Podcasts about Palliative care

In 1987, Mary P. Lovato, a member of Kewa Pueblo in New Mexico, was diagnosed with acute leukemia. To receive a bone marrow transplant, she had to travel more than 800 miles from home because specialized cancer care was unavailable through the Indian Health Service. When she returned, she discovered another obstacle: many in her community feared cancer so deeply that they avoided speaking about it altogether.This episode examines how cancer survivorship exposed profound inequities in the American healthcare system. Long before health equity became a national priority, advocates from underserved communities were confronting disparities rooted in geography, poverty, racism, language, underfunded healthcare systems, and historical mistrust of medical institutions. Their work demonstrated that scientific advances alone cannot improve survival if patients cannot reach, afford, or trust the care available to them.The story follows pioneers including Mary P. Lovato, who built the first national Native-led cancer support and education program for Indigenous communities, and Maimah Karmo, founder of the Tigerlily Foundation, whose breast cancer diagnosis inspired a movement to improve early detection, clinical trial participation, and representation for Black women. Their advocacy challenged longstanding barriers to culturally competent care while highlighting persistent inequities in access to screening, fertility preservation, navigation, and innovative treatments.The episode also explores why diversity in clinical research matters. For decades, many cancer clinical trials disproportionately enrolled White patients, limiting both access to promising therapies and the scientific understanding of how treatments perform across different populations. Researchers, patient advocates, and community leaders responded by redesigning outreach, improving patient navigation, reducing logistical barriers, and insisting that affected communities help shape the research itself.Cancer survivorship cannot be measured solely by scientific breakthroughs. It also depends on whether every patient has a meaningful opportunity to benefit from them. The pursuit of health equity remains one of the defining challenges and enduring responsibilities of modern oncology.RELATED LINKSNational Cancer Institute | Cancer Health Disparities⁠Indian Health Service⁠Tigerlily Foundation⁠National Cancer Institute | Cancer Clinical Trials⁠American Indian Cancer Foundation⁠Abramson Cancer Center | University of Pennsylvania⁠FEEDBACKLike this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to podcasts@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In 2000, Katie Couric underwent a live colonoscopy on national television following the death of her husband, Jay Monahan, from colorectal cancer at age 42. The broadcast demystified a procedure many Americans feared, led to an estimated 20% increase in colonoscopy screenings, and became one of the clearest examples of how public storytelling can change healthcare behavior.This episode examines how celebrities, journalists, filmmakers, and entertainers helped reshape the public conversation about cancer during a period when survivorship was becoming increasingly visible. As breakthroughs in targeted therapies, immunotherapy, and early detection allowed more people to live beyond cancer, public figures used their platforms to encourage screening, reduce stigma, and accelerate research. Their influence extended far beyond awareness campaigns, helping transform cancer from a private diagnosis into a national public health conversation.Central to this story is Laura Ziskin, the Hollywood producer behind Pretty Woman and the Spider-Man films, whose metastatic breast cancer diagnosis inspired the creation of Stand Up To Cancer. Working alongside Couric and leaders from entertainment, journalism, and biomedical research, Ziskin championed a new funding model that required multidisciplinary scientific collaboration, helping accelerate discoveries that contributed to multiple FDA-approved cancer therapies. The episode also highlights the advocacy of actor Patrick Dempsey, whose family's experience with ovarian cancer led to the creation of the Dempsey Center, expanding support for patients and caregivers beyond medical treatment.The story also asks what celebrity advocacy often leaves unsaid. Financial toxicity, caregiver burden, chronic pain, mental health, and the long-term effects of treatment rarely receive the same attention as dramatic diagnoses or breakthrough cures. As cancer survivorship continues to evolve, the greatest challenge may not be convincing people to care about cancer, but helping them understand what it truly means to live with and beyond it.RELATED LINKSStand Up To Cancer⁠Katie Couric Media⁠Dempsey Center⁠American Association for Cancer Research⁠National Cancer Institute⁠Dana-Farber Cancer Institute | Adult Survivorship Program⁠FEEDBACKLike this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to podcasts@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

How do families navigate a serious childhood diagnosis while still focusing on hope, quality of life, and the everyday moments that matter most? In this episode of Inside the Children's Hospital Podcast, Katie Taylor sits down with Dr. Korie Leigh, PhD, CCLS, a child life specialist, psychologist, thanatologist, author, educator, and pediatric palliative care advocate. Drawing on more than two decades of supporting children and families, Dr. Leigh shares what pediatric palliative care really is—and why it is so much more than many families believe. Together, they explore how pediatric palliative care supports children living with serious or complex medical conditions from the time of diagnosis, helping families manage not only medical needs, but also emotional, psychosocial, and spiritual well-being. Dr. Leigh discusses how parents can advocate for palliative care services, even if they are not offered at their local hospital, and explains why caregiver support and respite care are essential parts of caring for the whole family. The conversation also dives into resilience, grief, and the power of creativity. Dr. Leigh shares how writing can become a meaningful tool for processing difficult experiences, why preparing children for life's hardest moments matters, and how her books were created to help families navigate conversations surrounding illness, hospitalization, and loss with confidence and compassion. Whether you're navigating a new diagnosis, caring for a child with a complex medical condition, supporting a family through hospitalization, or you're a healthcare professional looking to better understand pediatric palliative care, this episode offers practical insights, encouragement, and hope. In This Episode, We Discuss: What pediatric palliative care really means The difference between palliative care and hospice Why palliative care should begin at diagnosis How parents can advocate for pediatric palliative care Finding support when services aren't available locally Caregiver burnout and the importance of respite care Building resilience during a child's medical journey Talking with children about illness, grief, and loss Using writing and creativity as tools for healing Improving access to pediatric palliative care through advocacy   Episode Timestamps 00:00 Meet Dr. Korie Leigh 02:33 A career in child life and palliative care 05:25 What is pediatric palliative care? 08:00 How parents can advocate for support 10:59 Insurance and access to care 12:05 Why respite care matters 14:18 Supporting families beyond the hospital 15:07 Building resilience through crisis 19:13 Writing through grief and healing 22:26 Creativity as a coping tool 27:29 Books, music, and final reflections Resources Mentioned When Everything Changes: Parenting through Loss and Grief by Dr. Korie Leigh Hero's Path Palliative Dr. Korie Leigh's Website Leigh Moody (music) George Mark Children's House The Artist's Way by Julia Cameron Medical information shared in this episode is not a substitute for professional medical advice. Please consult your healthcare team for guidance specific to your child and family.  

In 2006, a landmark report titled Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults with Cancer confirmed what young survivors had been saying for years. While survival rates for children and older adults had steadily improved, adolescents and young adults had experienced decades of stalled progress. They had become cancer's lost generation.This episode explores how young adult survivors transformed their shared isolation into one of the most influential grassroots movements in cancer advocacy. Diagnosed during the years typically devoted to education, careers, relationships, and starting families, patients between the ages of 15 and 39 confronted challenges that extended far beyond treatment. Fertility preservation, sexual health, employment, financial toxicity, insurance, and long-term quality of life were rarely discussed in oncology clinics, leaving many to navigate survivorship alone.The episode follows advocates including Tamika Felder, Lindsay Avner, Heidi Adams, Doug Ulman, and Dr. Archie Bleyer, whose research and advocacy fundamentally changed how medicine understands adolescent and young adult cancer. Through organizations including Planet Cancer, Fertile Hope, the Lance Armstrong Foundation, and later Stupid Cancer, survivors built online communities, educational resources, conferences, and national partnerships that challenged long-standing assumptions about cancer care. Their work helped establish fertility preservation as a standard discussion before treatment, expanded research dedicated to adolescent and young adult oncology, and elevated quality of life as a critical clinical outcome alongside survival.The movement also demonstrated the power of lived experience to reshape medicine. Survivors became researchers, educators, nonprofit founders, and policy advocates, insisting that cancer care account not only for years of life saved, but for the lives patients hoped to build afterward.What began as a search for peers evolved into a national movement that permanently transformed adolescent and young adult oncology. Today, dedicated research programs, clinical fellowships, survivorship resources, and patient advocacy organizations continue to build on the foundation these young cancer mavericks created.RELATED LINKSNational Cancer Institute | Adolescent and Young Adult (AYA) Cancer Program⁠Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults with Cancer⁠American Society of Clinical Oncology | Fertility Preservation Guidelines⁠Stupid Cancer⁠Livestrong Foundation⁠Journal of Adolescent and Young Adult Oncology⁠FEEDBACKLike this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to podcasts@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The Enlightened Family Business Podcast Ep. 167: The One Plan Every Family Is Missing with Libby Boatwright   In this episode of the Enlightened Family Business Podcast, host Chris Yonker sits down with Libby Boatwright — certified financial planner, former Stanford Medical Center chaplain, pastor, and author of The Last Things We Talk About — for a candid, deeply practical conversation about the one plan most families never make: an end-of-life plan. Drawing on decades of experience in palliative care, hospice work, financial planning, and pastoral ministry, Libby walks through the full spectrum of what families need to navigate when a loved one faces a serious diagnosis or decline — and why waiting until the last minute makes everything harder and more costly. Chris and Libby explore the critical difference between palliative care and hospice, how hospitals really operate and what they won't tell you, why your advanced directive is your most important legal document, the caregiving crisis quietly bankrupting American families, how to be an effective patient advocate inside a system not designed to help you, and what it actually looks like to help a loved one die well. Chris also shares his own firsthand experience navigating hospice for both parents — including a powerful story about standing up to a hospital trying to redirect his mother's care. This is a conversation every family should hear before they need it. Episode Chapters ·       2:22   Meet Libby Boatwright ·       4:31   What End-of-Life Planning Actually Covers ·       7:29   When the Diagnosis Arrives: Legacy, Bucket Lists, and Getting the House in Order ·       10:00  The Circles of Support — Who Will Be There When It Matters? ·       12:44  How to Start the Conversation When Families Don't Want To ·       15:00  The Advanced Directive, HIPAA, and the POLST — The Three Essential Documents ·       18:32  The Caregiving Crisis: Costs, Burnout, and Family Conflict ·       23:36  Alzheimer's, Memory Care, and What It Actually Costs ·       26:17  Protecting Assets: Trusts, Look-Back Periods, and Planning Ahead ·       28:13  Navigating the Hospital System: Case Managers, Patient Advocates, and How to Fight for Your Loved One ·       35:00  Palliative Care: What It Is, When to Use It, and Why Most People Don't Know ·       38:09  Hospice: Medicare's Gift at the End of Life ·       41:18  Chris's Story: Standing Up to the Hospital ·       46:59  About the Book: The Last Things We Talk About ·       50:16  Resources and Farewell   Websites ·       elizabethboatwright.com ·       chrisyonker.com   Book ·       The Last Things We Talk About: Your Guide to End of Life Transitions by Elizabeth Boatwright (Bull Publishing, 2021) — available on Amazon   About Libby Boatwright Rev. Dr. Elizabeth "Libby" Boatwright, BCC-PCHAC, CFP, is a chaplain, pastor, certified financial planner, and author who has spent over 30 years counseling families on end-of-life issues, loss, grief, estate planning, and the emotional and spiritual dimensions of dying. She served as a Relief Chaplain in Oncology Outpatient Palliative Care Medicine at Stanford Health Care, where she worked alongside hundreds of patients and families navigating serious illness and end-of-life transitions. In her book The Last Things We Talk About: Your Guide to End of Life Transitions (Bull Publishing, 2021), Libby offers a practical framework for creating what she calls the "white book" — a simple binder or flash drive of all the materials a family will need when a loved one passes — helping heirs avoid what she calls "the treasure hunt" of lost documents and unspoken wishes. Libby has lectured at universities, colleges, and medical institutions, led seminars at national conventions, faith communities, parenting groups, senior fellowships, and estate planning forums. She has published in Cancer.net, Morningstar, CSA Journal, and Barron's, and has been featured in newspapers across the country. She has also appeared on ABC Nightly News and hosted her own radio show, The Fiscal Therapist, on KAIM. Libby holds Master's degrees from UC Berkeley, San Francisco State University, and Fuller Seminary, a Doctor of Ministry in Semiotics and Future Studies from George Fox University, and holds certifications as a Certified Financial Planner and Board Certified Chaplain with Advanced Certification in Hospice and Palliative Care. She lives in Northern California.

