizen. They're like, we don't care. Let me just break your arm. Let me run over your legs. Let me take, you're a US service member with a naval id. That's not real. Just pure absurdity is insane. And I think he said he was going to do it, he's doing it. And then a lot of people in our community were speaking out and saying, this is going to happen. And people were like, no, no, no, no, no. Well, guess what?Rebecca (35:37):Right? Which goes back to Martin Luther King's words about injustice anywhere is a threat to justice everywhere. The notion that if you're willing to take rights and opportunities and privileges from one, you are willing to take them from all. And so again, back to what Jenny said earlier, this notion that we rise our fall together, and as long as we have this mindset that I can get mine, and it doesn't matter if you don't get yours, there will always be a vulnerability there. And what you're saying is interesting to me, Danielle, talking about the military service in Latino communities or other whatever it is that we believed was the ticket in. And I don't think it's an accident or a coincidence that just around the time that black women are named the most educated and the fastest rising group for graduate and doctoral degrees, you see the dismantling of affirmative action by the Supreme Court.(36:49):You see now, the latest thing is that the Department of Education has come out and declassified a list of degrees as professional degrees. And overwhelmingly the degrees that are named on that list that are no longer considered professional are ones that are inhabited primarily by women and people of color. And I don't think that that is a coincidence, nor do I think it's a coincidence that in the mass firings of the federal government, 300,000 black women lost their jobs. And a lot of that is because in the nineties when we were graduated from college and getting our degrees, corporate America was not a welcome place for people of color, for black people, for black women. So we went into the government sector because that was the place where there was a bit more of a playing field that would allow you to succeed. And I don't think it is a coincidence that the dismantling intentionally of the on-ramps that we thought were there, that would give us a sense of belonging. Like you're in now, right? You have arrived, so to speak. And I am only naming the ones that I see from my vantage point. I hear you naming some things that you see from your vantage point, right? I'm sure, Jenny, you have thoughts about how those things have impacted white women.Jenny (38:20):Yeah, yeah. And I'm thinking about, we also went yesterday to the Native American Museum and I learned, I did not realize this, that there was something called, I want to say, the Pocahontas exception. And if a native person claimed up to one 14th of Pocahontas, DNA, they were then deemed white. What? And it just flabbergasted to me, and it was so evident just this, I was thinking about that when you were talking, Danielle, just like this moving target and this false promise of if you just do enough, if you just, you'll get two. But it's always a lie. It's always been a lie from literally the very first settlers in Jamestown. It has been a lie,Rebecca (39:27):Which is why it's sort of narcissistic and its sort of energy and movement, right? Because narcissism always moves the goalpost. It always changes the roles of the game to advantage the narcissist. And whiteness is good for that. This is where the goalpost is. You step up and meet it, and whiteness moves the goalpost.Danielle (40:00):I think it's funny that Texas redistricted based on how Latinos thought pre pre-migration crackdown, and they did it in Miami and Miami, Miami's democratic mayor won in a landslide just flipped. And I think they're like, oh, shit, what are we going to do? I think it's also interesting. I didn't realize that Steven Miller, who's the architect of this crap, did you know his wife is brownHell. That's creepy shit,Rebecca (40:41):Right? I mean headset. No, no. Vance is married to a brown woman. I'm sure in Trump's mind. Melania is from some Norwegian country, but she's an immigrant. She's not a US citizen. And the Supreme Court just granted cert on the birthright citizenship case, which means we're in trouble.(41:12):Well, I'm worried about everybody because once you start messing with that definition of citizenship, they can massage it any kind of way they want to. And so I don't think anybody's safe. I really don't. I think the low hanging fruit to speak, and I apologize for that language, is going to be people who are deemed undocumented, but they're not going to stop there. They're coming for everybody and anybody they can find any reason whatsoever to decide that you're not, if being born on US soil is not sufficient, then the sky's the limit. And just like they did at the turn of the century when they decided who was white and who wasn't and therefore who could vote and who could own property or who couldn't, we're going to watch the total and reimagining of who has access to power.Danielle (42:14):I just am worried because when you go back and you read stories about the Nazis or you read about genocide and other places in the world, you get inklings or World War I or even more ancient wars, you see these leads up in these telltale signs or you see a lead up to a complete ethnic cleansing, which is what it feels like we're gearing up for.I mean, and now with the requirement to come into the United States, even as a tourist, when you enter the border, you have to give access to five years of your social media history. I don't know. I think some people think, oh, you're futurizing too much. You're catastrophizing too much. But I'm like, wait a minute. That's why we studied history, so we didn't do this again. Right?Jenny (43:13):Yeah. I saw this really moving interview with this man who was 74 years old protesting outside of an nice facility, and they were talking to him and one of the things he said was like, Trump knows immigrants are not an issue. He's not concerned about that at all. He is using this most vulnerable population to desensitize us to masked men, stealing people off the streets.Rebecca (43:46):I agree. I agree. Yeah, a hundred percent. And I think it's desensitizing us. And I don't actually think that that is Trump. I don't know that he is cunning enough to get that whoever's masterminding, project 2025 and all that, you can ask the question in some ways, was Hitler actually antisemitic or did he just utilize the language of antisemitism to mask what he was really doing? And I don't mean that to sort of sound flippant or deny what happened in the Holocaust. I'm suggesting that same thing. In some ways it's like because America is vulnerable to racialized language and because racialized rhetoric moves masses of people, there's a sense in which, let me use that. So you won't be paying attention to the fact that I just stole billions of dollars out of the US economy so that you won't notice the massive redistribution of wealth and the shutting off of avenues to upward social mobility.