Podcasts about Palliative care

Dr. Anne Marie Morse walks into the studio like a one-woman Jersey Broadway show and leaves behind the best damn TED Talk you've never heard. She's a neurologist, sleep medicine doc, narcolepsy expert, founder of D.A.M.M. Good Sleep, and full-time myth buster in a white coat. We talk about why sleep isn't a luxury, why your mattress does matter, and how melatonin is the new Flintstones vitamin with a marketing budget. We unpack the BS around sleep hygiene, blow up the medical gaslighting around “disorders,” and dig into how a former aspiring butterfly became one of the loudest voices for patient-centered science. Also: naps, kids, burnout, CPAPs, co-sleeping, airport pods, the DeLorean, and Carl Sagan. If you think you're getting by on five hours of sleep and vibes, you're not. This episode will make you want to take a nap—and then call your doctor.RELATED LINKSdammgoodsleep.com: https://www.dammgoodsleep.comLinkedIn: https://www.linkedin.com/in/anne-marie-morse-753b2821/Instagram: https://www.instagram.com/dammgoodsleepDocWire News Author Page: https://www.docwirenews.com/author/anne-marie-morseSleep Review Interview: https://sleepreviewmag.com/practice-management/marketing/word-of-mouth/sleep-advocacy-anne-marie-morse/Geisinger Bio: https://providers.geisinger.org/provider/anne-marie-morse/756868SWHR Profile: https://swhr.org/team/anne-marie-morse-do-faasm/FEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Learn about Dr. Ira Byock’s strategic vision for approaching the major issues facing hospice and palliative care. My guest Dr. Ira Byock is a leading palliative care physician, author, and public advocate for improving care through the end of life. He is the author of the books Dying Well, The Four Things that Matter Most,… Continue reading Ep. 509 A Future Path for Hospice and Palliative Care with Ira Byock MD