Gugs Mhlungu speaks with resident clinical psychologist Dr Khosi Jiyane, about finding the right words to comfort someone who is terminally ill and approaching the end of life. They discuss being honest without overthinking what to say, recognising that the person may already understand their condition, and allowing space for different responses to grief and death. Gugs Mhlungu gets you ready for the weekend each Saturday and Sunday morning on 702. She is your weekend wake-up companion, with all you need to know for your weekend. The topics Gugs covers range from lifestyle, family, health, and fitness to books, motoring, cooking, culture, and what is happening on the weekend in 702land. Thank you for listening to a podcast from 702 Weekend Breakfast with Gugs Mhlungu. Listen live on Primedia+ on Saturdays and Sundays from 06:00 and 10:00 (SA Time) to Weekend Breakfast with Gugs Mhlungu broadcast on 702 https://buff.ly/gk3y0Kj For more from the show go to https://buff.ly/u3Sf7Zy or find all the catch-up podcasts here https://buff.ly/BIXS7AL Subscribe to the 702 daily and weekly newsletters https://buff.ly/v5mfetc Follow us on social media: 702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio702See omnystudio.com/listener for privacy information.

In 2006, the Institute of Medicine published From Cancer Patient to Cancer Survivor: Lost in Transition, concluding that millions of Americans were surviving cancer only to find themselves navigating a healthcare system unprepared for life after treatment. The report challenged oncology to recognize that curing cancer was not the end of care, but the beginning of survivorship.This episode explores how the growing cancer survivorship movement exposed the long-term consequences of cancer treatment that medicine had largely overlooked. As survival rates improved following the National Cancer Act of 1971, millions of survivors faced chronic fatigue, neuropathy, infertility, cognitive impairment, financial hardship, employment discrimination, anxiety, depression, and post-traumatic stress. These were not rare complications. They became defining features of survivorship for many patients.Drawing on the work of oncologist Dr. Patricia Ganz, survivor advocate Ellen Stovall, and researchers, clinicians, and survivors across the country, the episode examines how survivorship research expanded beyond recurrence and mortality to include quality of life, psychosocial care, rehabilitation, and long-term follow-up. Their efforts helped establish survivorship care plans, multidisciplinary survivorship clinics, and a broader understanding that cancer affects every aspect of a person's life long after treatment ends.The episode also confronts persistent inequities in survivorship care. Insurance coverage often ends when treatment stops, supportive services remain inconsistent, financial toxicity continues to drive medical hardship, and racial, geographic, and socioeconomic disparities still influence who receives comprehensive follow-up care. For many survivors, finishing treatment simply marks the beginning of another struggle.Modern oncology increasingly recognizes that surviving cancer is measured by more than years of life. It is also measured by quality of life, dignity, access to care, and the ability to rebuild a future after treatment. That evolution remains one of the most significant legacies of the cancer survivorship movement.RELATED LINKSNational Academy of Medicine | ⁠From Cancer Patient to Cancer Survivor: Lost in Transition⁠National Cancer Institute Office of Cancer Survivorship⁠American Society of Clinical Oncology | Survivorship Compendium⁠CancerCare⁠HopeWell Cancer Support⁠National Coalition for Cancer Survivorship⁠FEEDBACKLike this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to podcasts@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In 1967, breast surgeon Dr. Harold P. Freeman arrived at Harlem Hospital expecting to treat cancer. Instead, he confronted a healthcare system where poverty, racism, lack of insurance, and institutional barriers often determined who lived long enough to receive treatment. Patients frequently arrived with advanced disease, not because medicine lacked answers, but because access to care had failed them.This episode explores how cancer survivorship expanded beyond medical breakthroughs to include healthcare access, health equity, and organized advocacy. Building on the early work of the National Coalition for Cancer Survivorship (NCCS), it examines the recognition that surviving cancer depended not only on research, but also on whether patients could navigate a fragmented healthcare system.Freeman responded by creating one of the nation's first patient navigation programs at Harlem Hospital in 1990. Community-based navigators helped patients overcome practical barriers including insurance, transportation, appointments, communication, and fear. The model dramatically improved timely diagnosis and treatment, increased breast cancer survival in Harlem, and ultimately inspired the Patient Navigator Outreach and Chronic Disease Prevention Act of 2005, establishing navigation as a cornerstone of modern oncology care.The episode also follows cancer survivor Ellen Stovall, whose leadership transformed survivorship into a national policy movement. Through the NCCS, she united advocates across cancer types, fought for insurance protections, expanded access to clinical trials, helped shape the creation of the Office of Cancer Survivorship at the National Cancer Institute, and organized the landmark 1998 National March for Cancer Survivorship in Washington, D.C. Her work reframed survivorship as a public policy issue rather than a personal experience.Together, Freeman and Stovall demonstrated that scientific progress alone could not eliminate disparities in cancer outcomes. Their work established two enduring principles that continue to shape oncology today: patients need someone to help them navigate care, and survivors must have a voice in the policies that govern it. Modern cancer survivorship depends on both.RELATED LINKSNational Coalition for Cancer Survivorship⁠Harold P. Freeman Patient Navigation Institute⁠National Cancer Institute Office of Cancer Survivorship⁠Patient Navigator Outreach and Chronic Disease Prevention Act of 2005⁠American Cancer Society⁠Tuskegee Study Timeline | Centers for Disease Control and Prevention⁠FEEDBACKLike this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to podcasts@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Welcome to a very, very, very special bonus episode of Out of Patients, and one unlike anything published on this feed before. For nearly 20 years, Matthew Zachary has handed these microphones to patients, caregivers, doctors, advocates, troublemakers, and people with something worth saying. This time, he handed them to his daughter. Hannah Greenzweig grew up around this show, and now she has commandeered the studio with 3 of her wonderfully creative high school friends to talk about something they built entirely themselves. There is an enormous amount of Dad Pride baked into this episode, along with the strange and wonderful realization that sometimes your kid grows up, takes your chair, takes your microphone, and produces a better show without you.Hannah Greenzweig, Michael Aidinov, Gwendolyn Baldini, and Astronomy are student artists from the Roundabout Youth Ensemble at James Madison High School in Brooklyn. Working alongside teaching artists from Roundabout Theatre Company, they spent a school year creating an original play from the ground up, writing every scene, developing every character, and producing the performance themselves.Instead of discussing a Broadway production, they dissect one they invented.Their play, Subject Matter, began with a room full of improbable ideas. Murderous bounce houses, pirate family sagas, underwater adventures, courtroom dance battles, and birthday parties at math museums all competed before the group settled on an absurd rivalry between New York's fictional History Museum and Math Museum. From there, they built a fully staged comedy about institutional competition, sabotage, oversized personalities, and the unexpected discovery that history and mathematics need each other more than either side wants to admit.The conversation pulls back the curtain on a creative process most audiences never see. The students explain how scenes evolved through constant rewrites, how characters emerged from improvisation, how costumes came together with last minute ingenuity, and how rehearsals often collapsed into uncontrollable laughter. They recount cutting favorite ideas, solving production problems with limited resources, and trusting each other enough to keep rewriting until the story worked.The episode also captures something harder to script: teenagers speaking honestly about collaboration without adults translating their experience. They celebrate classmates who stepped into unexpected roles, teachers who quietly held the production together, and the strange joy of creating something that exists only because everyone showed up.It is a conversation about theater, friendship, education, creativity, and what happens when 4 young artists get the microphones and the adults get out of the way.RELATED LINKSRoundabout Theatre CompanyRoundabout Youth EnsembleJames Madison High SchoolFEEDBACKLike this bonus episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

End-of-life doulas are becoming an increasingly common part of how Americans approach death, helping people to navigate the dying process outside of traditional medical care. Alexandra Schwartz, staff writer at The New Yorker and co-host of the Critics at Large podcast, talks about the rise of death doulas, what they actually do, and why more people are rethinking how they want to die. And Virginia Chang, Ph.D., end-of-life doula and author of Preparing For End of Life For Dummies (Wiley 2026), talks about her approach to her work. Photo: Pauline Ramsey is on hospice care through Heartland Hospice. She has pancreatic cancer. Her nurse is Carly Bond and her aide is Nadege Filsaime. (Susan L. Angstadt via MediaNews Group/Reading Eagle & Getty Images) Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

As Diane Meier remarks to start today's podcast, palliative care has come a long way from the days when we were the "brink of death" consult. We're seeing patients earlier and earlier in the course of illness.  In fact, the evidence base for specialist palliative care is arguably stronger in the outpatient setting than the inpatient setting. In some ways, as Eric remarked, we are a victim of our own success. We've pushed on the boundaries of seeing patients earlier in the course of illness, we've demonstrated remarkable value to our colleagues and health systems: now they want us to see more and more patients, with conditions we would not have previously considered core to palliative care practice. Our guests modeled respectful disagreement, and we were somewhat surprised that there was more agreement than we expected.  I'm sure you will all have strong feelings about the opinions expressed, please let us know! In addition to Diane Meier, we welcome back Bob Arnold and Justin Sanders to talk through these issues, including: We agree specialist palliative care is for people with "serious illness" - but what constitutes "serious illness" Is a limited prognosis part of the definition of serious illness?  We discuss the Center to Advance Palliative Care definition of palliative care and Amy Kelley's oft-cited definition of serious illness.   Many patients with conditions that overlap with palliative care would benefit from our help, e.g. chronic pain, opioid use disorder, mental illness. Our health system is not meeting their needs.  Should palliative care see them, in the absence of a clear life-limiting illness? How limited a prognosis should we consider here - months, years…decades? We have a tremendous workforce shortage.  There are not enough specialist palliative care providers to see all patients with advanced cancer, much less the many other conditions whose guidelines now say should include palliative care.  The reality does not match the mission.  Does that change our mission?  Should local workforce issues dictate who should see palliative care? See this article by Pelleg in which clinicians at Mt Sinai agreed that patients with serious illness and high risk of mortality should be prioritized, explicitly excluding patients with chronic pain or psychosocial distress in the absence of serious illness. What is the role for Patient Reported Outcomes (PROs)? e.g. patients regularly reporting pain or other symptoms and an escalation in symptoms triggering a palliative care intervention.  How is the definition of who should see palliative care expanding in Canada, and is there a linkage to who is eligible for medical aid in dying in Canada.  Justin makes a good plug for the McGill National Palliative Care Grand Rounds Programme What is our vision for where palliative care should be 10 years from now? Population health specialists, or healing patients one visit at a time? To be sure, these are not mutually exclusive. How long should palliative care fellowship be - should we expand it to 3 years so palliative care specialists can care for people with a wider range of conditions?   What is Precision Palliative Care? Diane mentions this article by Ramy Sedhom on a couple of occasions.   Should palliative care see patients with sickle cell disease? How about survivorship clinics? How about very elderly patients with multiple mild chronic conditions (e.g. mild heart failure, mild COPD, mild cognitive impairment, arthritis, diabetes, hypertension)? And much more! Please listen to the audio only version of Stand by Me - my son Renn added an upright base, snap, and triangle parts - it's much better than the live version for YouTube that I accidentally started in a much too high key!  