(45:12):And the masses will follow you because they think it's about race, when in actuality it's not. Because if they're successful in undoing birthright citizenship, you can come after anybody you want because all of our citizenship is based on the fact that we were born on US soil. I don't care what color you are, I do not care what lineage you have. Every person in this country or every person that claims to be a US citizen, it's largely based on the fact that you were born on US soil. And it's easy to say, oh, we're only talking about the immigrants. But so far since he took office, we've worked our way through various Latin cultures, Somali people, he's gone after Asian people. I mean, so if you go after birthright citizenship and you tell everyone, we're only talking about people from brown countries, no, he's not, and it isn't going to matter. They will find some arbitrary line to decide you have power to vote to own property. And they will decide, and this is not new in US history. They took whole businesses, land property, they've seized property and wealth from so many different cultures in US history during Japanese internment during the Tulsa massacre. And those are only the couple that I could name. I'm sure Jenny and Danielle, you guys could name several, right? So it's coming and it's coming for everybody.Jenny (47:17):So what are you guys doing to, I know that you're both doing a lot to resist, and we talk a lot about that. What are you doing to care for yourself in the resistance knowing that things will get worse and this is going to be a long battle? What does helping take care of yourself look like in that for you?Danielle (47:55):I dunno, I thought about this a lot actually, because I got a notification from my health insurance that they're no longer covering thyroid medication that I take. So I have to go back to my doctor and find an alternative brand, hopefully one they would cover or provide more blood work to prove that that thyroid medication is necessary. And if you know anything about thyroids, it doesn't get better. You just take that medicine to balance yourself. So for me, my commitment and part of me would just want to let that go whenever it runs out at the end of December. But for me, one way I'm trying to take care of myself is one, stocking up on it, and two, I've made an appointment to go see my doctor. So I think just trying to do regular things because I could feel myself say, you know what?(48:53):Just screw it. I could live with this. I know I can't. I know I can technically maybe live, but it will cause a lot of trouble for me. So I think there's going to be probably not just for me, but for a lot of people, like invitations as care changes, like actual healthcare or whatever. And sometimes those decisions financially will dictate what we can do for ourselves, but I think as much as I can, I want to pursue staying healthy. And it's not just that just eating and exercising. So that's one way I'm thinking about it.Rebecca (49:37):I think I'm still in the phase of really curating my access to information and data. There's so much that happens every day and I cannot take it all in. And so I still largely don't watch the news. I may scan a headline once every couple days just to kind of get the general gist of what is happening because I can't, I just cannot take all of that in. Yeah, it will be way too overwhelming, I think. So that still has been a place of that feels like care. And I also think trying to move a little bit more, get a little bit of, and I actually wrote a blog post this month about chocolate because when I grew up in California seas, chocolate was a whole thing, and you cannot get it on the east coast. And so I actually ordered myself a box of seas chocolate, and I'm waiting for it to arrive at my house costs way too much money. But for me, that piece of chocolate represents something that makes me smile about my childhood. And plus, who doesn't think chocolate is care? And if you live a life where chocolate does not care, I humbly implore you to change your definition of care. But yeah, so I mean it is something small, but these days, small things that feel like there's something to smile about or actually big things.Jenny (51:30):I have been trying to allow myself to take dance classes. It's my therapy and it just helps me. A lot of the things that we're talking about, I don't have words for, I can only express through movement now. And so being able to be in a space where my body is held and I don't have to think about how to move my body and I can just have someone be like, put your hand here. That has been really supportive for me. And just feeling my body move with other bodies has been really supportive for me.Rebecca (52:17):Yeah. The other thing I would just add is that we started this conversation talking about Marjorie Taylor Green and the ways in which I feel like her response is insufficient, but there is a part of me that feels like it is a response, it however small it is, an acknowledgement that something isn't right. And I do think you're starting to see a little bit of that seep through. And I saw an interview recently where someone suggested it's going to take more than just Trump out of office to actually repair what has been broken over the last several years. I think that's true. So I want to say that putting a little bit of weight in the cracks in the surface feels a little bit like care to me, but it still feels risky. I don't know. I'm hopeful that something good will come of the cracks that are starting to surface the people that are starting to say, actually, this isn't what I meant when I voted. This isn't what I wanted when I voted. That cities like Miami are electing democratic mayors for the first time in 30 years, but I feel that it's a little bit risky. I am a little nervous about how far it will go and what will that mean. But I think that I can feel the beginnings of a seedling of hope that maybe this won't be as bad as maybe we'll stop it before we go off the edge of a cliff. We'll see.Kitsap County & Washington State Crisis and Mental Health ResourcesIf you or someone else is in immediate danger, please call 911.This resource list provides crisis and mental health contacts for Kitsap County and across Washington State.Kitsap County / Local ResourcesResourceContact InfoWhat They OfferSalish Regional Crisis Line / Kitsap Mental Health 24/7 Crisis Call LinePhone: 1‑888‑910‑0416Website: https://www.kitsapmentalhealth.org/crisis-24-7-services/24/7 emotional support for suicide or mental health crises; mobile crisis outreach; connection to services.KMHS Youth Mobile Crisis Outreach TeamEmergencies via Salish Crisis Line: 1‑888‑910‑0416Website: https://sync.salishbehavioralhealth.org/youth-mobile-crisis-outreach-team/Crisis outreach for minors and youth experiencing behavioral health emergencies.Kitsap Mental Health Services (KMHS)Main: 360‑373‑5031; Toll‑free: 888‑816‑0488; TDD: 360‑478‑2715Website: https://www.kitsapmentalhealth.org/crisis-24-7-services/Outpatient, inpatient, crisis triage, substance use treatment, stabilization, behavioral health services.Kitsap County Suicide Prevention / “Need Help Now”Call the Salish Regional Crisis Line at 1‑888‑910‑0416Website: https://www.kitsap.gov/hs/Pages/Suicide-Prevention-Website.aspx24/7/365 emotional support; connects people to resources; suicide prevention assistance.Crisis Clinic of the PeninsulasPhone: 360‑479‑3033 or 1‑800‑843‑4793Website: https://www.bainbridgewa.gov/607/Mental-Health-ResourcesLocal crisis intervention services, referrals, and