Drs. Hope Rugo, Sheri Brenner, and Mikolaj Slawkowski-Rode discuss the struggle that health care professionals experience when terminally ill patients are suffering and approaches to help clinicians understand and respond to suffering in a more patient-centered and therapeutic way. TRANSCRIPT Dr. Hope Rugo: Hello, and welcome to By the Book, a monthly podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book.  I'm your host, Dr. Hope Rugo. I'm director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center, and I'm also the editor-in-chief of the Educational Book. On today's episode, we'll be exploring the complexities of grief and oncology and the struggle we experience as healthcare professionals when terminally ill patients are suffering. Our guests will discuss approaches to help clinicians understand and respond to suffering in a more patient-centered and therapeutic way, as outlined in their recently published article titled, “Oncology and Suffering: Strategies on Coping With Grief for Healthcare Professionals.” I'm delighted today to welcome Dr. Keri Brenner, a clinical associate professor of medicine, palliative care attending, and psychiatrist at Stanford University, and Dr. Mikołaj Sławkowski-Rode, a senior research fellow in philosophy in the Humanities Research Institute at the University of Buckingham, where he also serves as director of graduate research in p hilosophy. He is also a research fellow in philosophy at Blackfriars Hall at the University of Oxford and associate professor at the University of Warsaw.  Our full disclosures are available in the transcript of this episode. Dr. Brenner and Dr. Sławkowski-Rode, thanks for being on the podcast today. Dr. Keri Brenner: Great to be here, Dr. Rugo. Thank you so much for that kind introduction. Dr. Mikołaj Sławkowski-Rode: Thank you very much, Dr. Rugo. It's a pleasure and an honor. Dr. Hope Rugo: So I'm going to start with some questions for both of you. I'll start with Dr. Brenner. You've spoken and written about the concept of suffering when there is no cure. For oncologists, what does it mean to attune to suffering, not just disease? And how might this impact the way they show up in difficult conversations with patients? Dr. Keri Brenner: Suffering is something that's so omnipresent in the work of clinical oncology, and I like to begin by just thinking about what is suffering, because it's a word that we use so commonly, and yet, it's important to know what we're talking about. I think about the definition of Eric Cassell, who was a beloved mentor of mine for decades, and he defined suffering as the state of severe distress that's associated with events that threaten the intactness of a person. And my colleague here at Stanford, Tyler Tate, has been working on a definition of suffering that encompasses the experience of a gap between how things are versus how things ought to be. Both of these definitions really touch upon suffering in a person-centered way that's relational about one's identity, meaning, autonomy, and connectedness with others. So these definitions alone remind us that suffering calls for a person-centered response, not the patient as a pathology, but the panoramic view of who the patient is as a person and their lived reality of illness. And in this light, the therapeutic alliance becomes one of our most active ingredients in care. The therapeutic alliance is that collaborative, trusting bond as persons that we have between clinician and patient, and it's actually one of the most powerful predictors of meaningful outcomes in our care, especially in oncologic care.  You know, I'll never forget my first day of internship at Massachusetts General Hospital. A faculty lecturer shared this really sage insight with us that left this indelible mark. She shared, “As physicians and healers, your very self is the primary instrument of healing. Our being is the median of the medicine.” So, our very selves as embodied, relationally grounded people, that's the median of the medicine and the first most enduring medicine that we offer. That has really borne fruit in the evidence that we see around the therapeutic alliance. And we see this in oncologic care, that in advanced cancer, a strong alliance with one's oncologist truly improves a patient's quality of life, treatment adherence, emotional well-being, and even surpasses structured interventions like psychotherapeutic interventions. Dr. Hope Rugo: That's just incredibly helpful information and actually terminology as well, and I think the concept of suffering differs so much. Suffering comes in many shapes and forms, and I think you really have highlighted that. But many oncologists struggle with knowing what to do when patients are suffering but can't be fixed, and I think a lot of times that has to do with oncologists when patients have pain or shortness of breath or issues like that. There are obviously many ways people suffer. But I think what's really challenging is how clinicians understand suffering and what the best approaches to respond to suffering are in the best patient-centered and therapeutic way. Dr. Keri Brenner: I get that question a lot from my trainees in palliative care, not knowing what to do. And my first response is, this is about how to be, not about knowing what to do, but how to be. In our medical training, we're trained often how to think and treat, but rarely how to be, how to accompany others. And I often have this image that I tell my trainees of, instead of this hierarchical approach of a fix-it mentality of all we're going to do, when it comes to elements of unavoidable loss, mortality, unavoidable sufferings, I imagine something more like accompaniment, a patient walking through some dark caverns, and I am accompanying them, trying to walk beside them, shining a light as a guide throughout that darkness. So it's a spirit of being and walking with. And it's so tempting in medicine to either avoid the suffering altogether or potentially overidentify with it, where the suffering just becomes so all-consuming like it's our own. And we're taught to instead strike a balance of authentic accompaniment through it. I often teach this key concept in my palli-psych work with my team about formulation. Formulation is a working hypothesis. It's taking a step back and asking, “Why? Why is this patient behaving in this manner? What might the patient's core inner struggle be?” Because asking that “why” and understanding the nuanced dimensions of a patient's core inner struggle will really help guide our therapeutic interactions and guide the way that we accompany them and where we choose to shine that light as we're walking with them. And oftentimes people think, “Well Keri, that sounds so sappy or oversentimental,” and it's not. You know, I'm just thinking about a case that I had a couple months ago, and it was a 28-year-old man with gastric cancer, metastatic disease, and that 28-year-old man, he was actually a college Division I athlete, and his dad was an acclaimed Division I coach. And our typical open-ended palliative care questions, that approach, infuriated them. They needed to know that I was showing up confident, competent, and that I was ready, on my A-game, with a real plan for them to follow through. And so my formulation about them was they needed somebody to show up with that confidence and competence, like the Division I athletes that they were, to really meet them and accompany them where they were on how they were going to walk through that experience of illness. Dr. Hope Rugo: These kinds of insights are so helpful to think about how we manage something that we face every day in oncology care. And I think that there are many ways to manage this.  Maybe I'll ask Dr. Sławkowski-Rode one question just that I think sequences nicely with what you're talking about.  A lot of our patients are trying to think about sort of the bigger picture and how that might help clinicians understand and support patients. So, the whole concept of spirituality, you know, how can we really use that as oncology clinicians to better understand and support patients with advanced illness, and how can that help patients themselves? And we'll talk about that in two different ways, but we'll just start with this broader question. Dr. Mikołaj Sławkowski-Rode: I think spirituality, and here, I usually refer to spirituality in terms of religious belief. Most people in the world are religious believers, and it is very intuitive and natural that religious beliefs would be a resource that people who help patients with a terminal diagnosis and healthcare professionals who work with those patients appeal to when they try to help them deal with the trauma and the stress of these situations.  Now, I think that the interesting thing there is that very often the benefit of appealing to a religious belief is misunderstood in terms of what it delivers. And there are many, many studies on how religious belief can be used to support therapy and to support patients in getting through the experience of suffering and defeating cancer or facing a terminal diagnosis. There's a wealth of literature on this. But most of the literature focuses on this idea that by appealing to religious belief, we help patients and healthcare practitioners who are working with them get over the fact and that there's a terminal diagnosis determining the course of someone's life and get on with our lives and engaging with whatever other pursuits we might have, with our job if we're healthcare practitioners, and with the other things that we might be passionate about in our lives. And the idea here is that this is what religion allows us to do because we sort of defer the need to worry about what's going to happen to us until the afterlife or some perspective beyond the horizon of our life here.  However, my view is – I have worked beyond philosophy also with theologians from many traditions, and my view here is that religion is something that does allow us to get on with our life but not because we're able to move on or move past the concerns that are being threatened by illness or death, but by forming stronger bonds with these things that we value in our life in a way and to have a sense of hope that these will be things that we will be able to keep an attachment to despite the threat to our life. So, in a sense, I think very many approaches in the field have the benefit of religion upside down, as it were, when it comes to helping patients and healthcare professionals who are engaged with their illness and treating it. Dr. Hope Rugo: You know, it's really interesting the points that you make, and I think really important, but, you know, sometimes the oncologists are really struggling with their own emotional reactions, how they are reacting to patients, and dealing with sort of taking on the burden, which, Dr. Brenner, you were mentioning earlier. How can oncologists be aware of their own emotional reactions? You know, they're struggling with this patient who they're very attached to who's dying or whatever the situation is, but you want to avoid burnout as an oncologist but also understand the patient's inner world and support them. Dr. Keri Brenner: I believe that these affective, emotional states, they're contagious. As we accompany patients through these tragic losses, it's very normal and expected that we ourselves will experience that full range of the human experience as we accompany the patients. And so the more that we can recognize that this is a normative dimension of our work, to have a nonjudgmental stance about the whole panoramic set of emotions that we'll experience as we accompany patients with curiosity and openness about that, the more sustainable the work will become. And I often think about the concept of countertransference given to us by Sigmund Freud over 100 years ago. Countertransference is the clinician's response to the patient, the thoughts, feelings, associations that come up within us, shaped by our own history, our own life events, those unconscious processes that come to the foreground as we are accompanying patients with illness. And that is a natural part of the human experience. Historically, countertransference was viewed as something negative, and now it's actually seen as a key that can unlock and enlighten the formulation about what might be going on within the patient themselves even. You know, I was with a patient a couple weeks ago, and I found myself feeling pretty helpless and hopeless in the encounter as I was trying to care for them. And I recognized that countertransference within myself that I was feeling demoralized. It was a prompt for me to take a step back, get on the balcony, and be curious about that because I normally don't feel helpless and hopeless caring for my patients. Well, ultimately, I discovered through processing it with my interdisciplinary team that the patient likely had demoralization as a clinical syndrome, and so it's natural many of us were feeling helpless and hopeless also accompanying them with their care. And it allowed us to have a greater interdisciplinary approach and a more therapeutic response and deeper empathy for the patient's plight. And we can really be curious about our countertransferences. You know, a few months ago, I was feeling bored and distracted in a family meeting, which is quite atypical for me when I'm sharing serious illness news. And it was actually a key that allowed me to recognize that the patient was trying to distract all of us talking about inconsequential facts and details rather than the gravitas of her illness.  Being curious about these affective states really allows us to have greater sustainability within our own practice because it normalizes that human spectrum of emotions and also allows us to reduce unconscious bias and have greater inclusivity with our practice because what Freud also said is that what we can't recognize and say within our own selves, if we don't have that self-reflective capacity, it will come out in what we do. So really recognizing and having the self-awareness and naming some of these emotions with trusted colleagues or even within our own selves allows us to ensure that it doesn't come out in aberrant behaviors like avoiding the patient, staving off that patient till the end of the day, or overtreating, offering more chemotherapy or not having the goals of care, doing everything possible when we know that that might result in medically ineffective care. Dr. Hope Rugo: Yeah, I love the comments that you made, sort of weaving in Freud, but also, I think the importance of talking to colleagues and to sharing some of these issues because I do think that oncologists suffer from the fact that no one else in your life wants to hear about dying people. They don't really want to hear about the tragic cases either. So, I think that using your community, your oncology community and greater community within medicine, is an important part of being able to sort of process. Dr. Keri Brenner: Yes, and Dr. Rugo, this came up in our ASCO [Education] Session. I'd love to double click into some of those ways that we can do this that aren't too time consuming in our everyday practice. You know, within palliative care, we have interdisciplinary rounds where we process complex cases. Some of us do case supervision with a trusted mentor or colleague where we bring complex cases to them. My team and I offer process rounds virtually where we go through countertransference, formulation, and therapeutic responses on some tough cases.  You know, on a personal note, just last week when I left a family meeting feeling really depleted and stuck, I called one of my trusted colleagues and just for 3 minutes constructively, sort of cathartically vented what was coming up within me after that family meeting, which allowed me to have more of an enlightened stance on what to do next and how to be therapeutically helpful for the case. One of my colleagues calls this "friend-tors." They coined the phrase, and they actually wrote a paper about it. Who within your peer group of trusted colleagues can you utilize and phone in real time or have process opportunities with to get a pulse check on where what's coming up within us as we're doing this work? Dr. Hope Rugo: Yeah, and it's an interesting question about how one does that and, you know, maintaining that as you move institutions or change places or become more senior, it's really important.  One of the, I think, the challenges sometimes is that we come from different places from our patients, and that can be an issue, I think when our patients are very religious and the provider is not, or the reverse, patients who don't have religious beliefs and you're trying to sort of focus on the spirituality, but it doesn't really ring true. So, Dr. Sławkowski-Rode, what resources can patients and practitioners draw on when they're facing death and loss in the absence of, or just different religious beliefs that don't fit into the standard model? Dr. Mikołaj Sławkowski-Rode: You're absolutely right that this can be an extremely problematic situation to be in when there is that disconnect of religious belief or more generally spiritual engagement with the situation that we're in. But I just wanted to tie into what Dr. Brenner was saying just before. I couldn't agree more, and I think that a lot of healthcare practitioners, oncologists in particular who I've had the pleasure to talk to at ASCO and at other events as well, are very often quite skeptical about emotional engagement in their profession. They feel as though this is something to be managed, as it were, and something that gets in the way. And they can often be very critical of methods that help them understand the emotions and extend them towards patients because they feel that this will be an obstacle to doing their job and potentially an obstacle also to helping patients to their full ability if they focus on their own emotions or the burden that emotionally, spiritually, and in other ways the illness is for the patient. They feel that they should be focusing on the cancer rather than on the patient's emotions. And I think that a useful comparison, although, you know, perhaps slightly drastic, is that of combat experience of soldiers. They also need to be up and running and can't be too emotionally invested in the situation that they're in. But there's a crucial difference, which is that soldiers are usually engaged in very short bursts of activity with the time to go back and rethink, and they often have a lot of support for this in between. Whereas doctors are in a profession where their exposure to the emotions of patients and their own emotions, the emotions of families of patients is constant. And I think that there's a great danger in thinking that this is something to be avoided and something to compartmentalize in order to avoid burnout. I think, in a way, burnout is more sure to happen if your emotions and your attachment to your patients goes ignored for too long. So that's just following up on Keri's absolutely excellent points. As far as the disconnect is concerned, that's, in fact, an area in which I'm particularly interested in. That's where my research comes in. I'm interested in the kinds of connections that we have with other people, especially in terms of maintaining bonds when there is no spiritual belief, no spiritual backdrop to support this connection. In most religious traditions, we have the framework of the religious belief that tells us that the person who we've lost or the values that have become undermined in our life are something that hasn't been destroyed permanently but something that we can still believe we have a deep connection to despite its absence from our life. And how do you rebuild that sense of the existence of the things that you have perceivably lost without the appeal to some sort of transcendent realm which is defined by a given religion? And that is a hard question. That's a question, I think, that can be answered partly by psychology but also partly by philosophy in terms of looking at who we are as human beings and our nature as people who are essentially, or as entities that are essentially connected to one another. That connection, I believe, is more direct than the mediation of religion might at first suggest. I think that we essentially share the world not only physically, it's not just the case that we're all here, but more importantly, the world that we live in is not just the physical world but the world of meanings and values that helps us orient ourselves in society and amongst one another as friends and foes. And it is that shared sense of the world that we can appeal to when we're thinking about retaining the value or retaining the connection with the people who we have lost or the people who are helping through, go through an experience of facing death. And just to finish, there's a very interesting question, I think, something that we possibly don't have time to explore, about the degree of connection that we have with other people. So, what I've just been saying is something that rings more true or is more intuitive when we think about the connections that we have to our closest ones. We share a similar outlook onto the world, and our preferences and our moods and our emotions and our values are shaped by life with the other person. And so, appealing to these values can give us a sense of a continued presence. But what in those relationships where the connection isn't that close? For example, given the topic of this podcast, the connection that a patient has with their doctor and vice versa. In what sense can we talk about a shared world of experience? Well, I think, obviously, we should admit degrees to the kind of relationship that can sustain our connection with another person. But at the same time, I don't think there's a clear cutoff point. And I think part of emotional engagement in medical practice is finding yourself somewhere on that spectrum rather than thinking you're completely off of it. That's what I would say. Dr. Hope Rugo: That's very helpful and I think a very helpful way of thinking about how to manage this challenging situation for all of us.  One of the things that really, I think, is a big question for all of us throughout our careers, is when to address the dying process and how to do that. Dr. Brenner, you know, I still struggle with this – what to do when patients refuse to discuss end-of-life but they're very close to end of life? They don't want to talk about it. It's very stressful for all of us, even where you're going to be, how you're going to manage this. They're just absolutely opposed to that discussion. How should we approach those kinds of discussions? How do we manage that? How do you address the code discussion, which is so important? You know, these patients are not able to stay at home at end-of-life in general, so you really do need to have a code discussion before you're admitting them. It actually ends up being kind of a challenge and a mess all around. You know, I would love your advice about how to manage those situations. Dr. Keri Brenner: I think that's one of the most piercing and relevant inquiries we have within our clinical work and challenges. I often think of denial not as an all-or-nothing concept but rather as parts of self. There's a part of everyone's being where the unconscious believes it's immortal and will live on forever, and yet we all know intellectually that we all have mortality and finitude and transience, and that time will end. We often think of this work as more iterative and gradual and exposure based. There's potency to words. Saying, “You are dying within days,” is a lot higher potency of a phrase to share than, “This is serious illness. This illness is incurable. Time might be shorter than we hoped.” And so the earlier and more upstream we begin to have these conversations, even in small, subtle ways, it starts to begin to expose the patient to the concept so they can go from the head to the heart, not only knowing their prognosis intellectually but also affectively, to integrate it into who they are as a person because all patients are trying to live well while also we're gradually exposing them to this awareness of mortality within their own lived experience of illness. And that, ideally, happens gradually over time. Now, there are moments where the medical frame is very limited, and we might have short days, and we have to uptitrate those words and really accompany them more radically through those high-affective moments. And that's when we have to take a lot of more nuanced approaches, but I would say the more earlier and upstream the better. And then the second piece to that question as well is coping with our own mortality. The more we can be comfortable with our own transience and finitude and limitations, the more we will be able to accompany others through that. And even within my own life, I've had to integrate losses in a way where before I go in to talk to one of my own palliative care patients, one mantra I often say to myself is, “I'm just a few steps behind you. I don't know if it's going to be 30 days or 30 years, but I'm just a few steps behind you on this finite, transient road of life that is the human experience.” And that creates a stance of accompaniment that patients really can experience as they're traversing these tragedies. Dr. Hope Rugo: That's great. And I think those are really important points and actually some pearls, which I think we can take into the clinic. I think being really concrete when really the expected life expectancy is a few days to a couple of weeks can be very, very helpful. And making sure the patients hear you, but also continuing to let them know that, as oncologists, we're here for them. We're not abandoning them. I think that's a big worry for many, certainly of my patients, is that somehow when they would go to hospice or be a ‘no code', that we're not going to support them anymore or treat them anymore. That is a really important process of that as well. And of course, engaging the team makes a big difference because the whole oncology team can help to manage situations that are particularly challenging like that. And just as we close, I wanted to ask one last question of you, Dr. Brenner, that suffering, grief, and burnout, you've really made the point that these are not problems to fix but dimensions that we want to attend to and acknowledge as part of our lives, the dying process is part of all of our lives. It's just dealing with this in the unexpected and the, I think, unpredictability of life, you know, that people take on a lot of guilt and all sorts of things about, all sorts of emotions. And the question is now, people have listened to this podcast, what can they take back to their oncology teams to build a culture that supports clinicians and their team at large to engage with these realities in a meaningful and sustainable way? I really feel like if we could build the whole team approach where we're supporting each other and supporting the patients together, that that will help this process immeasurably. Dr. Keri Brenner: Yes, and I'm thinking about Dr. Sławkowski-Rode's observation about the combat analogy, and it made me recognize this distinction between suppression and repression. Repression is this unconscious process, and this is what we're taught to do in medical training all the time, to just involuntarily shove that tragedy under the rug, just forget about it and see the next patient and move on. And we know that if we keep unconsciously shoving things under the rug, that it will lead to burnout and lack of sustainability for our clinical teams. Suppression is a more conscious process. That deliberate effort to say, “This was a tragedy that I bore witness to. I know I need to put that in a box on the shelf for now because I have 10 other patients I have to see.” And yet, do I work in a culture where I can take that off the shelf during particular moments and process it with my interdisciplinary team, phone a friend, talk to a trusted colleague, have some trusted case supervision around it, or process rounds around it, talk to my social worker? And I think the more that we model this type of self-reflective capacity as attendings, folks who have been in the field for decades, the more we create that ethos and culture that is sustainable because clinician self-reflection is never a weakness, rather it's a silent strength. Clinician self-reflection is this portal for wisdom, connectedness, sustainability, and ultimately transformative growth within ourselves. Dr. Hope Rugo: That's such a great point, and I think this whole discussion has been so helpful for me and I hope for our audience that we really can take these points and bring them to our practice. I think, “Wow, this is such a great conversation. I'd like to have the team as a whole listen to this as ways to sort of strategize talking about the process, our patients, and being supportive as a team, understanding how we manage spirituality when it connects and when it doesn't.” All of these points, they're bringing in how we process these issues and the whole idea of suppressing versus sort of deciding that it never happened at all is, I think, very important because that's just a tool for managing our daily lives, our busy clinics, and everything we manage. Dr. Keri Brenner: And Dr. Rugo, it's reminding me at Stanford, you know, we have this weekly practice that's just a ritual where every Friday morning for 30 minutes, our social worker leads a process rounds with us as a team, where we talk about how the work that we're doing clinically is affecting us in our lives in ways that have joy and greater meaning and connectedness and other ways that might be depleting. And that kind of authentic vulnerability with one another allows us to show up more authentically for our patients. So those rituals, that small 30 minutes once a week, goes a long way. And it reminds me that sometimes slowing things down with those rituals can really get us to more meaningful, transformative places ultimately. Dr. Hope Rugo: It's a great idea, and I think, you know, making time for that in everybody's busy days where they just don't have any time anymore is important. And you don't have to do it weekly, you could even do something monthly. I think there's a lot of options, and that's a great suggestion. I want to thank you both for taking your time out for this enriching and incredibly helpful conversation. Our listeners will find a link to the Ed Book article we discussed today, which is excellent, in the transcript of this episode. I want to thank you again, Dr. Brenner and Dr. Sławkowski-Rode, for your time and for your excellent thoughts and advice and direction. Dr. Mikołaj Sławkowski-Rode: Thank you very much, Dr. Rugo. Dr. Keri Brenner: Thank you. Dr. Hope Rugo: And thanks to our listeners for joining us today. Please join us again next month on By the Book for more insightful views on topics you'll be hearing at the education sessions from ASCO meetings and our deep dives on new approaches that are shaping modern oncology. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:      Dr. Hope Rugo @hope.rugo Dr. Keri Brenner @keri_brenner Dr. Mikolaj Slawkowski-Rode @MikolajRode Follow ASCO on social media:      @ASCO on X (formerly Twitter)      ASCO on Bluesky     ASCO on Facebook      ASCO on LinkedIn      Disclosures:     Dr. Hope Rugo: Honoraria: Mylan/Viatris, Chugai Pharma Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx Dr. Keri Brenner: No relationships to disclose Dr. Mikolaj Slawkowski-Rode: No relationships to disclose    