A man is struck by a car on the streets of Los Angeles. In the emergency department, a CT scan ordered to look for traumatic injuries reveals something nobody expected: a mass in his colon. Days later, sitting across from Dr. Belinda Waltman, he calls the accident “a blessing in disguise.” Then he changes the subject. He is less worried about cancer than about whether he can afford to miss another day of work. In this season finale of Standard Deviation, host Dr. Oliver Bogler explores what happens when biomedical science collides with the realities of the healthcare safety net. Dr. Waltman, a primary care physician in Los Angeles County, specializes in expedited cancer workups for uninsured and underinsured patients. Every diagnosis arrives carrying another set of questions about housing, transportation, food insecurity, wages, and survival that rarely appear in medical records or scientific literature. For years, Waltman carried those stories without knowing how to bring them into the academic record. As a full-time clinician without a research lab, grant funding, or publication pipeline, she faced barriers familiar to many working scientists and physicians whose most important observations happen outside traditional research settings. With support from the Life Science Editors Foundation's JEDI program, those experiences became The Margins Matter, a narrative medicine essay published in JAMA that argues the social realities surrounding cancer care are not background details. They are part of the disease itself. Bogler traces how editorial mentorship transformed lived clinical experience into published scholarship while asking a larger question about who gets to shape the scientific record. The conversation examines cancer care, Medicaid, health-related social needs, medical publishing, and the structural incentives that determine which stories become evidence and which disappear from view.The result is a conversation about documentation, visibility, and why the margins of medicine often determine who survives long enough to benefit from its advances.RELATED LINKSDr. Belinda Waltman⁠The Margins Matter | JAMA⁠The Margins Matter | PubMed⁠Life Science Editors Foundation⁠FEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In 1986, 23 survivors, physicians, nurses, attorneys, and community organizers gathered in Albuquerque, New Mexico, for a weekend that would permanently change the language and politics of cancer. Working late into the night, they debated not only strategy, but identity, ultimately declaring that from the moment of diagnosis, every person with cancer is a survivor.This episode traces the social and political forces that gave birth to the modern cancer survivorship movement. As advances in early detection and treatment allowed more people to live beyond cancer, survivors discovered that finishing treatment did not mean returning to normal life. Many faced employment discrimination, loss of insurance, social stigma, infertility, chronic health complications, and a healthcare system that viewed survival as the end of care rather than the beginning of a new chapter.Against the backdrop of the civil rights, disability rights, and community health movements of the 1960s and 1970s, physicians, activists, and survivors challenged medicine's paternalistic culture and demanded a greater voice in decisions affecting their lives. Central to this story are physician and survivor Dr. Fitzhugh Mullan, whose landmark 1985 essay, Seasons of Survival, redefined survivorship as a lifelong continuum, and community organizer Katherine Logan, whose determination united dozens of grassroots organizations into what became the National Coalition for Cancer Survivorship.The coalition's founding established principles that continue to shape oncology today. Survivors were no longer defined solely by disease or treatment outcomes. Their experiences became evidence. Their voices became essential to clinical research, healthcare policy, and patient advocacy. By redefining survivorship as an ongoing experience rather than a destination, the movement challenged medicine to recognize the lasting physical, emotional, financial, and social consequences of cancer.The ideas forged during that weekend in Albuquerque became the foundation of modern cancer survivorship. Nearly 40 years later, the coalition's defining principle, that survivorship begins at diagnosis, continues to influence cancer care, research, policy, and the way millions of people understand life after cancer.RELATED LINKSNational Coalition for Cancer Survivorship⁠National Cancer Institute Office of Cancer Survivorship⁠The New England Journal of Medicine⁠Americans with Disabilities Act (ADA.gov)⁠Library of Congress | Civil Rights History Project⁠White Coat, Clenched Fist by Fitzhugh Mullan⁠FEEDBACKLike this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to podcasts@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Send us Fan MailWhat if the biggest breakthrough in hospice care isn't a new technology—but a better way of focusing on what matters most?In Part Two of this special conversation, host Chris Comeaux continues his discussion with Kelly McCutcheon Adams and Margherita Labson about how the Four M's Framework—What Matters, Medication, Mentation, and Mobility—is transforming hospice and palliative care into a more reliable, person-centered model. Together, they explore why exceptional hospice care goes far beyond symptom management to preserve dignity, independence, emotional well-being, and meaningful moments for patients and families. The conversation dives into practical questions every hospice leader and clinician should be asking:How can we better address delirium, depression, and cognition at the end of life?Why should mobility be viewed as preserving independence instead of simply preventing falls?Is it time to add a fifth "M" to the framework?What would healthcare look like if every decision truly began with what matters most?Kelly and Margherita also paint a compelling vision for the future of hospice—one where earlier conversations, better continuity of care, and reliable systems lead to fewer late hospice admissions, better patient experiences, and stronger healthcare organizations. Their message to leaders is both practical and inspiring: hospice is not something to apologize for—it's one of healthcare's greatest expressions of compassion. Whether you're a hospice executive, palliative care professional, healthcare leader, clinician, nonprofit executive, or someone passionate about improving the patient experience, this episode offers actionable insights that can reshape the way you think about quality care.In This Episode:✅ Why Mentation deserves greater attention in hospice care✅ Looking beyond fall prevention to meaningful Mobility✅ The debate over adding a Fifth M to Age-Friendly Care✅ Why earlier hospice conversations improve patient outcomes✅ Practical leadership advice for creating reliable, person-centered care systems✅ Resources available through the Institute for Healthcare Improvement (IHI)Guest: Kelly McCutcheon Adams, Senior Director at the Institute for Healthcare Improvement (IHI)Margherita Labson, President and CEO, MCLabson Consultation and Education ServicesHost:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipLearn More➡️ Institute for Healthcare Improvement (IHI): https://www.ihi.org➡️ Learn more about Teleios Collaborative Network: https://www.teleioscn.org

What if the biggest breakthrough in hospice care isn't a new technology—but a better way of focusing on what matters most?In Part Two of this special conversation, host Chris Comeaux continues his discussion with Kelly McCutcheon Adams and Margherita Labson about how the Four M's Framework—What Matters, Medication, Mentation, and Mobility—is transforming hospice and palliative care into a more reliable, person-centered model. Together, they explore why exceptional hospice care goes far beyond symptom management to preserve dignity, independence, emotional well-being, and meaningful moments for patients and families. The conversation dives into practical questions every hospice leader and clinician should be asking:How can we better address delirium, depression, and cognition at the end of life?Why should mobility be viewed as preserving independence instead of simply preventing falls?Is it time to add a fifth "M" to the framework?What would healthcare look like if every decision truly began with what matters most?Kelly and Margherita also paint a compelling vision for the future of hospice—one where earlier conversations, better continuity of care, and reliable systems lead to fewer late hospice admissions, better patient experiences, and stronger healthcare organizations. Their message to leaders is both practical and inspiring: hospice is not something to apologize for—it's one of healthcare's greatest expressions of compassion. Whether you're a hospice executive, palliative care professional, healthcare leader, clinician, nonprofit executive, or someone passionate about improving the patient experience, this episode offers actionable insights that can reshape the way you think about quality care.In This Episode:✅ Why Mentation deserves greater attention in hospice care✅ Looking beyond fall prevention to meaningful Mobility✅ The debate over adding a Fifth M to Age-Friendly Care✅ Why earlier hospice conversations improve patient outcomes✅ Practical leadership advice for creating reliable, person-centered care systems✅ Resources available through the Institute for Healthcare Improvement (IHI)Guest: Kelly McCutcheon Adams, Senior Director at the Institute for Healthcare Improvement (IHI)Margherita Labson, President and CEO, MCLabson Consultation and Education ServicesHost:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipLearn More➡️ Institute for Healthcare Improvement (IHI): https://www.ihi.org➡️ Learn more about Teleios Collaborative Network: https://www.teleioscn.org