emotional support.NAMI Kitsap CountyWebsite: https://namikitsap.org/Peer support groups, education, and resources for individuals and families affected by mental illness.Statewide & National Crisis ResourcesResourceContact InfoWhat They Offer988 Suicide & Crisis Lifeline (WA‑988)Call or text 988; Website: https://wa988.org/Free, 24/7 support for suicidal thoughts, emotional distress, relationship problems, and substance concerns.Washington Recovery Help Line1‑866‑789‑1511Website: https://doh.wa.gov/you-and-your-family/injury-and-violence-prevention/suicide-prevention/hotline-text-and-chat-resourcesHelp for mental health, substance use, and problem gambling; 24/7 statewide support.WA Warm Line877‑500‑9276Website: https://www.crisisconnections.org/wa-warm-line/Peer-support line for emotional or mental health distress; support outside of crisis moments.Native & Strong Crisis LifelineDial 988 then press 4Website: https://doh.wa.gov/you-and-your-family/injury-and-violence-prevention/suicide-prevention/hotline-text-and-chat-resourcesCulturally relevant crisis counseling by Indigenous counselors.Additional Helpful Tools & Tips• Behavioral Health Services Access: Request assessments and access to outpatient, residential, or inpatient care through the Salish Behavioral Health Organization. Website: https://www.kitsap.gov/hs/Pages/SBHO-Get-Behaviroal-Health-Services.aspx• Deaf / Hard of Hearing: Use your preferred relay service (for example dial 711 then the appropriate number) to access crisis services.• Warning Signs & Risk Factors: If someone is talking about harming themselves, giving away possessions, expressing hopelessness, or showing extreme behavior changes, contact crisis resources immediately.Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that.Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that.Rebecca A. Wheeler Walston, J.D., Master of Arts in CounselingEmail: asolidfoundationcoaching@gmail.comPhone:  +1.5104686137Website: Rebuildingmyfoundation.comI have been doing story work for nearly a decade. I earned a Master of Arts in Counseling from Reformed Theological Seminary and trained in story work at The Allender Center at The Seattle School of Theology and Psychology. I have served as a story facilitator and trainer at both The Allender Center and the Art of Living Counseling Center. I currently see clients for one-on-one story coaching and work as a speaker and facilitator with Hope & Anchor, an initiative of The Impact Movement, Inc., bringing the power of story work to college students.By all accounts, I should not be the person that I am today. I should not have survived the difficulties and the struggles that I have faced. At best, I should be beaten down by life‘s struggles, perhaps bitter. I should have given in and given up long ago. But I was invited to do the good work of (re)building a solid foundation. More than once in my life, I have witnessed God send someone my way at just the right moment to help me understand my own story, and to find the strength to step away from the seemingly inevitable ending of living life in defeat. More than once I have been invited and challenged to find the resilience that lies within me to overcome the difficult moment. To trust in the goodness and the power of a kind gesture. What follows is a snapshot of a pivotal invitation to trust the kindness of another in my own story. May it invite you to receive to the pivotal invitation of kindness in your own story. Listen with me…  Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that.

????️ Guest: Phil McKelvy, DPT???? Topics: Parkinson's care without neuro certs, RTM implementation, digital health, and balancing clinical work with creative PT projects.What you'll learn:Why intensity matters more than certifications in Parkinson's careFree tools to treat movement disorders without overwhelming your practiceThe truth about RTM: what it is, how to do it, and why it's here to stayHow to think differently about burnout, energy, and filling your cup in PTWhy APTA isn't just about CEUs — it's about connection???? Resources Mentioned:Rogue Physical Therapy YouTubePower for Parkinson'sMatt Jurek on RTMPrompt EMR, Orva HealthOne More Wave - Adaptive Surf Therapy???? Phil's Contact:???? philmckelvey@gmail.comLinkedIn: Philip McKelveyInstagram: @philmckelvey.dpt

Outpatient CDI is still in its pioneer-”ish” stage. Why do I say that? Per the most recent ACDIS survey data, only 31% of respondents indicated their organization had a dedicated OP CDI program.  Progress, but not enough, and still a minority. So when you find an “OG” who has been working in risk adjustment for well over a decade, you need to pay attention. Odds are they've got some lessons to share and wisdom to confer. That certainly describes Amy Campbell, Director of Outpatient CDI for LifePoint Health.  Listen in as we discuss:   “Building the airplane as we were flying...” Her start and early days in OP CDI. A “day in the life of” her role as OP CDI Director today for a large and growing healthcare organization Dashboard for success and most impactful/important KPIs Manual chart reviews (yes, they do this—no assistive tech). What does a pre-visit review look like/how is it conducted, and what common clarifications and dx opportunities are her team finding? Rapid fire round: Biggest OP CDI pet peeve (a doozy), RN vs. HIM staffing decisions, and the hardest part of managing people Interesting career stops, from critical care nurse and neurological intensive care nurse, to consulting, to content reviewer for Lippincott. Being a mother of an adult child with autism 

Danielle (00:02):Hey, Jenny, you and I usually hop on here and you're like, what's happening today? Is there a guest today? Isn't that what you told me at the beginning?And then I sent you this Instagram reel that was talking about, I feel like I've had this, my own therapeutic journey of landing with someone that was very unhelpful, going to someone that I thought was more helpful. And then coming out of that and doing some somatic work and different kind of therapeutic tools, but all in the effort for me at least, it's been like, I want to feel better. I want my body to have less pain. I want to have less PTSD. I want to have a richer life, stay present with my kids and my family. So those are the places pursuit of healing came from for me. What about you? Why did you enter therapy?Jenny (00:53):I entered therapy because of chronic state of dissociation and not feeling real, coupled with pretty incessant intrusive thoughts, kind of OCD tendencies and just fixating and paranoid about so many things that I knew even before I did therapy. I needed therapy. And I came from a world where therapy wasn't really considered very Christian. It was like, you should just pray and if you pray, God will take it away. So I actually remember I went to the Seattle School of Theology and Psychology, partly because I knew it was a requirement to get therapy. And so for the first three years I was like, yeah, yeah, my school requires me to go to therapy. And then even after I graduated, I was like, well, I'm just staying in therapy to talk about what's coming up for my clients. And then it was probably five years, six years into therapy when I was finally like, no, I've gone through some really tough things and I just actually need a space to talk about it