One of the most overlooked but transformative tools in health care is the courage to face hard truths, especially at the end of life. In this episode, Dr. Jessica Zitter shares how burnout and a pivotal confrontation early in her ICU career led her to embrace the palliative care movement and shift toward more human-centered healing. Through her films Extremis, Caregiver: A Love Story, and The Chaplain and the Doctor, she uses storytelling to explore ethical dilemmas, systemic challenges, and the urgent need for holistic care and honest conversations about death. Tune in and learn how emotional honesty, empathy, and art can rehumanize health care, one story at a time! Learn more about your ad choices. Visit megaphone.fm/adchoices

In today's episode, supported by Coherus BioSciences, we had the pleasure of speaking with Justine Bruce, MD, about the ongoing evolution of nasopharyngeal carcinoma management. Dr Bruce is a faculty member in the Division of Hematology, Medical Oncology and Palliative Care within the Department of Medicine at the University of Wisconsin, as well as the director of the VA Medical Oncology Clinical Research Program and chair of the Protocol Review and Monitoring Committee at the University of Wisconsin Carbone Cancer Center in Madison. In our exclusive interview, Dr Bruce discussed evolving treatment strategies for nasopharyngeal cancer, emphasizing the shift from chemoradiation followed by adjuvant chemotherapy to induction chemotherapy with gemcitabine and cisplatin. She also noted how toripalimab-tpzi (Loqtorzi) combined with gemcitabine and cisplatin showed improved overall survival (OS) in the first-line setting in the phase 3 JUPITER-02 trial (NCT03581786). Bruce also expressed her preference for OS as the gold standard for determining the efficacy of nasopharyngeal cancer treatments and noted the need for more US-based trials to reflect the local patient population.

In this episode, Susan Ryan sits down with Rachel Broudy, MD, a passionate physician, innovator, and advocate for transforming eldercare. Her extensive experience includes serving as medical director at two PACE programs and currently as medical director of Pioneer Valley Hospice and Palliative Care and eldercare faculty at Ariadne Labs. This episode explores Dr. Broudy's journey into aging services and her groundbreaking work at Ariadne Labs, where she led the creation of a well-being framework and conversation guide for nursing homes. Developed through Ariadne's Innovation Arc process—research, design, test, and spread—this four-year project culminated in a pilot at two Mississippi nursing homes. The result? A practical, scalable toolkit that empowers staff and centers care on purpose, connection, and meaning. Dr. Broudy also shares her work on the Living Well with Dementia Toolkit, which redefines dementia care as an adaptive, relational journey. The toolkit includes conversation and emotion cards that help families and caregivers explore emotions, relationships, and identity—helping shift how we understand and support those living with dementia. If you're looking for inspiring ideas and practical tools to shift the culture of aging and long-term care, this episode is a must-listen. Some links of interest: Ariadne Labs Innovation Arc: https://www.ariadnelabs.org/about-us/ariadne-labs-arc/ Ariadne Labs Well-being Framework & Conversation Guide: https://www.ariadnelabs.org/resources/downloads/wellbeing-toolkit-conversation-guide/ Ariadne Labs Living Well with Dementia Toolkit: https://www.ariadnelabs.org/dementia-solutions/

Gigi Robinson grew up with Ehlers-Danlos syndrome, a disease that turns your joints into overcooked spaghetti. Instead of letting it sideline her, she built a career out of telling the truth about invisible illness. We talk about what it takes to grow up faster than you should, why chronic illness is the worst unpaid internship, and how she turned her story into a business. You'll hear about her days schlepping to physical therapy before sunrise, documenting the sterile absurdity of waiting rooms, and finding purpose in the mess. Gigi's not interested in pity or polished narratives. She wants you to see what resilience really looks like, even when it's ugly. If you think you know what an influencer does, think again. This conversation will challenge your assumptions about work, health, and what it means to be seen.RELATED LINKSGigi Robinson Website: https://www.gigirobinson.comLinkedIn: https://www.linkedin.com/in/gigirobinsonInstagram: https://www.instagram.com/itsgigirobinsonTikTok: @itsgigirobinsonA Kids Book About Chronic Illness: https://akidsco.com/products/a-kids-book-about-chronic-illnessFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Cancer is an identity-shaping experience. Survivors are forever changed and carry both physical and mental scars. In this episode, Dr. John Mulder and Dr. Jason Beckrow talk with special guest Dr. Joseph McCollum. Dr. McCollum is both a medical oncologist and palliative oncologist who is also a part of a survivorship care clinic. He shares how he and his team are working to integrate palliative care concepts into survivorship care, helping those who have overcome this harrowing experience start putting the pieces back together. 