In 1971, President Richard Nixon signed the National Cancer Act, transforming cancer research with an unprecedented federal investment and launching what became known as the War on Cancer. The legislation did not emerge from scientific discovery alone. It was the culmination of decades of relentless advocacy by researchers, philanthropists, journalists, and patients who believed cancer demanded the same national commitment that had put astronauts on the Moon.This episode traces the origins of the cancer survivorship movement by returning to a time when cancer was rarely discussed in public, many physicians withheld diagnoses from their patients, and surgery offered few lasting cures. It follows the pioneering work of pathologist Dr. Sidney Farber, whose early chemotherapy research challenged conventional thinking, and Mary Lasker, whose political strategy, fundraising, and public campaigns helped transform cancer from a private tragedy into a national public health priority. Together, they built the coalition that reshaped federal support for oncology research and forever changed the relationship between science, government, and the American public.The story then turns to journalist and breast cancer survivor Rose Kushner, whose refusal to accept the standard one-step radical mastectomy challenged nearly a century of surgical dogma. Working alongside surgeon Dr. Bernard Fisher, Kushner helped bring evidence-based medicine to breast cancer treatment through randomized clinical trials that demonstrated less invasive surgery could achieve equivalent outcomes. Their efforts changed clinical practice, strengthened informed consent, and helped establish the principle that patients should participate in decisions about their own care.The breakthroughs explored in this episode extended far beyond new treatments. They redefined the role of patients in medicine, accelerated clinical research, and laid the foundation for modern cancer survivorship. The movement that followed would not simply help more people live longer. It would change what surviving cancer meant.RELATED LINKSNational Cancer Institute⁠National Cancer Act of 1971⁠American Cancer Society⁠Dana-Farber Cancer Institute⁠National Library of Medicine⁠The New England Journal of Medicine⁠FEEDBACKLike this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Please send any questions to podcasts@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Send us Fan MailHow can hospice and palliative care become more person-centered while also becoming more reliable?In Part One of this Anatomy of Leadership conversation, host Chris Comeaux sits down with Kelly McCutcheon Adams, Senior Director at the Institute for Healthcare Improvement (IHI), and Margherita Labson, President and CEO of McLabson Consultation & Education Services, to explore the groundbreaking 4 M's Framework and its growing impact on hospice and palliative care. Originally developed through the Age-Friendly Health Systems Initiative, the 4 M's—What Matters, Medication, Mentation, and Mobility—provide a practical, evidence-based framework for helping healthcare teams consistently deliver individualized care that aligns with each patient's goals while improving reliability across the care continuum. During this conversation, you'll discover:Why the 4 M's are a framework—not another quality measureHow "What Matters" transforms goal-concordant hospice careWhy reliability and individualized care are not mutually exclusiveHow medication decisions should be guided by patient goals—not habitsWhat hospice leaders can learn from the science of quality improvementWhether you're a hospice executive, palliative care clinician, healthcare leader, or quality improvement professional, this episode offers practical insights for building care systems that are both compassionate and consistently excellent. Don't miss Part Two, where we continue the discussion by exploring the remaining 4Ms and practical strategies for implementing this framework within hospice organizations.Chapters00:00 Introduction00:22 Meet Kelly McCutcheon Adams & Margherita Labson04:14 What is the 4Ms Framework?06:58 How IHI is Bringing the 4Ms to Hospice Care09:43 The Mission of the Institute for Healthcare Improvement (IHI)11:46 Why the 4Ms Work Across Every Care Setting15:17 Framework vs. Traditional Quality Measures17:24 What "What Matters" Really Means in Hospice21:08 Reliable Systems for Individualized Care26:57 Medication Decisions Guided by Patient Goals32:12 Hospice, Opioids, and Changing the Conversation34:37 Coming Up in Part Two

How can hospice and palliative care become more person-centered while also becoming more reliable?In Part One of this Anatomy of Leadership conversation, host Chris Comeaux sits down with Kelly McCutcheon Adams, Senior Director at the Institute for Healthcare Improvement (IHI), and Margherita Labson, President and CEO of McLabson Consultation & Education Services, to explore the groundbreaking 4 M's Framework and its growing impact on hospice and palliative care. Originally developed through the Age-Friendly Health Systems Initiative, the 4 M's—What Matters, Medication, Mentation, and Mobility—provide a practical, evidence-based framework for helping healthcare teams consistently deliver individualized care that aligns with each patient's goals while improving reliability across the care continuum. During this conversation, you'll discover:Why the 4 M's are a framework—not another quality measureHow "What Matters" transforms goal-concordant hospice careWhy reliability and individualized care are not mutually exclusiveHow medication decisions should be guided by patient goals—not habitsWhat hospice leaders can learn from the science of quality improvementWhether you're a hospice executive, palliative care clinician, healthcare leader, or quality improvement professional, this episode offers practical insights for building care systems that are both compassionate and consistently excellent. Don't miss Part Two, where we continue the discussion by exploring the remaining 4Ms and practical strategies for implementing this framework within hospice organizations.Chapters00:00 Introduction00:22 Meet Kelly McCutcheon Adams & Margherita Labson04:14 What is the 4Ms Framework?06:58 How IHI is Bringing the 4Ms to Hospice Care09:43 The Mission of the Institute for Healthcare Improvement (IHI)11:46 Why the 4Ms Work Across Every Care Setting15:17 Framework vs. Traditional Quality Measures17:24 What "What Matters" Really Means in Hospice21:08 Reliable Systems for Individualized Care26:57 Medication Decisions Guided by Patient Goals32:12 Hospice, Opioids, and Changing the Conversation34:37 Coming Up in Part Two

Long before cancer survivors organized into a movement, Hollywood had already shaped how Americans understood the disease. Films rarely used the word “cancer,” physicians often withheld diagnoses from patients, and the people who survived were almost nowhere to be found on screen.Recorded before The Cancer Mavericks: A History of Survivorship became a documentary series, this bonus conversation explores where the project first began. Matthew Zachary sits down with his mother, Roz Greenzweig, a retired educator and lifelong film enthusiast whose memories of classic cinema became an unexpected lens for understanding how cancer was portrayed throughout the twentieth century.Together, they revisit landmark films including Dark Victory, Love Story, and other iconic portrayals that reflected an era when cancer was treated as unspeakable, inevitable, and almost always fatal. Their conversation contrasts those carefully constructed Hollywood narratives with the lived reality of a family confronting a brain cancer diagnosis in 1995, revealing how popular culture both reflected and reinforced the fears surrounding the disease.The discussion also foreshadows many of the themes explored throughout the documentary series: the evolution of patient advocacy, the emergence of cancer survivorship, the role of caregivers, and the power of storytelling to influence public understanding. Before policy changed, before advocacy organizations grew into national movements, conversations like these were already challenging long-held assumptions about what cancer looked like and who had the right to tell its story.Consider this the prologue to The Cancer Mavericks. Before the movement found its history, it began with a family trying to make sense of the stories they had inherited.RELATED LINKSAmerican Cancer Society⁠National Cancer Institute⁠American Film Institute⁠ER (NBC)⁠50/50 (Official)⁠Chasing Life (ABC Family Archive)⁠FEEDBACKLike this episode? Rate and review The Cancer Mavericks: A History of Survivorship on your favorite podcast platform. For more information, visit CancerMavericks.com. Questions? Email podcasts@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. George J. Taylor is an expert in palliative care medicine. He has written many texts. Our discussion relates to his most recent publication, A Caregiver's Guide to Palliative Medicine. He explains how we can use medications to achieve pain control, when to start Hospice care, the difference between dependence and addiction, and longevity vs quality of life. https://www.amazon.com/Caregivers-Guide-Palliative-Medicine/dp/B0GZHX9G9SNotes: 25:00 Mobic for pain, Tylenol for pain34:00 Get on Hospice early.46:00 Aging, Nutrition, treatments to ‘make young people better'. 55:30: Dependence vs addiction and the Other Opioid Crisis. 1:00 The Five Wishes and the importance of the Durable Power of Attorney for Healthcare.You can read critiques written about his book here:https://independentbookreview.com/2026/07/08/a-caregivers-guide-to-palliative-medicine-by-george-j-taylor-m-d/ https://www.netgalley.com/catalog/book/857762Send us Fan MailListen and read my blog: https://whilewerestillhere.com Reach me at kathy@whilewerestillhere.comFacebook: While We're Still HereStarting with Episode 56, the episode music was added. It was composed, produced and provided by Kyle Bray specifically for this show. Reach out to me if you want the score. The logo artwork was provided by Maddie's Plush Pouch - maddelinesplushpouch@gmail.com

For many nurses, retirement marks not the end of a career, but the beginning of a new chapter of service. In this episode, former HPNA CEO Judy Lentz, PhD, RN, reflects on how retirement created an opportunity to reimagine her role in palliative care through volunteer leadership and the development of palliative care ministry within faith communities.  Drawing on decades of experience in clinical practice, education, research, and organizational leadership, Judy explores how retired nurses and other healthcare professionals can continue to improve quality of life by supporting individuals and families living with serious illness. She also discusses the concept of the palliative care doula as one model for companioning individuals and families through serious illness, alongside practical examples of how congregations can become compassionate partners in care by providing spiritual, emotional, and social support that complements the work of interdisciplinary palliative care teams.  The conversation also reflects on the evolution of hospice and palliative care, the enduring value of mentorship and leadership, and the fulfillment that comes from continuing to serve beyond a traditional career. Whether you're approaching retirement, considering volunteer opportunities, or looking for new ways to extend the reach of palliative care, this episode offers inspiration for finding purpose in the next season of professional life.      Judy Lentz, PhD, RN Judy Lentz, PhD, RN, retired in 2012 as the CEO of the Hospice and Palliative Nurses Association, the National Board of Certification for Hospice and Palliative Nurses and the Hospice and Palliative Nurses Foundation. In her retirement, her interests were in serving those experiencing serious illnesses as a palliative care doula®.  Over the past 14 years, Dr. Lentz has coordinated palliative care ministries in two Christian churches. Her research focused on the impact of spirituality in Christians experiencing serious illness. She is widely published, has presented at national conferences and has spoken to multiple groups locally.  She has encouraged the initiation of palliative care ministries in three local and regional faith communities, continues to serve as coordinator in her faith community' ministry as well as serves independently on a national level as a volunteer palliative care doula®. Her website can be found at http://www.palliativecaredoula.com     Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP Dr. Brett Snodgrass has been a registered nurse for 28 years and a Family Nurse Practitioner for 18 years, practicing in multiple settings, including family practice, urgent care, emergency departments, administration, chronic pain and palliative medicine. She is currently the Operations Director for Palliative Medicine at Baptist Health Systems in Memphis, TN. She is board certified with the American Academy of Nurse Practitioners. She is also a Fellow of the American Association of Nurse Practitioners and an Advanced Certified Hospice and Palliative Nurse. She completed a Doctorate of Nursing Practice at the University of Alabama – Huntsville. She is a nationally recognized nurse practitioner speaker and teacher. Brett is a chronic pain expert, working for more than 20 years with chronic pain and palliative patients in a variety of settings. She is honored to be the HPNA 2025 podcast host. She is married with two daughters, two son in laws, one grandson, and now an empty nest cat. She and her family are actively involved in their church and she is an avid reader.

Today on the show we talk palliative care in Newfoundland and Labrdor -- everything from your options at the end of life, what's available for you in the hospital or at home, and the current state of the system that provides care for this.