and process it. And so trying to develop a healthier relationship with my own body and figuring out how I wanted to move with integrity through the world is a big part of my healing journey.Danielle (02:23):I remember when I went to therapy as a kid and well, it was a psychologist and him just kind of asking really direct questions and because they were so direct and pointed, just me just saying like, nah, never happened, never did that, never felt that way, et cetera, et cetera. So I feel like as I've progressed through life, I've had even a better understanding of what's healing for me, what is love life like my imagination for what things could be. But also I think I was very trusting and taught to trust authority figures, even though at the same time my own trauma kept me very distrusting, if that makes sense. So my first recommendations when I went, I was skeptical, but I was also very hopeful. This is going to help.Jenny (03:13):Yeah, totally. Yep. Yeah. And sometimes it's hard for me to know what is my homeschool brain and what is just my brain, because I always think everyone else knows more than me about pretty much everything. And so then I will do crazy amount of research about something and then Sean will be like, yeah, most people don't even know that much about that subject. And I'm like, dang it, I wasted so much effort again. But I think especially in the therapy world, when I first started therapy, and I've seen different therapists over the years, some better experiences than others, and I think I often had that same dissonance where I was like, I think more than me, but I don't want you to know more than me. And so I would feel like this wrestling of you don't know me actually. And so it created a lot of tension in my earlier days of therapy, I think.Danielle (04:16):Yeah, I didn't know too with my faith background how therapy and my faith or theological beliefs might impact therapy. So along the lines of stereotypes for race or stereotypes for gender or what do you do? I am a spiritual person, so what do I do with the thought of I do believe in angels and spiritual beings and evil and good in the world, and what do I do? How does that mix into therapy? And I grew up evangelical. And so there was always this story, I don't know if you watched Heaven's Gates, Hells Flames at your church Ever? No. But it was this play that they came and they did, and you were supposed to invite your friends. And the story was some people came and at the end of their life, they had this choice to choose Jesus or not. And the story of some people choosing Jesus and making it into heaven and some people not choosing Jesus and being sent to hell, and then there was these pictures of these demons and the devil and stuff. So I had a lot of fear around how evil spirits were even just interacting with us on a daily basis.Jenny (05:35):Yeah, I grew up evangelical, but not in a Pentecostal charismatic world at all. And so in my family, things like spiritual warfare or things like that were not often talked about in my faith tradition in my family. But I grew up in Colorado Springs, and so by the time I was in sixth, seventh grade, maybe seventh or eighth grade, I was spending a lot of time at Ted Haggard's New Life Church, which was this huge mega, very charismatic church. And every year they would do this play called The Thorn, and it would have these terrifying hell scenes. It was very common for people to throw up in the audience. They were so freaked out and they'd have demons repelling down from the ceiling. And so I had a lot of fear earlier than that. I always had a fear of hell. I remember on my probably 10th or 11th birthday, I was at Chuck E Cheese and my birthday Wish was that I could live to be a thousand because I thought then I would be good enough to not go to hell.(06:52):I was always so afraid that I would just make the simplest mistake and then I would end up in hell. And even when I went to bed at night, I would tell my parents goodnight and they'd say, see you tomorrow. And I wouldn't say it because I thought as a 9-year-old, what if I die and I don't see them tomorrow? Then the last thing I said was a lie, and then I'm going to go to hell. And so it was always policing everything I did or said to try to avoid this scary, like a fire that I thought awaited me.Yeah, yeah. I mean, I am currently in New York right now, and I remember seeing nine 11 happen on the news, and it was the same year I had watched Left Behind on that same TV with my family. So as I was watching it, my very first thought was, well, these planes ran into these buildings because the pilots were raptured and I was left behind.Danielle (08:09):And so I know we were like, we get to grad school, you're studying therapy. It's mixed with psychology. I remember some people saying to me, Hey, you're going to lose your faith. And I was like, what does that mean? I'm like 40, do you assume because I learned something about my brain that's going to alter my faith. So even then I felt the flavor of that, but at the time I was with seeing a Christian therapist, a therapist that was a Christian and engaging in therapy through that lens. And I think I was grateful for that at the time, but also there were things that just didn't feel right to me or fell off or racially motivated, and I didn't know what to say because when I brought them into the session, that became part of the work as my resistance or my UNC cooperation in therapy. So that was hard for me. I don't know if you noticed similar things in your own therapy journey.Jenny (09:06):I feel sick as you say, that I can feel my stomach clenching and yeah, I think for there to be a sense of this is how I think, and therefore if you as the client don't agree, that's your resistance(09:27):Is itself whiteness being enacted because it's this, I think about Tema, Koon's, white supremacy, cultural norms, and one of them is objectivity and the belief that there is this one capital T objective truth, and it just so happens that white bodies have it apparently. And so then if you differ with that than there is something you aren't seeing, rather than how do I stay in relation to you knowing that we might see this in a very different way and how do we practice being together or not being together because of how our experiences in our worldviews differ? But I can honor that and honor you as a sovereign being to choose your own journey and your self-actualization on that journey.Danielle(10:22):So what are you saying is that a lot of our therapeutic lens, even though maybe it's not Christian, has been developed in this, I think you used the word before we got on here like dominion or capital T. I do believe there is truth, but almost a truth that overrides any experience you might have. How would you describe that? Yeah. Well,Jenny (10:49):When I think about a specific type of saying that things are demonic or they're spiritual, a lot of that language comes from the very charismatic movement of dominion and it uses a lot of spiritual warfare language to justify dominion. And it's saying there's a stronghold of Buddhism in Thailand and that's why we have to go and bring Jesus. And what that means is bring white capitalistic Jesus. And so I think that that plays out on mass scales. And a big part of dominion is that the idea that there's seven spheres of