Host Rachel Neufeld chats with Dr Ripu Minhas, a developmental pediatrician at St. Michael's Hospital, Unity Health Toronto and an Associate Professor of Pediatrics. They explore how diverse sociolinguistic identities impact how information is shared and received and how it can impact care of children. NewsletterSign Up:  http://tinyurl.com/ourkidshealthWebsite: https://kidshealthnetwork.org/ LinkedIn: www.linkedin.com/company/our-kids-health Twitter/X:https://twitter.com/Our_KidsHealth Our Chapters: https://linktr.ee/ourkidshealth

In this week's episode, we dig into two deceptively simple questions: When does someone become a cancer survivor, and should palliative care be in the business of caring for them? Spoiler: It's more complicated than it seems. We've invited two palliative care doctors to talk about survivorship with us: Laura Petrillo, a physician-researcher at Mass General Hospital and Harvard Medical School, and Laura Shoemaker, an outpatient palliative care doctor at the Cleveland Clinic. This episode is a must-listen for those navigating the evolving landscape of cancer care, and asking not just how we treat cancer, but how we support people who are living with it.  If you want some further reading on survivorship, check out some of these articles: A NEJM article titled “Time to Study Metastatic-Cancer Survivorship” A ASCO publication that includes a section on survivorship - Patient-Centered Palliative Care for Patients With Advanced Lung Cancer A webinar on survivorship - Blending Survivorship and Palliative Care (NCI)

What makes Hospice special isn't magic—it's the masterful implementation of coordinated care plans that align interdisciplinary teams with patient priorities.  This month's deep dive into June's most critical Hospice and Palliative Care developments explores how this "secret sauce" remains simultaneously the heart of our philosophy and our most common survey deficiency.  In this episode of TCNtalks, host Chris Comeaux and Cordt Kassner, Publisher of Hospice & Palliative Care Today & CEO and Founder of Hospice Analytics, discuss relevant top news stories in Hospice and Palliative Care for June.They also explore technology's dual-edged potential, suggesting that AI and robotics should enhance, rather than replace, the human elements of Hospice Care.  As Daniel Pink notes, "if a robot can replace you, you should be"—allowing us to focus our irreplaceable human capacity on meaningful connection rather than routine tasks.Dr. Ira Byock's strategic framework for hospice's future emerges as perhaps the most significant development of the month, offering four concrete paths forward: establishing clear clinical standards (like appropriate caseload sizes), creating meaningful data transparency, driving quality-based competition, and embracing our authentic brand as specialists in fostering well-being through the end of life. Subscribe to TCNtalks for monthly insights.  Additionally, we explore leadership strategies for growth and the necessity of a strategic path forward in Hospice and Palliative Care, emphasizing the importance of quality and ethical practices in the field.  We respect your time while keeping you informed on what truly matters.  Join us.Guest:Cordt KassnerPhD, Publisher of Hospice & Palliative Care Today & CEO and Founder of Hospice AnalyticsHost:Chris ComeauxPresident / CEO of TELEIOShttps://www.teleioscn.org/tcntalkspodcast/plans-of-care-ethics-robotics-and-more-top-news-stories-june-2025Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

Mike Wills speaks to Leigh Meinert, operations manager at Dignity South Africa and former advocacy manager for the Association of Palliative Care Centres. Leigh is a trained death doula with over 20 years’ experience in making healthcare and compassionate care more accessible — and she’s part of a growing movement calling for South Africa to offer both: excellent palliative care and the legal right to assisted dying for those facing irreversible suffering. Presenter John Maytham is an actor and author-turned-talk radio veteran and seasoned journalist. His show serves a round-up of local and international news coupled with the latest in business, sport, traffic and weather. The host’s eclectic interests mean the program often surprises the audience with intriguing book reviews and inspiring interviews profiling artists. A daily highlight is Rapid Fire, just after 5:30pm. CapeTalk fans call in, to stump the presenter with their general knowledge questions. Another firm favourite is the humorous Thursday crossing with award-winning journalist Rebecca Davis, called “Plan B”. Thank you for listening to a podcast from Afternoon Drive with John Maytham Listen live on Primedia+ weekdays from 15:00 and 18:00 (SA Time) to Afternoon Drive with John Maytham broadcast on CapeTalk https://buff.ly/NnFM3Nk For more from the show go to https://buff.ly/BSFy4Cn or find all the catch-up podcasts here https://buff.ly/n8nWt4x Subscribe to the CapeTalk Daily and Weekly Newsletters https://buff.ly/sbvVZD5Follow us on social media:CapeTalk on Facebook: https://www.facebook.com/CapeTalkCapeTalk on TikTok: https://www.tiktok.com/@capetalkCapeTalk on Instagram: https://www.instagram.com/CapeTalk on X: https://x.com/CapeTalkCapeTalk on YouTube: https://www.youtube.com/@CapeTalk567See omnystudio.com/listener for privacy information.

Episode Description:If you've ever wondered what happens when a Bronx-born pediatric nurse with stage 4 colon cancer survives, raises a kid, becomes a policy shark, and fights like hell for the ignored, meet Vanessa Ghigliotty. She's not inspirational. She's a bulldozer. We go way back—like pre-Stupid Cancer back—when there was no “young adult cancer movement,” just a handful of pissed-off survivors building something out of nothing. This episode is personal. Vanessa and I built the plane while flying it. She fought to be heard, showed up in chemo dragging her kid to IEP meetings, and never stopped screaming for the rest of us to get what we needed. We talk war stories, progress, side-eyeing advocacy fads, TikTok activism, gatekeeping, policy wins, and why being loud is still necessary. And yeah—she's a damn good mom. Probably a better one than you. You'll laugh. You'll cry. You'll want to scream into a pillow. Come for the nostalgia. Stay for the righteous anger and iced coffee.RELATED LINKSVanessa on LinkedInColorectal Cancer Alliance: Vanessa's StoryZenOnco Interview with VanessaFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

What role can psychedelics play in helping terminally ill patients face death with peace, clarity, and meaning?  In this episode, we welcome Hannah Whitmore, PhD, RN, CHPN®, a Registered Nurse and PhD researcher whose work—The Pragmatism of Palliative Care—explores the clinical potential of Psychedelic-Assisted Therapy (PAT) to support death acceptance in patients at the end of life. Dr. Whitmore brings a compassionate and evidence-based lens to a topic that challenges long-standing models of care, offering insight into how PAT could be thoughtfully integrated into palliative and hospice settings.  Together, we explore:  The latest research on PAT for existential distress and death anxiety  Clinical and ethical considerations when working with terminally ill populations  Barriers to implementation and the future possibilities for PAT in end-of-life care  How nursing science is shaping new approaches to healing at the end of life  This episode is a grounded, deeply human conversation at the intersection of medicine, mortality, and meaning—guided by a nurse scientist dedicated to easing suffering when it matters most.      Hannah Whitmore, PhD, RN, CHPN Certified hospice and palliative care nurse and clinician scientist, Dr. Whitmore supports individuals, families, and healthcare teams navigating serious illness and end-of-life transitions. Currently a post-doctoral fellow at the University of California, San Francisco (UCSF), she combines hands-on experience with a holistic approach informed by the latest research, mindfulness practices, and symptom management expertise. Her research focuses on symptom science and the integration of psychedelic-assisted therapy to address existential distress, depression, and promote death acceptance in seriously ill individuals. A member of Sigma Global Nursing Excellence, Dr. Whitmore guides healthcare teams and provides culturally sensitive care to diverse populations. She collaborates with healthcare organizations to enhance palliative care services and empowers individuals and teams to find resilience and dignity in complex end-of-life situations.    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.

Dr Michelle Meiring spoke to Mike Wills about her open letter opposing the legalisation of assisted dying in South Africa, the ethical concerns raised by palliative care specialists, and why she believes better pain management-not assisted suicide-is the answer. The Money Show is a podcast hosted by well-known journalist and radio presenter, Stephen Grootes. He explores the latest economic trends, business developments, investment opportunities, and personal finance strategies. Each episode features engaging conversations with top newsmakers, industry experts, financial advisors, entrepreneurs, and politicians, offering you thought-provoking insights to navigate the ever-changing financial landscape. Thank you for listening to a podcast from The Money Show Listen live Primedia+ weekdays from 18:00 and 20:00 (SA Time) to The Money Show with Stephen Grootes broadcast on 702 https://buff.ly/gk3y0Kj and CapeTalk https://buff.ly/NnFM3Nk For more from the show, go to https://buff.ly/7QpH0jY or find all the catch-up podcasts here https://buff.ly/PlhvUVe Subscribe to The Money Show Daily Newsletter and the Weekly Business Wrap here https://buff.ly/v5mfetc The Money Show is brought to you by Absa Follow us on social media 702 on Facebook: https://www.facebook.com/TalkRadio702702 on TikTok: https://www.tiktok.com/@talkradio702702 on Instagram: https://www.instagram.com/talkradio702/702 on X: https://x.com/CapeTalk702 on YouTube: https://www.youtube.com/@radio702 CapeTalk on Facebook: https://www.facebook.com/CapeTalkCapeTalk on TikTok: https://www.tiktok.com/@capetalkCapeTalk on Instagram: https://www.instagram.com/CapeTalk on X: https://x.com/Radio702CapeTalk on YouTube: https://www.youtube.com/@CapeTalk567See omnystudio.com/listener for privacy information.

Risa Arin doesn't just talk about health literacy. She built the damn platform. As founder and CEO of XpertPatient.com (yes, expert with no E), Risa's taking a wrecking ball to how cancer education is delivered. A Cornell alum, cancer caregiver, and ex-agency insider who once sold Doritos to teens, she now applies that same marketing muscle to helping patients actually understand the garbage fire that is our healthcare system. We talk about why she left the “complacent social safety” of agency life, how her mom unknowingly used her own site during treatment, what it's like to pitch cancer education after someone pitches warm cookies, and why healthcare should come with a map, a translator, and a refund policy. Risa brings data, chutzpah, and Murphy Brown energy to the conversation—and you'll leave smarter, angrier, and maybe even a little more hopeful.RELATED LINKS• XpertPatient.com• Risa Arin on LinkedIn• XpertPatient & Antidote Partnership• XpertPatient Featured on KTLA• 2024 Health Award BioFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