Why don't more doctors talk about death? Dr. Lydia Dugdale has been asking this question since she was a medical student. She is the Silberberg Professor of Medicine and directs the Center for Clinical Medical Ethics, and two books on how we die, including "The Lost Art of Dying." "Most medical professionals today are very unpracticed at talking to patients about their mortality," she says. Not only unpracticed, but even themselves afraid. In this bonus clip from Episode 232 with Macie Bridge, Dugdale traces the path from that early perplexity on the wards to the ars moriendi, the medieval art of dying, grounded in the idea that dying is part of living, so if you want to die well you have to live well. Lydia comments on the emergence of palliative care and the way it let physicians hand conversations about death to specialists; the doctor who inherited the priest's old place at the threshold between life and death; the death anxiety clinicians carry without examining; virtue as preparation for dying, and community as the other half of living well; the unrepresented patients of New York City who die alone; and a grumpy old man, hospitalized for 20 years, who wept when she read aloud what she had written about him. Episode Highlights “Most medical professionals today are very unpracticed at talking to patients about their mortality.” “we are really the intermediaries between life and death, I'm not saying we're priests, but that used to be the role of the priest. And so it is now the role of the physician. “If you want to die well, you have to live well.” We have to be all in or we end up like all of these patients here in New York City who have no one that I can reach out to as they're dying. “He started weeping and he said, someone finally saw me. Someone finally saw me. I've been in this hospital for 20 years and I didn't think anyone ever saw me.” About Lydia Dugdale Lydia Dugdale is a physician and medical ethicist who has spent fifteen years asking why medicine finds death so hard to talk about. She is the Silberberg Professor of Medicine at Columbia, directs the Columbia Center for Clinical Medical Ethics, and co-directs clinical ethics at NewYork-Presbyterian Milstein Hospital, where she still sees patients. She edited "Dying in the Twenty-First Century" and wrote "The Lost Art of Dying," a modern ars moriendi. She trained at the University of Chicago and Yale-New Haven Hospital, holds a master's in ethics from Yale Divinity School, and in 2025 founded the nonprofit Heal the Nation. Helpful Links and Resources “Dying Alone,” the full Episode 232 with Lydia Dugdale and Macie Bridge: https://faith.yale.edu/media/dying-alone Lydia Dugdale's website: https://lydiadugdale.com/ The Lost Art of Dying: Reviving Forgotten Wisdom, Lydia Dugdale's book: https://www.harpercollins.com/products/the-lost-art-of-dying-ls-dugdale Dying in the Twenty-First Century, edited by Lydia Dugdale: https://mitpress.mit.edu/9780262534598/dying-in-the-twenty-first-century/ Columbia Center for Clinical Medical Ethics, which Dugdale directs: https://www.vagelos.columbia.edu/departments-centers/columbia-center-clinical-medical-ethics Columbia Center for Clinical Medical Ethics on X: https://x.com/columbia_ccme Ars moriendi, the medieval art of dying, at the Morgan Library and Museum: https://www.themorgan.org/blog/new-acquisition-ars-moriendi-blockbook Ars moriendi block book, 1475, at the Library of Congress: https://www.loc.gov/item/2021666798/ Lydia Dugdale at the Yale Center for Faith and Culture: https://faith.yale.edu/people/lydia-dugdale-md Show Notes Death anxiety in medicine Why doctors avoid frank conversations about mortality Palliative care's arrival as a discipline, and what it made possible Real gains in symptom relief for the sick and the dying The unintended cost: death conversations outsourced to specialists Clinicians as intermediaries between life and death The priest's old place at the threshold, now the physician's Nurses at the bedside, doctors calling the shots on treatment Existential questions physicians have never worked through A colleague who would never tell a patient they were dying, out of her own fear of death Digging into how other times and places handled mortality Ars moriendi: the medieval genre on the preparation for death Illustrated editions made for people who could not read Fifteen years and two books spent reviving the art of dying Living well as the precondition of dying well Virtue as preparation: hope, patience, joy against bitterness and despair The role of community in dying well New York's unrepresented patients, dying alone A reader estranged from his adult children who committed to years of repair after the book Relationship as ongoing work: rupture, forgiveness, iron sharpening iron A long-hospitalized patient nobody wanted assigned to their team Modeling care for young doctors, and being verbally destroyed in front of them Loneliness of the neighbor, the colleague, the checkout person Practice as the only way to get better at it #ForTheLifeOfTheWorld #LydiaDugdale #TheLostArtOfDying #ArsMoriendi #MedicalEthics #DyingWell #Loneliness #EndOfLifeCare Production Notes This podcast featured Lydia Dugdale Edited and Produced by Evan Rosa Hosted by Evan Rosa Production Assistance by Noah Senthil A Production of the Yale Center for Faith & Culture at Yale Divinity School https://faith.yale.edu/about Support For the Life of the World podcast by giving to the Yale Center for Faith & Culture: https://faith.yale.edu/give

Rebecca Bloom is a former employee benefits and executive compensation attorney who spent more than 25 years helping women navigate cancer, work, insurance, disability coverage, and financial survival. She is the founder and author of When Women Get Sick, a book built from decades inside the legal, workplace, and patient advocacy systems most people only discover after diagnosis.Bloom started in Big Law at Simpson Thacher handling employee benefits and compensation work she originally chose to pay off student loans. Then her mother was diagnosed with breast cancer. Suddenly the language she used in corporate law offices became the language of survival at home. Explanation of benefits forms. Coverage disputes. Second opinions. Disability protections. Medical leave. Bills no one could explain.That collision changed the direction of her life.In this episode, Bloom explains how serious illness quietly turns patients into unpaid administrators managing paperwork, logistics, financial risk, and emotional labor while trying to survive treatment. She breaks down how employer based health insurance shapes nearly every aspect of cancer care in America and why women often carry the invisible burden of protecting everyone else from discomfort while they themselves fall apart.The conversation digs into workplace power, the illusion of the healthcare “safety net,” caregiver exhaustion, and the class divide hiding underneath patient empowerment culture. Bloom explains why educated, insured women with resources still struggle to navigate healthcare bureaucracy and what happens to patients without those advantages.This episode explores cancer care, health insurance, employee benefits, patient advocacy, workplace protections, caregiving, and the structural incentives that force sick people to become project managers of their own survival.RELATED LINKSRebecca BloomWhen Women Get SickBay Area Cancer ConnectionsSimpson Thacher & BartlettFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This week, Bobbi Conner talks with MUSC's Dr. Conrad Williams about palliative care for children and adults.

Grief is one of the most universal yet isolating experiences we endure—and psychedelics may offer a path through it. This Salon explores how substances like psilocybin, MDMA, and 5-MeO-DMT are being used to support those navigating loss, whether from death, identity shifts, or life transitions. This session sheds light on how altered states can help us reconnect to love, soften the sharp edges of sorrow, and reorient to a life forever changed. Attendees will gain insight into the science and integration practices that support emotional processing and meaning-making in the context of grief. Dr. Sunil Aggarwal is a physician in hospice and palliative medicine, physical medicine and rehabilitation, and a medical geographer. Dr. Aggarwal's primary clinical work is as an Integrative Pain, Palliative Care, and Rehabilitation Physician in private practice at the AIMS Institute in Seattle, Washington, and as an on-call Palliative and Hospice Physician within a Puget Sound–based healthcare system. He has a petition to reschedule psilocybin that is currently under review at the US Department of Health and Human Services. Dr. Aggarwal's medical geography scholarship focuses on the geographies of access, delivery, and development of cannabinologic and psychedelic integrative medicine—particularly as these relate to pain management, hospice and palliative medicine, and rehabilitation services. After two decades in journalism and content direction, Laura Sullivan Cassidy (she/her) used the early pandemic years to begin building a new career serving communities in grief and loss. She's trained as a grief work facilitator, creative coach, and death doula, and is employed at Recompose, the Seattle-based green funeral home known for pioneering the process of human composting. Her role at Recompose involves outreach, community, and client work—specifically with communities for whom a death is approaching, either via terminal diagnosis or hospice care. Laura writes a Substack called Griever's Ball and offers creative expression, listening groups, and death awareness workshops. — Psychedelic Salon: Cultivating Conscious Connections Join Seattle-based psychedelics educator and podcast host April Pride in a dynamic series co-produced with Town Hall Seattle. Psychedelic Salon explores the transformative potential of psychedelic medicines through engaging conversations, expert panels, and interactive community discussions. Rooted in scientific evidence, each event highlights unique themes—including grief, seniors, menopause, and more—emphasizing their role in mental health, spiritual growth, and personal optimization. Designed to be inclusive and insightful, this series invites attendees of all backgrounds to discover how psychedelics can foster profound connections, healing, and well-being. About April Pride April Pride is a Seattle-based creative entrepreneur and harm reduction advocate with over two decades of experience building brands at the intersection of lifestyle, cannabis, psychedelics, and women's health. Her work has been featured in The New York Times, Forbes, Vice, and The Guardian. April is the founder of SetSet, the world's first clinician-approved woman-focused platform for safe, accessible psychedelic integration. To learn more, follow April on Substack – aprilpride.substack.com

In this episode, we had the honor of talking to Miriam Stewart, the Chief Well-being Officer at the Children's Hospital of Philadelphia and attending physician in the Justin Michael Ingerman Center for Palliative Care. In our conversation, she shares her insights on balancing work and life, supporting flexibility, and leading healthy teams. Want More? Follow Miriam Steward on LinkedIn Check out her workplace, CHOP Order your copy of “Leading for Wellness” Listen on Apple Podcasts Listen on Spotify Follow Patricia and Katina on LinkedIn Sign up to never miss a Workr Beeing update Don't forget to subscribe and rate our show! The post Gain Balance With Miriam Stewart appeared first on Workr Beeing | The Science Of Thriving Workplaces.

Carl Jung called it “an acausal connecting principle” — but for Dan Ross, a Jungian analyst working in hospice care, synchronicity isn’t just theoretical. In this episode, Dan reveals what thirty years of end-of-life work taught him about Jung’s most misappropriated theory, its roots in Jung’s relationship with physicist Wolfgang Pauli, and why studying synchronicity seems to produce more of it. This episode is rich with poignant examples blended that will leave you thinking differently about how synchronicity works in your own life. Daniel Ross, RN, PMHNP, MSN, MBA has been a nurse for 40 years and in hospice for over 30. As a Psychiatric Mental Health Nurse Practitioner, he brings both a medical and psychiatric experience to the field of end-of-life care. He is a Jungian Analyst at the C. G. Jung Institute of Chicago where he has been Director of Training in the Analyst Training Program and Co-Director of the Jungian Psychotherapy Program and Jungian Studies Program. Dan works in the field of Hospice and Palliative Care and is in private practice as a psychotherapist in Chicago. Patricia Martin, MFA, is the host of Jung in the World. A noted cultural analyst, she applies Jungian theory to her work as a researcher and writer. Author of three books, her work has been featured in the New York Times, Harvard Business Review, Huffington Post, and USA Today. She holds an MFA in writing and literature from Bennington College and an MA in cultural studies at the University College, Dublin (honors). In 2018, she completed the Jungian Studies Program at the C. G. Jung Institute Chicago where she is a professional affiliate. A scholar in residence at the Chicago Public Library, for the last decade she's been studying the digital culture and its impact on the individuation process. Patricia travels the world giving talks and workshops based on her findings and has a private consulting practice in Chicago. Be informed of new programs and content by joining our mailing list! Support this free podcast by making a donation, becoming a member of the Institute, or making a purchase in our online store! Your support enables us to provide free and low-cost educational resources to all. This podcast is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. You may share it, but please do not change it, sell it, or transcribe it.Executive Producer: Ben LawHosts: Patricia Martin, Judith Cooper, Daniel Ross, Adina Davidson, and Raisa Cabrera2025-2026 Season Intern: Zoe KalawMusic: Peter Demuth