society, it's like family culture, I don't remember all of them education, and the idea is that Christians should be leaders in each those seven spheres of society. And so a lot of the language in that is that there are demons or demonic strongholds. And a lot of that language I think is also racialized because a lot of it is colorism. We are going into this very dark place and the association with darkness always seems to coincide with melanin, You don't often hear that language as much when you're talking about white communities.Danielle (12:29):Yeah, I don't know. Yeah, it's interesting when you talk about nuts and bolts and you're in therapy, then it becomes almost to me, if a trauma happens to you and let's say then the theory is that alongside of that trauma and evil entity or a spirit comes in and places itself in that weak spot, then it feels like we're placing the victim as sharing the blame for what happened to them or how they're impacted by that trauma. I'm not sure if I'm saying it right, but I dunno, maybe you can say it better. (13:25):Well, I think that it's a way of making even the case of sexual assault, for instance, I've been in scenarios where or heard stories where someone shared a story of sexual assault or sexual violence and then their life has been impacted by that trauma in certain patterned ways and in the patterns of how that's been impacted. The lens that's additionally added to that is saying an evil entity or an evil spirit has taken a stronghold or a footing in their life, or it's related to a generational curse. This happened to your mother or your grandma too. And so therefore to even get free of the trauma that happened to you, you also have to take responsibility for your mom or your grandma or for exiting an evil entity out of your life then to get better. Does that make sense or what are you hearing me say?Jenny (14:27):Well, I think I am hearing it on a few different levels. One, there's not really any justification for that. Even if we were to talk about biblical counseling, there's not a sense of in the Bible, a demon came into you because this thing happened or darkness came into you or whatever problematic language you want to use. Those are actually pretty relatively new constructs and ideas. And it makes me think about how it also feels like whiteness because I think about whiteness as a system that disables agency. And so of course there may be symptoms of trauma that will always be with us. And I really like the framework of thinking of trauma more like diabetes where it's something you learn to moderate, it's something you learn to take care of, but it's probably never going to totally leave you. And I think, sorry, there's loud music playing, but even in that, it's like if I know I have diabetes, I know what I can do. If there's some other entity somewhere in me, whatever that means, that is so disempowering to my own agency and my own choice to be able to say, how do I make meaning out of these symptoms and how do I continue living a meaningful life even if I might have difficulties? It's a very victimizing and victim blaming language is what I'm hearing in that.Danielle (16:15):And it also is this idea that somehow, for instance, I hate the word Christian, but people that have faith in Jesus that somewhere wrapped up in his world and his work and his walk on earth, there's some implication that if you do the right things, your life will be pain-free or you can get to a place where you love your life and the life that you're loving no longer has that same struggle. I find that exactly opposite of what Jesus actually said, but in the moment, of course, when you're engaged in that kind of work, whether it's with a spiritual counselor or another kind of counselor, the idea that you could be pain-free is, I mean, who doesn't want to be? Not a lot of people I know that were just consciously bring it on. I love waking up every day and feeling slightly ungrounded, doesn't everyone, or I like having friends and feeling alone who wakes up and consciously says that, but somehow this idea has gotten mixed in that if we live or make enough money, whether it's inside of therapy or outside of healing, looks like the idea of absence of whether I'm not trying to glorify suffering, but I am saying that to have an ongoing struggle feels very normal and very in step with Jesus rather than out of step.Jenny  (17:53):It makes me think of this term I love, and I can't remember who coined it at the moment, but it's the word, and it's the idea that your health and that could kind of be encompassing a lot of different things, relational health, spiritual health, physical health is co-opted by this neoliberal capitalistic idea that you are just this lone island responsible for your health and that your health isn't impacted by colonialism and white supremacy and capitalism and all of these things that are going to be detrimental to the wellness and health of all the different parts of you. And so I think that that's it or hyper spiritualizing it. Not to say there's not a spiritual component, but to say, yes, I've reduced this down to know that this is a stronghold or a demon. I think it abdicates responsibility for the shared relational field and how am I currently contributing and benefiting from those systems that may be harming you or someone else that I'm in relationship with. And so I think about spiritual warfare. Language often is an abdication for holding the tension of that relational field.Danielle  (19:18):Yeah, that's really powerful. It reminds me of, I often think of this because I grew up in these wild, charismatic religion spaces, but people getting prayed for and then them miraculously being healed. I remember one person being healed from healed from marijuana and alcohol, and as a kid I was like, wow. So they just left the church and this person had gotten up in front of the entire church and confessed their struggle or their addiction that they said it was and confessed it out loud with their family standing by them and then left a stage. And sometime later I ran into one of their kids and they're like, yeah, dad didn't drink any alcohol again, but he still hit my mom. He still yelled at us, but at church it was this huge success. It was like you didn't have any other alcohol, but was such a narrow view of what healing actually is or capacity they missed. The bigger what I feel like is the important stuff, whatever thatBut that's how I think about it. I think I felt in that type of therapy as I've reflected that it was a problem to be fixed. Whatever I had going on was a problem to be fixed, and my lack of progress or maybe persistent pain sometimes became this symbol that I somehow wasn't engaging in the therapeutic process of showing up, or I somehow have bought in and wanted that pain longterm. And so I think as I've reflected on that viewpoint from therapy, I've had to back out even from my own way of working with clients, I think there are times when we do engage in things and we're choosing, but I do think there's a lot of times when we're not, it's just happening.Jenny (21:29):Yeah, I feel like for me, I was trained in a model that was very aggressive therapy. It was like, you got to go after the hardest part in the story. You have to go dig out the trauma. And it was like this very intense way of being with people. And