หมอแนต-พญ.นิษฐา เอื้ออารีมิตร เติบโตมาในครอบครัวผู้บริหารโรงพยาบาลเอกชัย แต่กลับไม่เคยมีความคิดสานต่องานบริหารเลย จนกระทั่งอายุ 39 หลังได้อ่านสมุดเบาใจของคุณพ่อ เธอจึงเริ่มเข้าสู่งานบริหารและสร้าง ‘โรงพยาบาลคูน (KOON Hospital)' ที่มีการรักษาแบบประคับประคอง (Palliative Care) แห่งแรกในไทย ภายใต้แนวคิดที่เน้นให้คนไข้และครอบครัวมีความสุขและมีคุณภาพชีวิตที่ดีขึ้นในช่วงเวลาที่ลำบาก พร้อมออกแบบพื้นที่โรงพยาบาลให้เหมือนอยู่บ้าน มากกว่าการนอนรอในห้องพักผู้ป่วยธรรมดา   กว่าจะมาเป็นหมอแนตในวันนี้ เธอเคยเป็นหมอ ICU ที่คุ้นเคยกับการรับมือคนไข้ในช่วงวิกฤตมาก่อน เธอชอบทำงานในโรงพยาบาลรัฐ และมีใจรักการสอนนักเรียนแพทย์ จนวันหนึ่งที่ไม่รู้ว่าจะสอนอะไรให้นักเรียนแพทย์ที่ต้องดูแลคนไข้รับมือกับผู้ป่วย NR (No Resuscitation) หรือผู้ป่วยที่ไม่มีโอกาสรอดแล้ว หมอแนตจึงตัดสินใจลงเรียนเกี่ยวกับ Palliative Care และคอร์สสั้น ๆ นั้นกลับเป็นจุดเปลี่ยนสำคัญที่พาเธอก้าวออกจากพื้นที่เดิม สู่วิธีคิดแบบใหม่ไปตลอดกาล วันนี้ในวัย 44 ปี หมอแนตแตกต่างจากหมอ ICU ในอดีตคนนั้นอย่างสิ้นเชิง เธอไม่ได้เป็นหมอที่พยายามทำทุกวิถีทางให้คนไข้รอดชีวิตเพียงอย่างเดียว แต่เธอเป็นนักออกแบบคุณภาพชีวิตที่เชื่อในพลังของการสื่อสาร ความเข้าใจ และการเรียนรู้ร่วมกัน   เธอสนุกกับการสอน พัฒนาทีม และสร้างพื้นที่ให้คนไข้ไม่เพียงได้รับการดูแลทางการแพทย์ แต่ยังได้ใช้ชีวิตอย่างมีความหมายร่วมกับครอบครัวในช่วงเวลาเปราะบางที่สุด โรงพยาบาลคูนไม่ได้เป็นแค่สถานที่สำหรับผู้ป่วยระยะท้าย แต่ยังเป็นจุดเริ่มต้นของการหายดีสำหรับหลายคนที่กลับบ้านไปพร้อมชีวิตที่มีคุณภาพขึ้น และเธอยังเดินหน้าเปิดโรงพยาบาลคูนสาขาใหม่ที่อ่าวนาง จังหวัดกระบี่ เร็ว ๆ นี้อีกด้วย    ดำเนินรายการ : ทรงกลด บางยี่ขัน กำกับ : เมธี สมานทอง ถ่ายภาพ : เมธี สมานทอง ตัดต่อ : กิตติรักษ์ คงอาวุธ ควบคุมการผลิต : วรัมพร ศิริสวัสดิ์, ชนกพัดชา สินอาษา นักศึกษาฝึกงาน : กานต์ ปิยารักษ์, มนัสวี งามนิมิตรธรรม 

Learn about the specialty of pediatric palliative care and how one doctor has benefitted from his relationship with his seriously ill patients. My guest Dr. Bob Macauley is one of only a few hundred pediatricians in the U.S. specializing in palliative care for children with life-threatening illness. Uniquely Dr. Macauley attended both divinity school and… Continue reading Ep. 506 Pediatric Palliative Care and the Remarkable Children it Serves with Bob Macauley MD

In this episode, Dr. Janet Abrahm shares transformative insights from ASCO 2025, focusing on palliative care and supportive care in oncology. Topics discussed include the role of exercise in cancer survival, cannabis use for symptom management, and the challenges of chemotherapy-induced peripheral neuropathy. We also highlight the importance of communication with patients, particularly in the context of grief and transition to palliative care, as well as the pervasive issue of burnout among oncology professionals.Studies discussed in the episode:Cannabis [Educational session re: ASCO 2024 Guideline; abstrs 120831; 12061]Hot flashes [508]Is local estrogen therapy safe for breast cancer survivors [578]Duloxetine: Disappointing results [12010]2021 study report [9005] with discussion of 2023 updatesChallenge Trial - Exercise extends life in Colon CA pts: already in NEJM and reported earlier in ASCO GI meeting LBA3510AND MORE!Check out Janet's page for more palliative care information: https://janetabrahm.com/ For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer, Gilead Pharmaceuticals and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content. Hosted on Acast. See acast.com/privacy for more information.

หมอแนต-พญ.นิษฐา เอื้ออารีมิตร เติบโตมาในครอบครัวผู้บริหารโรงพยาบาลเอกชัย แต่กลับไม่เคยมีความคิดสานต่องานบริหารเลย จนกระทั่งอายุ 39 หลังได้อ่านสมุดเบาใจของคุณพ่อ เธอจึงเริ่มเข้าสู่งานบริหารและสร้าง ‘โรงพยาบาลคูน (KOON Hospital)' ที่มีการรักษาแบบประคับประคอง (Palliative Care) แห่งแรกในไทย ภายใต้แนวคิดที่เน้นให้คนไข้และครอบครัวมีความสุขและมีคุณภาพชีวิตที่ดีขึ้นในช่วงเวลาที่ลำบาก พร้อมออกแบบพื้นที่โรงพยาบาลให้เหมือนอยู่บ้าน มากกว่าการนอนรอในห้องพักผู้ป่วยธรรมดา กว่าจะมาเป็นหมอแนตในวันนี้ เธอเคยเป็นหมอ ICU ที่คุ้นเคยกับการรับมือคนไข้ในช่วงวิกฤตมาก่อน เธอชอบทำงานในโรงพยาบาลรัฐ และมีใจรักการสอนนักเรียนแพทย์ จนวันหนึ่งที่ไม่รู้ว่าจะสอนอะไรให้นักเรียนแพทย์ที่ต้องดูแลคนไข้รับมือกับผู้ป่วย NR (No Resuscitation) หรือผู้ป่วยที่ไม่มีโอกาสรอดแล้ว หมอแนตจึงตัดสินใจลงเรียนเกี่ยวกับ Palliative Care และคอร์สสั้น ๆ นั้นกลับเป็นจุดเปลี่ยนสำคัญที่พาเธอก้าวออกจากพื้นที่เดิม สู่วิธีคิดแบบใหม่ไปตลอดกาล วันนี้ในวัย 44 ปี หมอแนตแตกต่างจากหมอ ICU ในอดีตคนนั้นอย่างสิ้นเชิง เธอไม่ได้เป็นหมอที่พยายามทำทุกวิถีทางให้คนไข้รอดชีวิตเพียงอย่างเดียว แต่เธอเป็นนักออกแบบคุณภาพชีวิตที่เชื่อในพลังของการสื่อสาร ความเข้าใจ และการเรียนรู้ร่วมกัน เธอสนุกกับการสอน พัฒนาทีม และสร้างพื้นที่ให้คนไข้ไม่เพียงได้รับการดูแลทางการแพทย์ แต่ยังได้ใช้ชีวิตอย่างมีความหมายร่วมกับครอบครัวในช่วงเวลาเปราะบางที่สุด โรงพยาบาลคูนไม่ได้เป็นแค่สถานที่สำหรับผู้ป่วยระยะท้าย แต่ยังเป็นจุดเริ่มต้นของการหายดีสำหรับหลายคนที่กลับบ้านไปพร้อมชีวิตที่มีคุณภาพขึ้น และเธอยังเดินหน้าเปิดโรงพยาบาลคูนสาขาใหม่ที่อ่าวนาง จังหวัดกระบี่ เร็ว ๆ นี้อีกด้วย  ดำเนินรายการ : ทรงกลด บางยี่ขัน กำกับ : เมธี สมานทอง ถ่ายภาพ : เมธี สมานทอง ตัดต่อ : กิตติรักษ์ คงอาวุธ ควบคุมการผลิต : วรัมพร ศิริสวัสดิ์, ชนกพัดชา สินอาษา นักศึกษาฝึกงาน : กานต์ ปิยารักษ์, มนัสวี งามนิมิตรธรรม

Shrug off the cloak of secrecy and awkwardness around death with palliative care nurse Pippa White. I've been wanting to bring a death convo to the airwaves for ages, because there's a huge imbalance between light/dark, above/below, waxing/waning, growth/decay, possessing/relinquishing energies in our culture (and I'm the first person to perpetuate it). Shout out to everyone who sent frank and thoughtful questions for Pippa to answer – you'll hear them towards the end of the ep.Pippa White is a palliative care nurse and death care advocate and educator in the Anthroposophical tradition. We discuss:

In this episode of Voices in Leadership, host Melissa Andrews, President and CEO of LeadingAge Virginia, speaks with Jennifer Martin, RN, CHPN, and Carlos Galliamore, BS, RN, of Blue Ridge Care in Winchester, VA. Together, they explore the importance of expanding access to hospice and palliative care and breaking down common misconceptions. The conversation highlights the organization's compassionate, community-centered approach, the leadership philosophies that guide their work, and how they are using innovation to better serve patients and families in their region.Voices in Leadership is produced by Association Briefings.

Dr. Jamie Wells is back—and this time, she brought a book. We cover everything from biomedical design screwups to the glorified billing software known as the EHR. Jamie's new book, A Clinical Lens on Pediatric Engineering, is a masterclass in what happens when you stop treating kids like small, drunk adults and start designing medicine around actual human factors. We talk about AI in pediatric radiology, why drug repurposing might save lives faster than biotech IPOs, and the absurdity of thinking one-size-fits-all in healthcare still works.Jamie's a former physician, a health policy disruptor, a bioethicist, an MIT director, and a recovering adjunct professor. She's also a unicorn. We dig into the wonk, throw shade at bad design, and channel our inner Lisa Simpsons. This one's for anyone who ever wondered why kids' hospitals feel like hell and why “make it taste like bubblegum” might be the most important clinical innovation of all time. You'll laugh, you'll learn, and you might get angry enough to fix something.RELATED LINKSJamie Wells on LinkedInBook: A Clinical Lens on Pediatric Engineering (Amazon)Book on SpringerDrexel BioMed ProfileGlobal Blockchain Business CouncilJamie's HuffPost ArticlesFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Providing free surgery is at the heart of Mercy Ships' mission — but what happens when we come across conditions that surgery can't fix?