Send us Fan MailWhat can American healthcare learn from global healthcare?  In our latest episode, Dr. Mark Stoltenberg, Harvard Medical School professor and Massachusetts General Hospital physician, joins Chris Comeaux to explore global healthcare, palliative care, hospice leadership, healthcare innovation, and the future of serious illness care in America.Healthcare leaders often assume innovation requires more money, more technology, or more specialists.  Dr. Stoltenberg argues the opposite, drawing from his work leading global palliative care programs throughout Latin America, the Caribbean, Africa, and other underserved regions.  He shares how resource-limited healthcare systems are pioneering solutions that can improve American healthcare, strengthen the healthcare workforce, and restore compassionate, person-centered care.Together, Chris and Dr. Stoltenberg discuss workforce shortages, Project ECHO, community-based care, volunteerism, family-centered decision-making, healthcare leadership, and why hospice and palliative care must preserve their founding values while continuing to innovate.Through moving patient stories—including a remarkable experience in Belize—they reveal why dignity, compassion, community, and purpose remain healthcare's greatest innovations.If you're a healthcare executive, hospice leader, physician, nonprofit executive, nurse, or business leader, this episode offers practical strategies for improving leadership, building stronger organizations, and delivering more compassionate care.In this episode you'll learn:✔ What America can learn from global healthcare systems✔ Why palliative care is rooted in social justice✔ How healthcare workforce shortages can be addressed creatively✔ Why Project ECHO is transforming healthcare education✔ How community-based care improves patient outcomes✔ Why family and spirituality remain essential to serious illness care✔ How great organizations preserve their mission while scaling innovationChapters00:00 Introduction00:23 Meet Dr. Mark Stoltenberg02:08 Leadership Superpower05:20 Palliative Care as Social Justice07:48 The Belize Story10:51  Innovation in Low-Resource Healthcare16:07  Project ECHO & Workforce Development20:58 Family, Community & Spiritual Care23:55 Loneliness & Rebuilding Community28:57 Preserving the Core While Scaling Access33:11  Part Two Preview

Doctors Lisa and Sara talk to Palliative Care Consultants Doctors Cat Barrat Ayres and Cat MacDermott about nausea and vomiting in palliative patients. We talk through their overview of assessing patients with these symptoms, tips to work out causes before considering medication options. A nice section on avoiding common prescribing pitfalls towards the end. A useful episode for all of us in primary care helping to manage palliative patients with these often distressing symptoms.  Resources: Greater Manchester Medicines Management Group palliative symptom control guidelines: https://gmmmg.nhs.uk/wp-content/uploads/2025/05/Palliative-Care-Pain-and-Symptom-Control-Guidelines-DIGITAL.pdf NICE Clinical Knowledge Summaries, Palliative Care - Nausea and Vomiting: https://cks.nice.org.uk/topics/palliative-care-nausea-vomiting ___ If you have any questions, suggestions, concerns or want any particular areas covered, leave a comment on our survey here: https://pckb.org/feedback Or email us at: primarycarepodcasts@gmail.com ___ Given that this episode was recorded with specific clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it's release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

What can American healthcare learn from global healthcare?  In our latest episode, Dr. Mark Stoltenberg, Harvard Medical School professor and Massachusetts General Hospital physician, joins Chris Comeaux to explore global healthcare, palliative care, hospice leadership, healthcare innovation, and the future of serious illness care in America.Healthcare leaders often assume innovation requires more money, more technology, or more specialists.  Dr. Stoltenberg argues the opposite, drawing from his work leading global palliative care programs throughout Latin America, the Caribbean, Africa, and other underserved regions.  He shares how resource-limited healthcare systems are pioneering solutions that can improve American healthcare, strengthen the healthcare workforce, and restore compassionate, person-centered care.Together, Chris and Dr. Stoltenberg discuss workforce shortages, Project ECHO, community-based care, volunteerism, family-centered decision-making, healthcare leadership, and why hospice and palliative care must preserve their founding values while continuing to innovate.Through moving patient stories—including a remarkable experience in Belize—they reveal why dignity, compassion, community, and purpose remain healthcare's greatest innovations.If you're a healthcare executive, hospice leader, physician, nonprofit executive, nurse, or business leader, this episode offers practical strategies for improving leadership, building stronger organizations, and delivering more compassionate care.In this episode you'll learn:✔ What America can learn from global healthcare systems✔ Why palliative care is rooted in social justice✔ How healthcare workforce shortages can be addressed creatively✔ Why Project ECHO is transforming healthcare education✔ How community-based care improves patient outcomes✔ Why family and spirituality remain essential to serious illness care✔ How great organizations preserve their mission while scaling innovation

Vasanta Pundarika built her career inside healthcare investment banking before launching Lotuspring, an advisory firm focused on women's health and behavioral health. She spent nearly 20 years advising healthcare systems, treatment providers, and growth stage companies on mergers, financing, and operational strategy while watching the industry repeatedly misunderstand the people it claimed to serve.The conversation starts unexpectedly with anthropology, bread, and language. Vasanta explains how she spent years changing the pronunciation of her own name to make other people comfortable before eventually reclaiming it. That thread opens into a much larger discussion about adaptation, identity, and what institutions quietly train people to tolerate.From there, the discussion moves into behavioral health, women delaying care, and the invisible labor that healthcare business models routinely ignore. During COVID, Vasanta noticed men's behavioral health units refilled faster than women's units. The reason had nothing to do with demand. Women were still home managing caregiving responsibilities, children, aging parents, and households while their own mental health collapsed in the background.The episode examines what happens when healthcare companies become “snazzy big brands” before building real clinical substance underneath. Vasanta describes the tension between mission and margin inside healthcare startups, private equity backed care models, and behavioral health expansion. The conversation pushes on who benefits when healthcare scales aggressively, who absorbs the operational pressure, and how patient trust erodes long before executives notice it on a dashboard.They also discuss patient advocacy culture, anthropology as systems analysis, healthcare capitalism, prior authorization, investor language, and why some clinically excellent companies never survive long enough to scale.RELATED LINKSVasanta PundarikaLotuspringWomen's Health HorizonsSakhi for South Asian SurvivorsNACDPrinceton University Anthropology DepartmentFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

 Dr. Jessica Zitter and Chaplain Betty Clark have spent over a decade caring for patients together at Highland Hospital in Oakland, California, where Dr. Zitter is a critical and palliative care physician and Betty is the chaplain. Their partnership is at the heart of the documentary, "The Chaplain & The Doctor," and in this episode they tell Sarah what it means to treat the body and the spirit. Betty explains why she doesn't walk into a room because someone is dying, but because they are still living, while Jessica reflects on how Betty has changed the way she doctors. They also talk about generational trauma, decoding empathy, and how science can make room for the soul.For more information about the film and Jessica and Betty's work together, you can visit The Chaplain & The Doctor

Love the podcast? Send us a text!When you're living with breast cancer, the medical team treats the cancer — but who takes care of everything else? The fear that won't quiet down at 2 a.m. The diarrhea you're not sure is "bad enough" to call about. The FMLA paperwork, the school pickup, the light bill, the strange grief that shows up right when everyone expects you to feel grateful.In this episode, host Laura Carfang sits down with Dr. Julia Frydman, palliative care physician and medical director at Thyme Care, and Dr. Stephanie Broussard, director of social work at Thyme Care, to talk about what whole-person cancer support actually looks like — at every stage, from newly diagnosed through survivorship and metastatic disease. Together they unpack how a proactive, interdisciplinary team of nurses, social workers, and physicians closes the gaps that so often get missed, meeting people where they are, on their schedule, whether that's a text, an after-hours call, or simply someone to talk to.Julia and Stephanie share how structured, evidence-based check-ins catch symptoms early (before a small problem becomes an ER visit), how they screen for the emotional distress patients often don't realize they're carrying, and why the transitions in a cancer journey can feel like the rug being pulled out from under you. They tackle one of the biggest misconceptions in cancer care head-on: palliative care is NOT hospice — it's added support at any age and any stage. And they get honest about the things we rarely make space for: the ambivalence of "no evidence of disease," the grief that lives alongside the gratitude, financial toxicity, caregiver burnout, and the particular weight carried by those living with metastatic breast cancer, for whom treatment never ends.This is a warm, practical conversation about being seen, being heard, and knowing you don't have to endure it all alone.In this episode:Why "you don't know what you don't know" is one of the biggest barriers in cancer careProactive check-ins and patient-reported outcomes: catching symptoms before they escalateWhen a symptom is clinically significant — and when it's okay to manage it at homeEmotional distress vs. depression and anxiety: what's normal adjustment, and what needs supportThe grief-and-gratitude paradox of survivorship, and making space for bothFear of recurrence, "no evidence of disease," and the symptom burden that follows patientsHow a nurse/social-work triage team coordinates with your oncology team (not around it)Mental health escalation in action — from a routine call to real-time supportFinancial toxicity, social needs, and caregiver supportWho can access Thyme Care, insurance partnerships, and 50-state licensingMetastatic and life-limiting breast cancer: bearing witness and living with uncertaintyThe truth about palliative care: it adds, it doesn't take awayOutcomes: higher satisfaction, improved symptoms, fewer avoidable hospitalizations, and expanded access to palliative careAbout the guests:Dr. Julia Frydman is a palliative care physician and medical director at Thyme Care, where an interdisciplinary team provides whole-person support to people living with cancer as an extra layer alongside their oncology care.Dr. Stephanie Broussard, DSW, is director of social work at Thyme Care, leading its clinical and non-clinical social support teams, with a background in oncology, palliative care, and behavioral health.About the show: Breast Cancer Conversations is produced by SurvivingBreastCancer.org, a nonprofit providing evidence-based education, emotional support, and well-being resources to everyone touched by breast cancer — at every stage. All of our programs are virtual, online, and 100% free, with a global reach. Learn more at survivingbreastcancer.org.This episode is for educational and emotional-support purposes and is not a substitute for medical advice. Please talk with your own care team about your symptoms and treatment. Eligibility for Thyme Care depends on your insurer, employer, or provider — check their website to see if you're covered.Support the showListener FeedbackIf this episode resonated with you, we invite you to leave a review on Apple Podcasts or Spotify.You can also click the link in the show notes that says "Love this episode? Send us a text" to share feedback.Messages are completely anonymous.If you would like us to follow up directly, please include your email address in your message so we can respond.Latest News: Join our Mailing List - New content drops every Monday! Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org! Become a Breast Cancer Conversations+ Member! Sign Up Now. Enjoying our content? Please consider supporting our work. 

In this episode, we speak with Oliver Christen, author of As She Chose: A Conscious End to a Life Well Lived. Oliver shares the deeply personal story behind his book, which chronicles his mother's decision to approach the end of her life with dignity, intention, and presence. Drawing on his experiences as a son, traveller, entrepreneur, and student of meditation, Oliver explores themes of choice, mortality, spirituality, family, and what it truly means to live—and die—well. This thoughtful conversation offers insight, compassion, and a fresh perspective on one of life's most profound journeys.See omnystudio.com/listener for privacy information.