unfortunately, I caused a lot of harm in that world and have had to do repair with folks will probably have to do more repair with folks in the future. And through somatic experiencing training and learning different nervous system modalities, I've come to believe that it's actually about being receptive and really believing that my client's body is the widest person in the room. And so how do I create a container to just be with and listen and observe and trust that whatever shifts need to happen will come from that and not from whatever I'm trying to project or put into the space.Danielle (22:45):I mean, it's such a wild area of work that it feels now in my job, it feels so profoundly dangerous to bring in spirituality in any sense that says there's an unseen stronghold on you that it takes secret knowledge to get rid of a secret prayer or a specific prayer written down in a certain order or a specific group of people to pray for you, or you have to know, I mean, a part of this frame, I heard there's contracts in heaven that have agreed with whatever spirit might be in you, and you have to break those contracts in order for your therapy to keep moving forward. Now, I think that's so wild. How could I ever bring that to a client in a vulnerable?And so it's just like, where are these ideas coming from? I'm going to take a wild hair of a guest to say some white guy, maybe a white lady. It's probably going to be one or the other. And how has their own psychology and theology formed how they think about that? And if they want to make meaning out of that and that is their thing, great. But I think the problem is whenever we create a dogma around something and then go, and then this is a universal truth that is going to apply to my clients, and if it doesn't apply to my clients, then my clients are doing it wrong. I think that's incredibly harmful.Yeah, I know. I think the audacity and the level of privilege it would be to even bring that up with a client and make that assumption that that could be it. I think it'd be another thing if a client comes and says, Hey, I think this is it, then that's something you can talk about. But to bring it up as a possible reason someone is stuck, that there's demonic in their life, I think, well, I have, I've read recently some studies that actually increases suicidality. It increases self-harming behaviors because it's not the evil spirit, but it's that feeling of I'm powerless. Yeah,Jenny (25:30):Yeah. And I ascribed to that in my early years of therapy and in my own experience I had, I had these very intensive prayer sessions when therapy wasn't cutting it, so I needed to somehow have something even more vigorously digging out whatever it was. And it's kind of this weird both, and some of those experiences were actually very healing for me. But I actually think what was more healing was having attuned kind faces and maybe even hands on me sometimes and these very visceral experiences that my body needed, but then it was ascribed to something ethereal rather than how much power is in ritual and coming together and doing something that we can still acknowledge we are creating this,That we get to put on the meaning that we're making. We don't have to. Yeah, I don't know. I think we can do that. And I think there are gentler ways to do that that still center a sense of agency and less of this kind of paternalistic thinking too, which I think is historical through the field of psychology from Freud onwards, it was this idea that I'm the professional and I know what's best for you. And I think that there's been much work and still as much work to do around decolonizing what healing professions look like. And I find myself honestly more and more skeptical of individual work is this not only, and again, it's of this both, and I think it can be very helpful. And if individual work is all that we're ever doing, how are we then disabling ourselves from stepping into more of those places of our own agency and ability?Danielle (27:48):Man, I feel so many conflicts as you talk. I feel that so much of what we need in therapy is what we don't get from community and friendships, and that if we had people, when we have people and if we have people that can just hold our story for bits at a time, I think often that can really be healing or just as healing is meaning with the therapist. I also feel like getting to talk one-on-one with someone is such a relief at times to just be able to spill everything. And as you know, Jenny, we both have partners that can talk a lot, so having someone else that we can just go to also feels good. And then I think the group setting, I love it when I'm in a trusted place like that, however it looks, and because of so many ethics violations like the ones we're talking about, especially in the spiritual realm, that's one reason I've hung onto my license. But at the same time, I also feel like the license is a hindrance at sometimes that it doesn't allow us to do everything that we could do just as how do you frame groups within that? It just gets more complicated. I'm not saying that's wrong, it's just thoughts I have.Jenny (29:12):Totally. Yeah, and I think it's intentionally complicated. I think that's part of the problem I'm thinking about. I just spent a week with a very, very dear 4-year-old in my life, and Amari, my dog was whining, and the 4-year-old asked Is Amari and Amari just wanted to eat whatever we were eating, and she was tied to the couch so she wouldn't eat a cat. And Sean goes, Amari doesn't think she's okay. And the four-year-old goes, well, if Amari doesn't think she's okay, she's not okay. And it was just like this most precious, empathetic response that was so simple. I was like, yeah, if you don't think you're okay, you're not okay. And just her concern was just being with Amari because she didn't feel okay. And I really think that that's what we need, and yet we live in a world that is so disconnected because we're all grinding just to try to get food and healthcare and water and all of the things that have been commodified. It's really hard to take that time to be in those hospitable environments where those more vulnerable parts of us get to show upDanielle (30:34):And it can't be rushed. Even with good friends sometimes you just can't sit down and just talk about the inner things. Sometimes you need all that warmup time of just having fun, remembering what it's like to be in a space with someone. So I think we underestimate how much contact we actually need with people.Yeah. What are your recommendations then for folks? Say someone's coming out of that therapeutic space or they're wondering about it. What do you tell people?Jenny (31:06):Go to dance class.I do. And I went to a dance class last night, last I cried multiple times. And one of the times the teacher was like, this is $25. This is the cheapest therapy you're ever going to have. And it's very true. And I think it is so therapeutic to be in a space where you can move your body in a way that feels safe and good. And I recognize that shared movement spaces may not feel safe for all bodies. And so that's what I would say from my embodied experience, but I also want to hold that dance spaces are not void of whiteness and all of these other things that we're talking about too. And so I would say find what can feel like a safe enough