หลายคนคงรู้จัก รศ.นพ.ฉันชาย สิทธิพันธุ์ ในฐานะฝาแฝดของ รศ.ดร.ชัชชาติ สิทธิพันธุ์ ผู้ว่าราชการกรุงเทพมหานคร แต่วันนี้รายการ Coming of Age จะพาไปรู้จักตัวตนจริง ๆ ของเขาในฐานะ ‘ฉันชาย' ในหลากบทบาทชีวิต ตั้งแต่ผู้อำนวยการโรงพยาบาลจุฬาลงกรณ์ สภากาชาดไทย และคณบดีคณะแพทยศาสตร์ จุฬาลงกรณ์มหาวิทยาลัย ที่ทั้งทำหน้าที่ตรวจคนไข้และบริหารองค์กร ฉันชายเข้าสู่ตำแหน่งพร้อมเหตุการณ์คอมพิวเตอร์ล่มและวิกฤตโควิด-19 จนถึงขั้นต้องพาซินแสมาดูฮวงจุ้ยห้องทำงาน แต่สิ่งเหล่านั้นกลับกลายเป็นบทเรียนในการสร้างองค์กรที่ยืดหยุ่นจวบจนปัจจุบัน ถึงแม้จะมีเส้นทางอาชีพแตกต่างกับฝาแฝด แต่ที่เหมือนกันคือการมุ่งช่วยเหลือสังคม หลังจากเลือกเรียนเฉพาะทางเป็นหมอ ICU เขาเห็นสภาพแวดล้อมที่เต็มไปด้วยความกดดันและการรักษาที่ต้องขึ้นอยู่กับเงื่อนไขของเวลา จนเริ่มผลักดันการรักษาแบบประคับประคอง หรือ Palliative Care ที่เน้นทำให้คนไข้มีชีวิตอยู่อย่างมีคุณภาพ พร้อมส่งต่อแนวคิดนี้ให้นิสิตแพทย์รุ่นใหม่ ปีนี้โรงพยาบาลจุฬาฯ ก้าวสู่ปีที่ 111 เขายังคงเดินหน้าพัฒนาองค์กรและตัวเองอย่างมั่นคง นอกจากมาคุยถึงอนาคตที่ไม่ได้มองหาความสมบูรณ์แบบ ฉันชายยังย้อนเล่าถึงอดีตที่เติบโตมากับฝาแฝด และวิถีชีวิตในครอบครัวสิทธิพันธุ์ที่ทำให้เขาเป็นเขาในวันนี้   ดำเนินรายการ : ทรงกลด บางยี่ขัน

หลายคนคงรู้จัก รศ.นพ.ฉันชาย สิทธิพันธุ์ ในฐานะฝาแฝดของ รศ.ดร.ชัชชาติ สิทธิพันธุ์ ผู้ว่าราชการกรุงเทพมหานคร แต่วันนี้รายการ Coming of Age จะพาไปรู้จักตัวตนจริง ๆ ของเขาในฐานะ ‘ฉันชาย' ในหลากบทบาทชีวิต ตั้งแต่ผู้อำนวยการโรงพยาบาลจุฬาลงกรณ์ สภากาชาดไทย และคณบดีคณะแพทยศาสตร์ จุฬาลงกรณ์มหาวิทยาลัย ที่ทั้งทำหน้าที่ตรวจคนไข้และบริหารองค์กร ฉันชายเข้าสู่ตำแหน่งพร้อมเหตุการณ์คอมพิวเตอร์ล่มและวิกฤตโควิด-19 จนถึงขั้นต้องพาซินแสมาดูฮวงจุ้ยห้องทำงาน แต่สิ่งเหล่านั้นกลับกลายเป็นบทเรียนในการสร้างองค์กรที่ยืดหยุ่นจวบจนปัจจุบัน ถึงแม้จะมีเส้นทางอาชีพแตกต่างกับฝาแฝด แต่ที่เหมือนกันคือการมุ่งช่วยเหลือสังคม หลังจากเลือกเรียนเฉพาะทางเป็นหมอ ICU เขาเห็นสภาพแวดล้อมที่เต็มไปด้วยความกดดันและการรักษาที่ต้องขึ้นอยู่กับเงื่อนไขของเวลา จนเริ่มผลักดันการรักษาแบบประคับประคอง หรือ Palliative Care ที่เน้นทำให้คนไข้มีชีวิตอยู่อย่างมีคุณภาพ พร้อมส่งต่อแนวคิดนี้ให้นิสิตแพทย์รุ่นใหม่ ปีนี้โรงพยาบาลจุฬาฯ ก้าวสู่ปีที่ 111 เขายังคงเดินหน้าพัฒนาองค์กรและตัวเองอย่างมั่นคง นอกจากมาคุยถึงอนาคตที่ไม่ได้มองหาความสมบูรณ์แบบ ฉันชายยังย้อนเล่าถึงอดีตที่เติบโตมากับฝาแฝด และวิถีชีวิตในครอบครัวสิทธิพันธุ์ที่ทำให้เขาเป็นเขาในวันนี้   ดำเนินรายการ : ทรงกลด บางยี่ขัน

What if we embraced death not with fear, but with love, dignity, and thoughtful planning?In this powerful and moving episode, hosts Robin and Al sit down with Dipti Purbhoo, Executive Director of the Dorothy Ley Hospice, to explore the essential, but often overlooked, role of hospice and palliative care in our healthcare system.Dipti shares her personal journey into the world of hospice, emphasizing the importance of early access to palliative care, community support, and the compassionate legacy that end-of-life services offer. From demystifying death to advocating for a proactive healthcare approach, this conversation is a poignant reminder of what it truly means to care for others and for the legacy we leave behind.Key takeaways:✨ Hospice is Heart Work – At its core, hospice care is about love, dignity, and showing up for people at their most vulnerable.✨ Start Sooner, Not Later – Palliative care isn't just for the final days; it can begin at diagnosis to support quality of life.✨ Community is Essential – Volunteers, donors, and grief support services form the foundation of holistic, accessible care.✨ Talk About It – Open conversations about end-of-life wishes empower families and reduce fear around death.✨ Care is a Legacy – Success isn't always about achievements—it's the lasting impact of compassion, presence, and advocacy.Connect with DiptiLinkedIn: https://www.linkedin.com/in/dipti-purbhoo/Website: https://dlhospice.org/Connect with Us • LinkedIn: Robin Bailey and Al McDonald • Website: Aria Benefits and Life & Legacy Advisory Group

Is the true heart of pediatrics found in the connection between practitioner and family?In this powerful episode of Pediatric Meltdown, Dr. Lia Gaggino sits down with physician, educator, and hand-in-hand parenting advocate Dr. Pam Oatis, who brings decades of primary care and hospital experience to the forefront. Together, they explore how listening, humility, and authentic relationships transform patient outcomes far beyond medical treatments alone. From the challenges of working in high-need communities to navigating tense family moments and exploring ethics in end-of-life care, this episode delves into the artistry that makes pediatric medicine so uniquely soul-filling. If you've ever questioned whether technical skill is enough—or wondered what truly heals—this conversation will invite you to see the science of medicine through the eyes of connection and compassion. Don't miss the life-changing insights you'll carry into every patient encounter.Be sure to catch the special announcement in the Takeaways.[0:01 - 07:59] Leaning Into Pediatrics: Beginnings, Inspiration, and Learning From FamiliesUnderstand why primary care pediatrics is infinitely rewarding—not just for the broad medical knowledge it demands, but for the lifelong learning about people, relationships, and cultures it provides.Learn the importance of setting parents at ease through open-ended questions and authentic appreciation, establishing trust and safety from the very first visit.Explore how humility and willingness to learn from families reveal the limitations of one-size-fits-all approaches and fuel long-term, mutually respectful relationships.Hear personal stories illustrating the deep impact of simple listening skills, such as appreciating each parent and seeing profound transformation in both relationships and care outcomes.[08:00 -16:40] The Power of Listening and Cultural Humility in Pediatric CareUncover how being attuned to parents' fears and self-doubt allows physicians to connect deeply, providing reassurance and support that transcends medical advice.Examine situations where cultural differences and past experiences inform parenting approaches, challenging providers to pause, listen, and reflect rather than judge.Appreciate how open, honest dialogue about discipline and race can lead to decades-long partnerships founded on mutual respect and understanding.Acknowledge that the wisdom and resilience of families, when honored, can lead to better outcomes than following protocols alone.[16:41 - 26:01] Human Connection: Biology, Society, and the Foundation of CareInvestigate the deep human need for connection, acknowledging our social wiring and the essential role that physical and emotional closeness play from birth through adulthood.Discover why the medical “team sport” approach leads to improved outcomes—not just for children, but for providers and families navigating medical complexity together.Identify the under-recognized burdens society places on parents and why framing parental challenges as cultural rather than personal failures empower families.Explore how respect, dignity, and honest collaboration form the backbone of effective care—and why accurate patient histories and trusting relationships matter as much as diagnostics.[26:02 - 07:59] From Touch to Teamwork: Bioethics, Palliative Care, and Listening PartnershipsLearn how physical touch is not just diagnostic, but profoundly healing, fostering trust and well-being in children and families.Understand the evolution of bioethics and palliative care as disciplines built on listening, respect, and honoring families' definitions of meaning and...

Erica Campbell walked away from corporate life, took a hard left from the British Embassy, and found her calling writing checks for families nobody else sees. As Executive Director of Pinky Swear Foundation, she doesn't waste time on fluff. Her team pays rent, fills gas tanks, and gives sick kids' parents the one thing they don't have—time. Then, breast cancer hit her. She became the patient. Wrote a book about it. Didn't sugarcoat a damn thing. We talk about parking fees, grief, nonprofit burnout, and how the hell you decide which families get help and which don't. Also: AOL handles, John Hughes, and letters from strangers that make you cry. Erica is part Punky Brewster, part Rosie the Robot, and part Lisa Simpson—with just enough GenX Long Island sarcasm to make it all land. This one sticks.RELATED LINKSPinky Swear FoundationThe Mastectomy I Always Wanted (Book)Erica on LinkedInThink & Link: Erica Campbell“Like the Tale of a Starfish” - Blog Post“Cancer Diagnosis, Messy Life, Financial Support” - Blog PostFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

When a loved one is sick and caregiving gets exhausting, it can be powerful to have someone give you permission to take a break.Should you need their permission? Of course not. But the voices in your mind can be critical and bossy and insist that you continue to work or take care of other people until you're completely exhausted, stressed and depleted.This week we discuss the power of permission when we offer it to other people and also when we offer it to ourselves.What permission can you offer this week?Delia Delia Chiaramonte, MDCoping Courageously: A Heart-Centered Guide for Navigating a Loved One's Illness Without Losing Yourself is available here: www.copingcourageously.com A free guide for physicians to help reclaim your joy at work and in life https://trainings.integrativepalliative.com/pl/2148540010Please review this podcast wherever you listen and forward your favorite episode to a friend! And be sure to subscribe!Sign up to stay connected and learn about upcoming programs:https://trainings.integrativepalliative.com/IPI-stay-in-touchI'm thrilled to be listed in Feedspot's top 15 palliative podcasts!https://blog.feedspot.com/palliative_care_podcasts/

During this episode, I had the pleasure of chatting with Sofia Costa. Sofia is a Massage Therapist practicing in Hamilton, Ontario, Canada.In this episode, Sofia outlines the framework of a pilot project that she's helped develop ,alongside the University of McMaster. The project integrates Massage Therapy as part of the primary care team in the Pediatric PalliativeCare setting.Sofia and I also discuss the field of Pediatric Palliative care and its importance.While this topic can at times be difficult to hear, Sofia does a great job explaining its importance in our healthcare system.