Caring for a pet at the end of their life is one of the hardest parts of loving a them. In this episode of Ask the Vet, Dr. Ann Hohenhaus welcomes Dr. Wendy McCulloch, veterinarian and founder of Pet Requiem, to discuss quality of life, difficult decisions, and how to find compassionate support.Topics include:What seeing a pet in their home environment may reveal in contrast to seeing them in a traditional clinic settingWhat Pet Requiem does and how the practice came to beWhat palliative care for pets looks like and how it can help pets and their families make the most of their time togetherTips to assess a pet's quality of lifeHow to approach and navigate discussions about euthanasiaWhat a peaceful in-home euthanasia experience looks like and how to prepare for itNavigating grief and the role of rituals, keepsakes, and memorials in providing comfortAlso on this month's show:Trending animal story about Romeow, a stray orange tabby cat who made an unexpected appearance during an outdoor performance of “Romeo and Juliet”Animal news, including the story of how a new study challenges the common assumption that cat ownership automatically worsens asthma in childrenPet Health Listener Q&A: What sudden movements during deep sleep may mean; why cats may drool while kneading surfaces; and what to do if your pet gets sprayed by a skunkDo you have a pe t health question for Dr. Hohenhaus? Email AskTheVet@amcny.org to have your question answered on Ask the Vet.

Brad Power spent years advising major corporations on systems design, process engineering, and decision making before lymphoma shoved him into the patient side of American healthcare. Instead of accepting the experience at face value, he started reverse engineering the machinery around cancer itself. Brad is the founder of Cancer Patient Lab and Open Cancer AI, two projects built around a blunt reality most patients discover too late: the healthcare system rewards people who know how to navigate it. Everyone else risks getting steamrolled by information asymmetry, insurance barriers, administrative friction, and institutional incentives designed around efficiency instead of human survival.The conversation starts with Harvard Business Review and Tumblr blogs before moving directly into the darker architecture underneath modern cancer care. Power explains how hospitals optimize for throughput, how insurance companies reward operational consistency over personalized medicine, and why many patients quietly end up needing a crash course in oncology, reimbursement policy, and behavioral psychology while fighting for their lives.The discussion digs into CAR-T therapy, functional testing, AI assisted decision support, and the growing collision between personalized medicine and standardized care pathways. Power argues that engaged patients often get better outcomes because they learn how to push for off guideline treatments, contest denials, and ask smarter questions. The counterpoint lands hard: patients should never have needed to become experts in the first place.The episode also explores the cultural consequences of AI entering cancer care. OpenAI advertising, data privacy, trust erosion, pharmaceutical influence, and “agentic AI” all collide inside a healthcare economy already drowning in distrust. Power sees artificial intelligence as a force multiplier for patient literacy and access. The larger system still decides who gets approved, who gets delayed, and who gets left behind.By the end, the conversation lands exactly where modern healthcare keeps forcing people to land: survival increasingly depends on learning how the machine works before the machine works on you.RELATED LINKSBrad PowerCancer Patient LabOpen Cancer AIHarvard Business ReviewResearch to the PeopleCAR T Cell TherapyFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Love the podcast? Send us a text!Palliative care is one of the most misunderstood parts of cancer care. Many people hear the term and think it means hospice, end-of-life care, or giving up. But palliative care, also called supportive care, can be offered alongside active cancer treatment and is focused on improving quality of life.In this episode of Breast Cancer Conversations, we hear from Kacie Flaherty, Joyce Garber, Paula Bouckhuyt, Hillary Stackpole, and Aimee Hoes, who are living with metastatic breast cancer about their unique experiences with palliative care.  Some were offered it early. Some had to ask for it. Some learned about it from other patients. Others are still trying to access the support they need.Together, we explore what palliative care really looks like: pain management, side effect support, emotional care, medication questions, care coordination, and whole-person support.This episode is a powerful reminder that palliative care is not about giving up. It is about helping people live with more comfort, support, dignity, and quality of life.Resources: Listeners looking for a palliative care provider can search the Palliative Care Provider Directory through GetPalliativeCare.org.Support the showListener FeedbackIf this episode resonated with you, we invite you to leave a review on Apple Podcasts or Spotify.You can also click the link in the show notes that says "Love this episode? Send us a text" to share feedback.Messages are completely anonymous.If you would like us to follow up directly, please include your email address in your message so we can respond.Latest News: Join our Mailing List - New content drops every Monday! Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org! Become a Breast Cancer Conversations+ Member! Sign Up Now. Enjoying our content? Please consider supporting our work. 

By the time the paper hit version 71, Dr. Nirosha Murugan had already done the hard part. The data were real. The experiment had worked. A team of researchers had used a wearable bioreactor to trigger limb regeneration in frogs, a result with obvious implications for regenerative medicine. But the science still wasn't getting over the line. The problem wasn't the work. It was the translation.On this episode of Standard Deviation, host Oliver Bogler talks with Dr. Nirosha Murugan, a biophysicist and Tier II Canada Research Chair in Tissue Biophysics at Wilfrid Laurier University, about what happens when a scientist working at the edges of quantum biology, bioelectricity, and tissue regeneration runs headfirst into the unwritten rules of academic publishing. Murugan's research asks biologists to think beyond molecules and chemistry alone, and to consider the physical signals, electromagnetic fields, and invisible forces that shape development and healing. It is ambitious science. It is also exactly the kind of work that can make gatekeepers nervous.Bogler follows Murugan through the less glamorous part of discovery: the hidden curriculum of getting a paper published, securing scientific credibility, and learning that data do not simply “speak for themselves.” Murugan describes how jargon buried the pitch of her own work, how a lack of editorial support left her at a disadvantage, and how the JEDI program at the Life Science Editors Foundation paired her with a former journal editor who taught her how to structure a manuscript, write a cover letter, and survive peer review.The result was publication in Science Advances, but the larger story is about power. Who gets taught the rules of biomedical research. Who has access to grant writers, editors, and institutional polish. Who is left to brute-force their way through the maze. And how one scientist, having finally found the map, now makes sure her own trainees do not have to learn it the hard way.RELATED LINKSDr. Nirosha Murugan⁠Wilfrid Laurier University⁠Life Science Editors Foundation⁠JEDI Program⁠Science Advances paper on limb regeneration⁠FEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. Jess Peatross trained in conventional medicine and worked as a hospitalist before she started questioning why so many chronically ill patients kept getting worse inside the healthcare system she trusted. Her perspective carries weight because she spent years following every protocol exactly as taught before walking away from hospital medicine entirely.Raised in Huntington, West Virginia during the opioid crisis, she entered medicine believing the system existed to heal people. Instead, she found hospitals driven by billing codes, liability management, and pharmaceutical dependence while patients with chronic illness, autoimmune disease, mold exposure, and chronic pain cycled endlessly through appointments and prescriptions.Dr. Peatross explains what pushed her toward functional medicine, cannabis therapy, and prevention focused care after watching patients improve only after leaving conventional treatment pipelines behind. The conversation tackles physician burnout, chronic illness stigma, healthcare incentives, and the growing collapse of trust between patients and institutions.The discussion also moves into supplements, environmental toxins, ultra processed food, and the uncomfortable economics behind keeping people permanently sick but continuously billable. Dr. Peatross describes the professional backlash that comes with challenging medical orthodoxy while Matthew connects her experience to the broader erosion of public trust across American healthcare.Together they unpack what happens when patients stop believing the system can help them and start searching elsewhere for answers.RELATED LINKSDr. Jess PeatrossInstagramMarshall UniversityBrave New WeedFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Who's better at delivering palliative care to patients with liver disease: palliative care specialists, or hepatologists who have received liver disease-specific palliative care training?  That's the question we take a deep dive into on this week's podcast by breaking down the PAL-LIVER trial, published this year in JAMA Internal Medicine. We've invited three of the trial's authors, Manisha Verma, Chris Woodrell, and Marie Bakitas, to discuss this cluster-randomized clinical trial spanning 19 U.S. medical centers. We'll discuss: Why was this trial done? Do we really need to run a separate palliative care trial for every single organ disease? What kind of specialized palliative care training did the hepatologists receive? What exactly is meant by the finding that hepatologists were not statistically superior, but were shown to be statistically non-inferior? Lastly, we discuss whether these results change anyone's practice, and whether healthcare systems should decide which type of palliative care model to fund (primary vs. specialty.) —- References we discussed Developing palliative care interventions in liver disease using formative and summative qualitative evaluation. Hepatology 2026  Palliative Care for Advanced Liver Disease: Hepatology and Palliative Care Specialists Experiences. J Pain Symptom Manage 2026     

In the United States, nearly 70% of people say they want to die at home, yet the majority still die in medical settings, often after receiving care that may not match their goals and values. Closing that gap between preference and reality is at the heart of the work being done by End Well, a nonprofit dedicated to transforming how we think about, plan for, and experience the end of life. "The gap isn't about people wanting the wrong things. It's that our culture and our incentives aren't aligned with helping those wishes actually happen at the end of life,” says Dr. Shoshana Ungerleider, End Well's founder and president.  As Dr. Ungerleider explains to Raise the Line host Michael Carrese, End Well sponsors an annual symposium and year-round activities to bring together clinicians, patients, caregivers, and innovators to improve that alignment. Key steps include earlier integration of palliative care, allowing providers time for listening and goal setting with patients, and normalizing conversations about what matters most to people. This compelling conversation on reframing end of life care also covers how to bring wonder, joy, and hope into end-of-life conversations, and End Well's work to change how death is portrayed in the media. Mentioned in this episode:End Well If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Prolonged mechanical ventilation in rural long-term care settings brings a unique set of clinical, ethical, and logistical challenges for care teams, residents, and their families. In this episode, we explore the realities of ventilator use in rural long-term care environments, where limited resources and geographic barriers can complicate care decisions and delivery. We also take a thoughtful look at the emotional and practical impact of ventilator discontinuation, highlighting the experiences of those directly affected. Join us for a nuanced conversation that sheds light on an often-overlooked aspect of long-term care and the difficult decisions that come with it.      Von Vitto, DNP, CNP, AGNP-C, ACHPN® Von Vitto, DNP, CNP, AGNP-C, ACHPN® is a board-certified adult-gerontology nurse practitioner and has advanced certification as a hospice and palliative nurse. He currently serves as a nurse practitioner at HospiceCare in The Berkshires, Inc. in Berkshire County, MA. Von brings years of experience in delivering geriatric and specialty palliative care in skilled nursing facilities and to community-dwelling patients. He is passionate about navigating serious illness conversations and the provision of goal-concordant care. Von has also mentored and precepted nurse educator and nurse practitioner students.    Julie Thurston Julie Thurston is a board-certified Adult-Gerontology Primary Care Nurse Practitioner with advanced certification in Hospice and Palliative Care who currently serves as a key member of the leadership team at HospiceCare in The Berkshires, Berkshire County, Massachusetts. In her role, Julie provides comprehensive patient and family-centered care, supports her organization in ongoing performance improvement projects, and mentors her staff in various professional development opportunities. During her tenure, Julie has embraced diverse roles including RN Case Manager, RN Weekend/Evening Triage, and Staff Educator. Her commitment to the provision of high-quality care across the continuum earned her an Integritus Healthcare Profiles in Care award. Additionally, she shares her expert knowledge and experience providing education throughout the local community for healthcare providers across multiple disciplines. Julie has been an active member of the Hospice and Palliative Nurses Association since 2010.   Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP Dr. Brett Snodgrass has been a registered nurse for 28 years and a Family Nurse Practitioner for 18 years, practicing in multiple settings, including family practice, urgent care, emergency departments, administration, chronic pain and palliative medicine. She is currently the Operations Director for Palliative Medicine at Baptist Health Systems in Memphis, TN. She is board certified with the American Academy of Nurse Practitioners. She is also a Fellow of the American Association of Nurse Practitioners and an Advanced Certified Hospice and Palliative Nurse. She completed a Doctorate of Nursing Practice at the University of Alabama – Huntsville. She is a nationally recognized nurse practitioner speaker and teacher. Brett is a chronic pain expert, working for more than 20 years with chronic pain and palliative patients in a variety of settings. She is honored to be the HPNA 2025 podcast host. She is married with two daughters, two son in laws, one grandson, and now an empty nest cat. She and her family are actively involved in their church and she is an avid reader.