community for you, because I don't think any community is 100% safe,I think we can hopefully find places of shared interest where we get to bring the parts of us that are alive and passionate. And the more we get to share those, then I think like you're saying, we might have enough space that maybe one day in between classes we start talking about something meaningful or things like that. And so I'm a big fan of people trying to figure out what makes them excited to do what activity makes them excited to do, and is there a way you can invite, maybe it's one, maybe it's two, three people into that. It doesn't have to be this giant group, but how can we practice sharing space and moving through the world in a way that we would want to?Danielle (32:55):Yeah, that's good. I like that. I think for me, while I'm not living in a warm place, I mean, it's not as cold as New York probably, but it's not a warm place Washington state. But when I am in a warm place, I like to float in saltwater. I don't like to do cold plunges to cold for me, but I enjoy that when I feel like in warm salt water, I feel suddenly released and so happy. That's one thing for me, but it's not accessible here. So cooking with my kids, and honestly my regular contact with the same core people at my gym at a class most days of the week, I will go and I arrive 20 minutes early and I'll sit there and people are like, what are you doing? If they don't know me, I'm like, I'm warming up. And they're like, yeah.(33:48):And so now there's a couple other people that are arrive early and they just hang and sit there, and we're all just, I just need to warm up my energy to even be social in a different spot. But once I am, it's not deep convo. Sometimes it is. I showed up, I don't know, last week and cried at class or two weeks ago. So there's the possibility for that. No one judges you in the space that I'm in. So that, for me, that feels good. A little bit of movement and also just being able to sit or be somewhere where I'm with people, but I'm maybe not demanded to say anything. So yeah,Jenny (34:28):It makes me think about, and this may be offensive for some people, so I will give a caveat that this resonates with me. It's not dogma, but I love this podcast called Search for the Slavic Soul, and it is this Polish woman who talks about pre-Christian Slavic religion and tradition. And one of the things that she talks about is that there wasn't a lot of praying, and she's like, in Slavic tradition, you didn't want to bother the gods. The Gods would just tell you, get off your knees and go do something useful. And I'm not against prayer, but I do think in some ways it seems related to what we're talking about, about these hyper spiritualizing things, where it's like, at what point do we actually just get up and go live the life that we want? And it's not going to be void of these symptoms and the difficult things that we have with us, but what if we actually let our emphasis be more on joy and life and pleasure and fulfillment and trust that we will continue metabolizing these things as we do so rather than I have to always focus on the most negative, the most painful, the most traumatic thing ever.(35:47):I think that that's only going to put us more and more in that vortex to use somatic experiencing language rather than how do I grow my counter vortex of pleasure and joy and X, y, Z?Danielle (35:59):Oh yeah, you got all those awards and I know what they are now. Yeah. Yeah. We're wrapping up, but I just wanted to say, if you're listening in, we're not prescribing anything or saying that you can't have a spiritual experience, but we are describing and we are describing instances where it can be harmful or ways that it could be problematic for many, many people. So yeah. Any final thoughts, Jenny? IJenny (36:32):Embrace the mess. Life is messy and it's alright. Buckle up.Kitsap County & Washington State Crisis and Mental Health ResourcesIf you or someone else is in immediate danger, please call 911.This resource list provides crisis and mental health contacts for Kitsap County and across Washington State.Kitsap County / Local ResourcesResourceContact InfoWhat They OfferSalish Regional Crisis Line / Kitsap Mental Health 24/7 Crisis Call LinePhone: 1‑888‑910‑0416Website: https://www.kitsapmentalhealth.org/crisis-24-7-services/24/7 emotional support for suicide or mental health crises; mobile crisis outreach; connection to services.KMHS Youth Mobile Crisis Outreach TeamEmergencies via Salish Crisis Line: 1‑888‑910‑0416Website: https://sync.salishbehavioralhealth.org/youth-mobile-crisis-outreach-team/Crisis outreach for minors and youth experiencing behavioral health emergencies.Kitsap Mental Health Services (KMHS)Main: 360‑373‑5031; Toll‑free: 888‑816‑0488; TDD: 360‑478‑2715Website: https://www.kitsapmentalhealth.org/crisis-24-7-services/Outpatient, inpatient, crisis triage, substance use treatment, stabilization, behavioral health services.Kitsap County Suicide Prevention / “Need Help Now”Call the Salish Regional Crisis Line at 1‑888‑910‑0416Website: https://www.kitsap.gov/hs/Pages/Suicide-Prevention-Website.aspx24/7/365 emotional support; connects people to resources; suicide prevention assistance.Crisis Clinic of the PeninsulasPhone: 360‑479‑3033 or 1‑800‑843‑4793Website: https://www.bainbridgewa.gov/607/Mental-Health-ResourcesLocal crisis intervention services, referrals, and emotional support.NAMI Kitsap CountyWebsite: https://namikitsap.org/Peer support groups, education, and resources for individuals and families affected by mental illness.Statewide & National Crisis ResourcesResourceContact InfoWhat They Offer988 Suicide & Crisis Lifeline (WA‑988)Call or text 988; Website: https://wa988.org/Free, 24/7 support for suicidal thoughts, emotional distress, relationship problems, and substance concerns.Washington Recovery Help Line1‑866‑789‑1511Website: https://doh.wa.gov/you-and-your-family/injury-and-violence-prevention/suicide-prevention/hotline-text-and-chat-resourcesHelp for mental health, substance use, and problem gambling; 24/7 statewide support.WA Warm Line877‑500‑9276Website: https://www.crisisconnections.org/wa-warm-line/Peer-support line for emotional or mental health distress; support outside of crisis moments.Native & Strong Crisis LifelineDial 988 then press 4Website: https://doh.wa.gov/you-and-your-family/injury-and-violence-prevention/suicide-prevention/hotline-text-and-chat-resourcesCulturally relevant crisis counseling by Indigenous counselors.Additional Helpful Tools & Tips• Behavioral Health Services Access: Request assessments and access to outpatient, residential, or inpatient care through the Salish Behavioral Health Organization. Website: https://www.kitsap.gov/hs/Pages/SBHO-Get-Behaviroal-Health-Services.aspx• Deaf / Hard of Hearing: Use your preferred relay service (for example dial 711 then the appropriate number) to access crisis services.• Warning Signs & Risk Factors: If someone is talking about harming themselves, giving away possessions, expressing hopelessness, or showing extreme behavior changes, contact crisis resources immediately.Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that. Well, first I guess I would have to believe that there was or is an actual political dialogue taking place that I could potentially be a part of. And honestly, I'm not sure that I believe that.