ในช่วงหลายปีที่ผ่านมาแนวคิด ‘การดูแลแบบประคับประคอง' (palliative care) สำหรับผู้ป่วยระยะสุดท้ายได้รับความสำคัญมากขึ้นในสังคมไทย และเริ่มขยายวงกว้างทั้งในระดับบุคลากรทางการแพทย์ ครอบครัว และชุมชน การดูแลรูปแบบนี้ไม่ได้มุ่งหวังการรักษาให้หายขาด แต่เน้นไปที่การสร้างคุณภาพชีวิตที่ดีที่สุดในช่วงท้ายของชีวิต . อย่างไรก็ดี นอกจากการดูแลแบบประคับประคองในมนุษย์ ยังมีอีกหนึ่งองค์ความรู้ที่เริ่มถูกให้ความสำคัญ นั่นคือ ‘การดูแลแบบประคับประคองในสัตว์' ซึ่งหมายถึงการดูแลสัตว์เลี้ยงในวาระสุดท้ายของชีวิตอย่างเข้าใจ ไม่เพียงเพื่อลดความเจ็บปวดและไม่สบายทางกาย แต่ยังรวมถึงการดูแลสภาพจิตใจของสัตว์ อีกทั้งยังเป็นการเตรียมความพร้อมให้กับเจ้าของสัตว์เพื่อเผชิญหน้ากับการสูญเสียอย่างอ่อนโยน . 101 In Focus สัปดาห์นี้ ชวนสำรวจแนวคิด ‘การดูแลแบบประคับประคองในสัตว์' ซึ่งยังเป็นองค์ความรู้ที่ยังอยู่ในระยะตั้งไข่ในสังคมไทย เพื่อเข้าใจว่าการดูแลสัตว์เลี้ยงในวาระสุดท้ายของชีวิตนั้นคืออะไร มีขั้นตอนและกระบวนการอย่างไร และจะช่วยให้สัตว์เลี้ยง ‘ตายดี' อย่างสงบได้อย่างไร .

The need for better palliative care in nursing homes is significant. Consider this: the majority of the 1.4 million adults residing in U.S. nursing homes grapple with serious illnesses, and roughly half experience dementia. Many also suffer from distressing symptoms like pain. In addition, about 25% of all deaths in the United States occur within these facilities. Despite these substantial needs, specialized palliative care beyond hospice is rare in nursing homes. Furthermore, only about half of nursing home residents nearing the end of life receive hospice care. So, how can we improve palliative care for individuals in nursing homes? Today's podcast explores this crucial question with three leading experts: Connie Cole, Kathleen Unroe, and Cari Levy. Our discussion delves into: The specific palliative care needs of nursing home residents. How to think about primary and specialized palliative care in this setting. The obstacles hindering referrals to palliative care services. Practical strategies to overcome these barriers and enhance care. We also take a dive into these 2 articles that Connie first authored: Palliative care in nursing homes: A qualitative study on referral criteria and implications for research and practice. JAGS 2024 Nursing Home Palliative Care Referral Process, Barriers, and Proposed Solutions: A Qualitative Study. 2024 If you are interested in learning more, check out some of our other palliative care in nursing home podcasts including: Discussion of a primary palliative care multinational trial with Lieve Van den Block Understanding the variability in nursing home care A podcast on Palliative Rehab?!? with Ann Henshaw, Tamra Keeney, and Sarguni Singh  

In the UK, there is much discussion around assisted dying with a bill that is being voted on in government at the moment.In this episode I look at the ethics around it and what it might mean on an individual and societal level.Palliative Care: https://www.nhs.uk/tests-and-treatments/end-of-life-care/what-it-involves-and-when-it-starts/Dr Florian Willett's death: https://www.independent.co.uk/news/world/europe/suicide-pod-activist-euthanasia-sarco-b2762514.htmlLocked-in syndrome: https://my.clevelandclinic.org/health/diseases/22462-locked-in-syndrome-lisHow assisted dying works in The Netherlands: https://www.theguardian.com/lifeandstyle/2015/sep/11/assisted-dying-dutch-end-of-life-netherlands-unbearable-sufferingTalking about death and dying: https://www.hospiceuk.org/information-and-support/death-and-dying-what-expect/about-death-and-dyingThe Humanists view: https://humanists.uk/2023/10/03/six-reasons-we-need-an-assisted-dying-law/The current state of affairs in the UK regarding the assisted dying bill: https://www.bbc.co.uk/news/articles/c5y5d2g3wgxoMy new website: https://drayan.co.uk/ Hosted on Acast. See acast.com/privacy for more information.

Allyson with a Y. Ocean with two Ls. And zero chill when it comes to changing the face of cancer care. Dr. Allyson Ocean has been quietly—loudly—at the center of every major cancer breakthrough, nonprofit board, and science-backed gut punch you didn't know you needed to hear. In this episode, she joins me in-studio for a conversation two decades in the making. We talk twin life, genetics, mitochondrial disease, and why she skipped the Doublemint Twins commercial but still ended up as one of the most recognizable forces in oncology. We cover her nonprofit hits, from Michael's Mission to Let's Win Pancreatic Cancer to launching the American Jewish Medical Association—yes, that's a thing now. We get personal about compassion in medicine, burnout, bad food science, and microplastics in your blood. She also drops the kind of wisdom only someone with her résumé and sarcasm can. It's raw. It's real. It's the kind of conversation we should've had 20 years ago—but better late than never.RELATED LINKS:– Dr. Allyson Ocean on LinkedIn– Let's Win Pancreatic Cancer– NovoCure Leadership Page– Michael's Mission– American Jewish Medical Association– The POLG Foundation– Cancer Buddy App (Bone Marrow and Cancer Foundation)– Dr. Ocean at OncLiveFEEDBACK:Like this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@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 this episode, we hear from Deb Russell, RN, MSN, FNP-BC, APRN-CNP, ACHPN® with over 20 years in the field, currently leading care in an outpatient, harm-reduction-based palliative clinic. She provides palliative support to patients undergoing active cancer treatment who are also living with substance use disorders—a population with complex and often unmet needs.  Deb shares firsthand insight into:  Navigating symptom management during cancer treatment in patients with active addiction  Building trust through a harm-reduction approach  Collaborating closely with an interdisciplinary team including a physician and pharmacist  Deb shares the unique challenges and clinical considerations—of meeting this patient population where they are—safely managing pain, communication, and care coordination. This conversation offers practical insights and compassionate strategies for anyone caring for patients with co-occurring serious illness and SUD.      Deb Russell, RN, MSN, FNP-BC, APRN-CNP, ACHPN® Deb Russell, RN, MSN, FNP-BC, APRN-CNP, ACHPN® is a dedicated Nurse Practitioner specializing in Palliative Care, with a focus on cancer and addiction. With a deep commitment to patient-centered care, Deb provides compassionate support to patients battling both cancer and substance use disorders.   With over 18 years of experience mostly inpatient, now in the ambulatory setting, Deb works closely with the interdisciplinary team to develop care plans that improve patient outcomes. Deb is passionate about bridging the gap between oncology and addiction, advocating for treatment approaches that empower patients throughout their journey.  Deb has co-authored a paper “Creating a Palliative Care Clinic for Patients with Cancer and Substance Use Disorder” and presented a poster at the Oncology Nursing Congress on” Nurse Practitioner Integration in a Multidisciplinary Team Caring for Patients with Cancer and Addiction”.    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.

Sponsored by Invivyd, Inc.Nobody wants to hear about COVID-19 anymore. Especially not cancer patients. But if you've got a suppressed immune system thanks to chemo, radiation, stem cell transplants—or any of the other alphabet soup in your chart—then no, it's not over. It never was. While everyone else is getting sweaty at music festivals, you're still dodging a virus that could knock you flat.In this episode, Matthew Zachary and Matt Toresco say the quiet part out loud: many immunocompromised people may not even know they have options beyond vaccines. Why? Because the system doesn't bother to tell them. So we're doing it instead. We teamed up with Invivyd to help get the word out about tools other than vaccines that can help prevent COVID-19. We break down the why, the what, and the WTF of COVID-19 risk for cancer patients and why every oncologist should be talking about this.No fear-mongering. No sugarcoating. Just two guys with mics who've been through it and want to make sure you don't get blindsided. It's fast, funny, and furious—with actual facts. You've got more power than you think. Time to use it.RELATED LINKSExpand Their OptionsInvivydMatt Toresco on LinkedInOut of Patients podcastFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Featuring perspectives from Dr Farshid Dayyani, Ms Caroline Kuhlman, Dr Philip A Philip and Ms Amanda K Wagner, including the following topics: Introduction: Initial Management of Pancreatic Adenocarcinoma (PAD) (0:00) Clinical Presentation and Prognosis of PAD; Recent Advances in Up-Front Treatment for Metastatic PAD (19:01) Selection and Sequencing of Therapy for Relapsed/Refractory Metastatic PAD (54:38) Importance of Palliative Care for Advanced PAD (1:06:09) Role of PARP Inhibitor Maintenance Therapy for Newly Diagnosed Metastatic PAD (1:14:59) Promising Investigational Strategies for PAD (1:26:56) NCPD information and select publications

EPISODE DESCRIPTIONLisa Shufro is the storyteller's storyteller. A musician turned innovation strategist, TEDMed curator, and unapologetic truth-teller, Lisa doesn't just craft narratives—she engineers constellations out of chaos. We go way back to the early TEDMed days, where she taught doctors, scientists, and technocrats how not to bore an audience to death. In this episode, we talk about how storytelling in healthcare has been weaponized, misunderstood, misused, and still holds the power to change lives—if done right. Lisa challenges the idea that storytelling should be persuasive and instead argues it should be connective. We get into AI, the myth of objectivity, musical scars, Richard Simmons, the Vegas healthcare experiment, and the real reason your startup pitch is still trash. If you've ever been told to “just tell your story,” this episode is the permission slip to do it your way. With a bow, not a violin.RELATED LINKSLisa Shufro's WebsiteLinkedInSuper Curious ArchiveEight Principles for Storytelling in InnovationStoryCorps InterviewCoursera Instructor ProfileWhatMatters ProjectFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@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 Understanding Death Can Help You Live More Fully — with Hospice Nurse JulieThis episode of Asking for a Friend is sponsored by Better Help. https://betterhelp.com/askingforafriendWhat if facing the realities of death could actually help you live with more intention, gratitude, and peace—right now?In this powerful episode of Asking for a Friend, I sit down with Julie McFadden, better known as Hospice Nurse Julie, a former ICU nurse turned nationally recognized hospice educator with over 15 years of experience and millions of followers online. Julie's mission? To normalize conversations around death and provide comfort, clarity, and dignity at the end of life.We explore:The most common experiences people have at the end of life—many of which are rarely talked aboutHow Julie transitioned from ICU to hospice, and what she learned about life in the processPractical advice for midlife women navigating aging parents and caregiving responsibilitiesHow to prepare emotionally and logistically for end-of-life situations—with grace and self-compassionWhy contemplating our mortality might be the greatest gift for living more meaningfullyJulie's new Nothing to Fear Journal offers a compassionate guide for reflection, planning, and healing—and this episode delivers the heart and honesty that midlife listeners crave.✨ If you're supporting aging parents, feeling overwhelmed, or simply curious about what a peaceful end-of-life journey can look like—this episode is a must-listen.