Farla Efros is a senior retail executive and former CEO who built and sold companies before facing her own breast cancer diagnosis. She brings that same operational mindset into a healthcare system that expects patients to manage complexity while they are at their most vulnerable.She was on a client call in Spain when the diagnosis came through. A clear mammogram had missed it. An MRI caught it. Within hours, she was ordering binders, building a plan, and structuring her treatment like a turnaround strategy. Every appointment became a meeting. Every doctor faced an agenda with dozens of questions. She paid out of pocket for PET scans that were denied and hired a third party firm to validate her treatment path when her own doctors resisted outside input. The conversation tracks what happens when a high-functioning executive enters a system built on delay, denial, and fragmentation. Efros describes negotiating for tests, managing physician relationships, and assembling an “executive board” of advisors across conventional and alternative care. She calls the experience “the worst client I ever had,” exposing how administrative burden shifts onto patients and families.The tension sits between what worked for her and what is inaccessible to most. Her approach requires confidence, time, and fluency in navigating power. The system rewards that behavior while quietly failing patients who cannot replicate it. Insurance coverage still left her paying out of pocket. Doctors pushed standard protocols over precision medicine. Survivorship offered little support once treatment ended.This episode examines how cancer care operates as a series of incentives rather than a coordinated system, and why patients are forced to become operators just to get through it.RELATED LINKSFarla EfrosFarla Efros on LinkedInF*ck CancerF*ck Cancer on AmazonAccentureCTOAMPULL QUOTES“I treated cancer like the worst client I ever had.”“They wouldn't approve the test, so I paid for it myself.”“Every appointment was a negotiation.”FEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Ihre Arbeit veränderte den Umgang mit dem Tod grundlegend: Die Sterbeforscherin Elisabeth Kübler-Ross. Diese Tage hätte sie ihren 100. Geburtstag gefeiert. Und heute, in einer zunehmend alternden Gesellschaft, stellt sich dringlicher denn je die Frage: Wie werden wir in Zukunft sterben? Mit «Interviews mit Sterbenden» leistete die schweizerisch-US-amerikanische Psychiaterin und Sterbeforscherin Elisabeth Kübler-Ross 1969 Epochemachendes: Sie brach das Schweigen über den Tod und verschob ihn aus der Tabuzone in den gesellschaftlichen Diskurs. Ihre kulturelle Leistung liegt darin, das Sterben als Teil des Lebens sichtbar gemacht zu haben – eine Voraussetzung für die moderne Palliativmedizin. Gleichzeitig stellt die demografische Entwicklung diese Errungenschaften infrage. Immer mehr Menschen erreichen ein hohes Alter – häufig verbunden mit langen Phasen von Krankheit und Demenz. Der Palliativmediziner Gian Domenico Borasio spricht von einem «Tsunami von hochaltrigen Sterbenden», der auf uns zukomme und grundlegende Fragen nach Würde, Autonomie und Fürsorge neu aufwirft. Ein auf Effizienz getrimmtes Gesundheitssystem gelangt damit an seine Grenzen. Braucht es neue Formen der Solidarität, «Caring Communities», und eine stärkere Vergesellschaftung von Sorgearbeit? Welche Rolle kann Palliative Care als Modell für ein menschlicheres System spielen – und was heisst das für uns alle? Olivia Röllin fragt nach bei Gian Domenico Borasio, eine der prägenden Stimmen in der Debatte um ein würdiges Lebensende.

In 2020, Emily Mendenhall drove from Washington, DC to Okoboji, Iowa, a town of 800 that swells to 200,000 every summer, and walked into a pandemic that looked nothing like the one dominating national headlines. Inside gas stations and bars, masks marked you as an outsider. In one stop, a man told her family they would not be served if they kept theirs on. Her 6 year old daughter cried, confused. Mendenhall, a medical anthropologist at Georgetown University, did what she always does. She started asking questions. Over months, she interviewed neighbors, former classmates, and local officials, including her own brother in law who helped lead the local COVID response. The result became Unmasked, a case study in how community identity, economics, and politics shaped public health decisions in real time. That work led directly into her latest book, Invisible Illness: A History, from Hysteria to Long COVID, where she tracks a much older problem. Patients with chronic illness, especially women, often fail to meet medicine's demand for proof. Without a clear diagnosis, they lose access to care, insurance coverage, and legitimacy. Mendenhall argues that long COVID did not create this failure. It exposed it.This conversation centers on how healthcare systems reward certainty and punish complexity. Long COVID clinics send patients to 17 specialists without resolution. Insurance structures require diagnoses that many conditions cannot provide. Medical training still struggles to integrate trauma, mental health, and chronic disease into a coherent model of care.Mendenhall brings lived experience into the conversation. After COVID, she dealt with months of fatigue and escalating anxiety that altered her baseline health. She does not claim the label of long COVID, but she understands how quickly the system becomes harder to navigate once symptoms stop fitting clean categories. The stakes are not theoretical. In the United States, access to healthcare, disability benefits, and treatment still depends on whether a condition can be measured, coded, and reimbursed. For millions living with invisible illness, the burden of proof becomes the illness itself.RELATED LINKSEmily MendenhallInvisible Illness: A History, from Hysteria to Long COVIDScience PoliticsGeorgetown UniversityFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

At 25, Jace Yawnick was building a career in health and wellness sales, chasing growth, status, and the usual young adult fantasy of getting somewhere fast. Then his body stopped cooperating. Fatigue turned into chemotherapy. The diagnosis was primary mediastinal B cell non Hodgkin lymphoma, and the rest of his life split into before and after. Now in remission, he talks about cancer the way people actually live it, not the way nonprofits package it. He gets into survivorship, mental health, young adult isolation, and the deadening absurdity of prior authorization. One of the sharpest parts of the conversation lands on a simple American insult disguised as policy: treatment innovation means very little when insurance can still deny the scan, the drug, or the next step. Jace has seen that firsthand, including during routine monitoring after active treatment. This episode tracks what happens when a young cancer patient becomes a public voice and refuses to play mascot. It covers oncology, insurance, remission, advocacy, and the long mental hangover that follows survival. It also names the part too many institutions dodge: the system works great right up until it doesn't, and when it fails, patients get handed the bill, the panic, and a camera if they want anyone to care. RELATED LINKSJace Beats CancerJace Yawnick on LinkedImConquer Cancer ArticleCURE Today ArticlePyure BrandsFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

At 20 years old, newly arrived from Puerto Rico and trying to build a future in science, Benjamin Suarez Jimenez found himself sitting in front of two senior faculty members accused of plagiarism. He knew the material. He had done the work. His mistake came from failing to cite class notes during an exam because nobody had told him that was expected. In a matter of minutes, he watched what felt like his entire career flash before him.On this episode of Standard Deviation, host Oliver Bogler examines the hidden architecture of academic science through the experiences of Dr. Benjamin Suarez Jimenez, Assistant Professor at the University of Rochester and a neuroscientist studying PTSD, anxiety, trauma, and spatial cognition through virtual reality and video game environments.Benjamin traces his path from Puerto Rico to the mainland United States, through the NIH, Columbia University, and eventually to leading his own laboratory. Along the way, he encountered a series of barriers that had little to do with scientific ability and everything to do with access to unwritten rules. From academic gatekeeping to grant writing expectations, he learned that success in biomedical research often depends on knowledge that never appears in a textbook.Oliver explores how those invisible obstacles shape careers, influence research funding, and determine who gains access to opportunity. The conversation also examines the Justice, Equity, Diversity, and Inclusion Program at the Life Science Editors Foundation, which pairs scientists from underrepresented backgrounds with experienced scientific editors. Through that mentorship, Benjamin transformed a critical grant proposal into a successful pilot award that helped launch an NIH R01 application.The discussion extends beyond one scientist's experience. Benjamin describes helping a former mentee navigate dissertation roadblocks that threatened her graduation, illustrating how institutional bureaucracy can delay careers and discourage talented researchers. Together, they explore the hidden administrative burden, cultural barriers, and bias that many scientists carry alongside their research, and what happens when someone who receives support turns around and opens the door for others.RELATED LINKSLife Science Editors FoundationBenjamin Suarez Jimenez LabDr. Benjamin Suarez JimenezBenjamin Suarez JimenezFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. Sarah Matt trained as a burn surgeon, working in a field where patients arrive with catastrophic injuries and survival depends on speed, skill, and resources. She left the bedside after confronting a limit that medicine does not like to admit. One physician can only see so many people in a day. The system surrounding those patients decides the rest. She moved into health technology, held leadership roles in startups, and built global infrastructure at Oracle to scale care across populations. Then she watched billions of dollars in digital health and AI initiatives stall out when they hit real clinical environments.This episode follows that pivot from surgeon to strategist and back into direct patient care in rural New York, where she now treats uninsured patients, migrant workers, and communities pushed to the margins. The conversation centers on a persistent failure across healthcare systems. Products get built for regulators, executives, and investors instead of the people who use them. The result shows up in failed adoption, broken workflows, prior authorization delays, and rising physician burnout.The discussion cuts through health policy language and lands on lived consequence. The system rewards speed over usability, scale over trust, and compliance over care. Patients absorb the fallout. Physicians carry the liability. The incentives remain intact.RELATED LINKSDr. Sarah MattThe Borderless Healthcare RevolutionThe Clinical RealistJessica FedererSovatoFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.