Contributor: Meghan Hurley, MD Educational Pearls: 1. Initial Assessment Start with a physical examination: Determine if the bleed is anterior or posterior. Perform a primary survey: assess airway, breathing, and circulation (ABCs). Airway compromise = intubation immediately. If the patient is stable, have them blow out any clots, then re-examine the nares. 2. Topical Medications Anesthetics: provide local anesthesia and pain relief. Lidocaine Tetracaine Vasoconstrictors: reduce bleeding. LET (Lidocaine, Epinephrine, Tetracaine) is ideal because it provides anesthesia and vasoconstriction. Cocaine pledgets (less common). Tranexamic acid (TXA). Oxymetazoline (Afrin). Cautery (Chemical): If an anterior bleed is visualized, silver nitrate can be applied for cauterization 3. Technique Tips Use a nasal speculum. Spread up and down rather than side to side to avoid injury to the septum. Place LET-soaked gauze in the nares. Apply a nasal clamp for ~15 minutes to compress the vessels. Note that pledgets may cause upper lip numbness 4. Reassessment After 15 minutes, remove materials and inspect for a source of bleeding. If still bleeding and a source is identified, cauterize the site. Observe for 15 minutes to monitor for recurrence of bleeding. 5. Packing If the above measures fail to control bleeding: Anterior packing: Nasal tampon (Merocel) Convenient for outpatient removal. Balloon device Inflate the anterior balloon for compression. Posterior packing:  More complex, should consult ENT for additional assistance. 6. Disposition & Follow-Up Although rare, toxic shock syndrome is a possible complication of nasal packing. Antibiotic prophylaxis is controversial, but may be considered in high-risk patients. Outpatient follow-up if stable: Tampon: The patient can remove it at home. Balloon: Return to ED for removal. 7. Risk Factors for Epistaxis & Prevention Deviated septum, dry environments, and anticoagulant use Advise on humidifier use, nasal saline, and medication review to minimize future episodes. References: Tunkel DE, Anne S, Payne SC, et al. Clinical Practice Guideline: Nosebleed (Epistaxis). Otolaryngology–Head and Neck Surgery. 2020;162(1_suppl):S1-S38. doi:10.1177/0194599819890327   Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons and Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/  

Let's be honest: the decision to go into a treatment program can feel terrifying. You're juggling work, kids, a million invisible tasks—and the idea of raising your hand and stepping away (even briefly) can feel impossible. What if people judge you? What if your boss notices? What if your partner uses it against you? What if the moms at the bus stop whisper? Here's the truth I wish someone had told me: the fear of getting help is almost always louder than the reality of it. I was much more worried about what people might think if I stopped drinking than I ever was about showing up hungover on a Tuesday. (Make it make sense, right?) To pull back the curtain and demystify treatment, I sat down with Jana Wu, Director of Clinical Integration at Mountainside Treatment Center and a mom in recovery who's helped women navigate every pathway: detox, inpatient, PHP, IOP, outpatient, medication—without shame and without blowing up their lives.  I asked Jana to share how to choose the right level of care, what modern programs actually look like, and how families can support—not sabotage—your healing. For the full shownotes, kindly go to this podcast episode link: https://hellosomedaycoaching.com/scared-to-try-rehab-real-talk-on-inpatient-outpatient-detox-and-recovery-options-for-women/ 4 Ways I Can Support You In Drinking Less + Living More Join The Sobriety Starter Kit, the only sober coaching course designed specifically for busy women. My proven, step-by-step sober coaching program will teach you exactly how to stop drinking  — and how to make it the best decision of your life. Save your seat in my FREE MASTERCLASS, 5 Secrets To Successfully Take a Break From Drinking  Grab the Free 30-Day Guide To Quitting Drinking, 30 Tips For Your First Month Alcohol-Free. Connect with me for free sober coaching tips, updates + videos on YouTube, Instagram, Facebook, Pinterest and TikTok @hellosomedaysober. Love The Podcast and Want To Say Thanks? ☕ Buy me a coffee! In the true spirit of Seattle, coffee is my love language. So if you want to support the hours that go into creating this show each week, click this link to buy me a coffee and I'll run to the nearest Starbucks + lift a Venti Almond Milk Latte and toast to you! https://www.buymeacoffee.com/hellosomeday 

In today's VETgirl online veterinary continuing education podcast, we're diving into a hot topic: managing pancreatitis in dogs. More specifically, we're taking a closer look at an outpatient treatment protocol. Let's face it, treatment for pancreatitis can be prolonged and expensive, often requiring hospitalization, intravenous (IV) fluids, antiemetic therapy, nutritional support, analgesics, anti-inflammatory therapy, and 24/7 care, and that's not always possible for some clients and patients. But what if there were a practical, cost-conscious alternative that could be managed outside the hospital for the more mild to moderate cases that strikes a balance between effective clinical care and financial feasibility for clients?Sponsored By: Ceva Animal Health

In today's VETgirl online veterinary continuing education podcast, we're diving into a hot topic: managing pancreatitis in dogs. More specifically, we're taking a closer look at an outpatient treatment protocol. Let's face it, treatment for pancreatitis can be prolonged and expensive, often requiring hospitalization, intravenous (IV) fluids, antiemetic therapy, nutritional support, analgesics, anti-inflammatory therapy, and 24/7 care, and that's not always possible for some clients and patients. But what if there were a practical, cost-conscious alternative that could be managed outside the hospital for the more mild to moderate cases that strikes a balance between effective clinical care and financial feasibility for clients?Sponsored By: Ceva Animal Health