In this episode, we explore the fascinating phenomenon of Terminal Lucidity - what it is, how it occurs, and why it continues to mystify both science and spirituality. Hear powerful, firsthand stories from those who've witnessed this final moment of clarity, offering insight, comfort, and awe at the threshold between life and death. Some of the references to this episode include: https://pubmed.ncbi.nlm.nih.gov/20010032/ https://theconversation.com/terminal-lucidity-why-do-loved-ones-with-dementia-sometimes-come-back-before-death-202342 https://www.buddhanet.net/bereaved/ https://www.leiferreport.com/poetry-life/ https://www.crossroadshospice.com/hospice-resources/spirituality-end-of-life-care https://en.wikipedia.org/wiki/Moksha https://waterfromrock.org https://en.wikipedia.org/wiki/Turiya www.reddit.com www.quora.com *** The views and opinions expressed in this podcast are intended solely for discussion and informational purposes. They do not necessarily represent the views of the hosts, guests, or affiliated organizations, and should not be taken as professional advice or endorsements. Please consider this content as part of an open dialogue. For more about Kirsty, visit www.kirstysalisbury.com

National Palliative Care Week is in its 30th year, with this year's theme: 'What's your plan?, aiming to encourage conversations around end of life care.Part of this could include discussing and implementing culturally appropriate customs and traditions related to death and dying for residents and their families, an issue being addressed through a new online course. - ‘तपाईँको योजना के छ?' भन्ने नारा सहित नेश्नल प्यालिएटिभ केयर सप्ताह गत मे ११ देखि १७ सम्म अस्ट्रेलियाभर मनाइएको थियो। आफ्नो ३० औं संस्करणमा रहेको उक्त सप्ताहको उद्देश्य, जीवनको अन्तिम चरणमा कसरी संवेदनशील र गरिमामय हेरचाह गर्न सकिन्छ भन्नेबारे छलफल गर्नु हो। एक रिपोर्ट।

Most of us try a few different jobs in our lives - and work in a few different places - but once Sally Hanrahan made the decision to become a nurse, that was it. And what's more, she has stayed in the same speciality, for almost 35 years. Sally is a palliative care nurse, and her exceptional dedication, skill and experience were recently recognised at the Southern Nursing Excellence Awards. She meets people as they are coming to terms with the end of their lives and while there is an inherent sadness to be had in that. she says it is a gift to spend time with them, to get to know them and to try and help them find whatever peace and comfort they need. Jesse spoke with Sally before her next shift at the Otago Community Hospice.

Join the University of Washington Surgical Palliative Care Team for their final episode of this series — a dual journal review and clinical challenges discussion on assessing medical decision-making capacity. Using Dr. Paul Applebaum's foundational framework, the team outlines the four key criteria for evaluating capacity and brings the topic to life through two contrasting standardized patient scenarios. This episode highlights why capacity assessment is not only relevant but essential for surgeons navigating complex, high-stakes decisions.  Hosts:  Dr. Katie O'Connell (@katmo15) is an associate professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. Dr. Ali Haruta is an assistant professor of surgery at the University of Washington. She is a trauma and emergency general surgeon and palliative care physician. Ali recently completed fellowships in palliative care at the University of Washington and Trauma and Critical Care at Parkland.  Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY6 general surgery resident at the University of Washington with an interest in surgical oncology.   Dr. Virginia Wang is a PGY3 general surgery resident at the University of Washington. Learning Objectives: 1.        Decipher the distinction between the terms “capacity” and “competence”.   2.        Describe the four criteria for assessing medical decision-making capacity presented in Dr. Paul Applebaum's article “Assessment of Patients' Competence to Consent to Treatment.” 3.        Apply the capacity assessment framework to real-world clinical scenarios in surgical practice.  References: 1.        Applebaum, PS. Assessment of Patients' Competence to Consent to Treatment. New England Journal of Medicine 2007; 357(18):1834-1840. https://pubmed.ncbi.nlm.nih.gov/17978292/ 2.        Special thank you to Mr. Mark Fox for his acting contribution to this episode. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

What does “code status” really mean — and how does it affect the care we receive at the end of life? In this episode, Dr. Matthew Tyler returns to clarify common misunderstandings about CPR, DNR, and medical interventions during serious illness and the frailty of old age. We explore when full code makes sense, when it probably doesn't, and how patients and families can make informed, values-based decisions. We also discuss Dr. Tyler's new caregiver coaching services, through which he offers personalized support when palliative care isn't available locally. I think everyone should explore these issues and have someone like Dr Tyler on their team to talk things through!⁠https://howtotrainyourdoctor.com/⁠⁠https://www.facebook.com/people/How-to-Train-Your-Doctor/100095193314200/?sk=reels_tab⁠⁠https://www.instagram.com/howtotrainyourdoctor/⁠⁠https://www.youtube.com/@howtotrainyourdoctor⁠

When it comes to managing serious illness or the final phase of life, surveys show that a majority of Americans say they have at least heard of hospice or palliative care but most admit they may not know a lot about either topic. We're going to talk about both to begin Wednesdays “Sound of Ideas." Later, it's an excerpt from the latest episode of "Living for We: Keep Ya Head Up."

What happens when you blend the soul of Mr. Rogers, the boldness of RuPaul, and just a pinch of Carrie Bradshaw? You get Sally Wolf.She's a Harvard and Stanford powerhouse who ditched corporate media to help people actually flourish at work and in life—because cancer kicked her ass and she kicked it back, with a pole dance routine on Netflix for good measure.In this episode, we unpack what it means to live (really live) with metastatic breast cancer. We talk about the toxic PR machine behind "pink ribbon" cancer, how the healthcare system gaslights survivors when treatment ends, and why spreadsheets and dance classes saved her sanity. Sally doesn't just survive. She rewrites the script, calls out the BS, and shows up in full color.If you've ever asked “Why me?”—or refused to—this one's for you.RELATED LINKS:Sally Wolf's WebsiteLinkedInInstagramCosmopolitan Essay: "What It's Like to Have the 'Good' Cancer"Oprah Daily Article: "Five Things I Wish Everyone Understood About My Metastatic Breast Cancer Diagnosis"Allure Photo ShootThe Story of Our Trauma PodcastFEEDBACK:Like this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@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. Emma Jones is a Best Selling author because of her book entitled THE PHOENIX BLUEPRINT: RISING STRONGER FROM THE BLAZE OF HEALTHCARE which details the real problem of BURNOUT in the Medical Community. Emma has been a victim of burnout twice and she will talk about her book plus her role as a Palliative Care Physician for Pediatric Cancer and Adolescent Cancer patients.

Dr. Matthew Tyler returns to explore the layers of palliative care — what it is, what it isn't, and how it differs from hospice. We discuss everything from managing physical and existential pain to the role of family dynamics and coping skills in end-of-life care. Is pain at the end of life inevitable, and how can it be managed? What role can patients and families play in guiding medical decisions at the end of life? How can families and caregivers better cope with the complexities of serious illness? Whether you're supporting a loved one or navigating illness yourself, this conversation offers practical insight and hope. Dr. Tyler also introduces his new caregiver coaching services, designed to help families find clarity and confidence in uncertain times, especially when local palliative care is not available.https://howtotrainyourdoctor.com/https://www.facebook.com/people/How-to-Train-Your-Doctor/100095193314200/?sk=reels_tabhttps://www.instagram.com/howtotrainyourdoctor/https://www.youtube.com/@howtotrainyourdoctor

Peter Selwyn, one of today's guests, has been caring for people living with HIV for over 40 years.  In that time, care of people with HIV has changed dramatically.  Initially, there was no treatment, then treatments with marginal efficacy, complex schedules, and a tremendous burden of side effects and drug-drug interactions.  The average age at death was in the 30s. Now, more people in the US die with HIV rather than from HIV.  Treatment regimens are simplified, and the anti-viral drugs are well tolerated.  People are living with HIV into advanced ages.  The average age at death is likely in the 60s.  Nearly half of people living with HIV are over age 55.  One in 10 people with newly diagnosed HIV is an older adult.  Our second guest, Meredith Greene, is a geriatrician and researcher who focuses on care of older adults living with HIV, in the US and Africa. On today's podcast we discuss: Implications of aging with HIV for clinical care Loneliness and social isolation among older adults living with HIV Persistence of stigma Need to consider HIV in the differential diagnosis for older adults Screening for HIV Screening for osteoporosis in people living with HIV Dementia and cognitive impairment risk in people living with HIV When to stop anti-virals near the end of life Toward the end we speak to the moment.  More older adults live with HIV in SubSaharan Africa and the global South than anywhere else in the world.  Funding for research and clinical care is at risk, as USAID and PEPFAR (which is under USAID), are shuttered.  Millions of lives are at stake.  Meredith wore a shirt that said Silence=death. Eric gave me the hook during my live cover of One, by U2, a song released in 1992 whose proceeds went entirely to AIDS research.  I couldn't help it, forgive me dear listeners, I had to do a longer than usual cut at the start! -Alex Smith   Useful links: Peter's article on the evolution of HIV: https://link.springer.com/article/10.1007/s11524-011-9552-y Peter's book Surviving the Fall: Personal Journey of an AIDS Doctor PEPFAR:  Global Health Policy | KFF   Articles: Geriatric Syndromes in Older HIV-Infected Adults - PMC Loneliness in Older Adults Living with HIV Management of Human Immunodeficiency Virus Infection in Advanced Age https://pmc.ncbi.nlm.nih.gov/articles/PMC3684249/ About Act-up for those who might know the Silence=Death t-shirt reference: https://www.npr.org/2021/06/16/1007361916/act-up-a-history-of-aids-hiv-activism https://www.newyorker.com/magazine/2021/06/14/how-act-up-changed-america