Podcasts about Yale New Haven Hospital

In this Leveling Up episode of the PRS Global Open Deep Cuts Podcast, Dr. Tormod Westvik talked about his diverse journey through the world of plastic surgery—from navigating residency training programs in America, Norway, and Australia to balancing algorithmic decision-making with highly individualized patient care. He shares why returning to first principles is essential in every clinical encounter, how serving as Section Editor for Case Reports in PRS Global Open has reshaped his surgical thinking, and the leadership lessons he carries forward from his mentors. Dr. Westvik also offers a memorable glimpse into his life outside the OR—including the surprising tool he uses to slice pizzas.   Read a classic PRS Global Open article by Dr. Chuang and co-authors, "The Value of Case Reports in Plastic Surgery: An Analysis of 68,444 Articles across Six Major Plastic Surgery Journals": https://bit.ly/Value_of_PS_Case_Reports   Dr. Tormod Westvik is a board-certified plastic surgeon and an Associate Professor in the department of plastic surgery at Yale University in New Haven, Connecticut. He completed medical school at the University of Oslo in 2001, followed by general surgery residency at Yale New Haven Hospital, and a plastic surgery residency at Harvard University. He returned to Norway where he became the Chief of Plastic Surgery and Program Director of the plastic surgery training program at Telemark Hospital Health Trust. After 12 years practicing in Norway, he spent a year in Queensland, Australia, returning to Yale in April 2025. He is the past president of the Norwegian Society of Aesthetic Plastic Surgery, the past vice president of the Norwegian Association for Plastic Surgeons, the Norwegian representative to the ASPS Global Leadership Forum, the Section Editor for case reports at Plastic Reconstructive Surgery Global Open, and a member of multiple committees within ASPS. Dr. Westvik has a broad plastic surgery practice including breast reconstruction, hand surgery, body contouring and facial aesthetic surgery, and general reconstruction. He is also leading the storied melanoma program at Yale, founded in 1976 by Dr. Stephan Ariyan.   Your host, Dr. Puru Nagarkar, is a board-certified plastic and hand surgeon, and Associate Professor of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas.   #PRSGlobalOpen #DeepCutsPodcast #PlasticSurgery #LevelingUp

Donna nominated her daughter Sarah for a WEBE108 Griffin Health Christmas Wish. Sarah has been a single mom since she was 18 years old. She and her daughter were in a severe car accident this fall. Sarah is a cancer nurse at Yale New Haven Hospital and since suffering injuries in the accident they can't work and are without a car. Thanks to Brown Roofing, we're able to help Sarah get some Christmas gifts and food for Christmas Day.

Women, Wealth and Entrepreneurship Podcast Season 6, 2025Welcome to Women, Wealth & Entrepreneurship with Ariel Shaw, MBA! We want to increase your bottom line and create generational wealth that lasts way beyond you!  It's 2025 and we are in Season 6! Wow! How Exciting! This is the year of Focus and Continued Expansion. Our 2025 Media Participants Include Sylvia Dennis-Wray of Sylvia The Advocate; Mica Johnson of The Mica Johnson State Farm Agency; Shamica Davis of JTS Vacations LLC; LaQuita Brooks of The Motivational Maven.We welcome Dr. John C. Lipman, MD, FSIR. Founder & Medical Director of Atlanta Fibroid Center.Dr. John Lipman is a board-certified Interventional Radiologist and renowned authority in the non-surgical treatment of uterine fibroids. He is also a philanthropist, entrepreneur, and an award-winning public speaker. He received his Masters and Medical degrees from Georgetown University School of Medicine in 1985. He completed a residency in Diagnostic Radiology at Brigham & Women's Hospital, Harvard Medical School, and then did a fellowship in Vascular & Interventional Radiology at Yale-New Haven Hospital, Yale University School of Medicine.

Date: October 17, 2025 Guest Skeptic: Dr. Kristen Panthagani is an emergency medicine resident and Yale Emergency Scholar at Yale New Haven Hospital. She's a physician-scientist, having completed her MD/PhD at Baylor College of Medicine. She's also well known as a science communicator, creator of You Can Know Things which helps explain science in a […] The post SGEM Xtra: Talkin' Bout a Revolution…Training Health Communicators first appeared on The Skeptics Guide to Emergency Medicine.

Pre-Order my new book ADHD IS OVER! now on Amazon: tinyurl.com/532b2ck8 My guest is psychiatrist Dr. Margaret Coffey. Dr. Coffey received her Bachelor of Science degree from Brown University and her M.D. from Columbia University Vagelos College of Physicians and Surgeons in New York City. After completing her residency in psychiatry at Yale-New Haven Hospital, she had a successful private practice in New Haven for 30 years while serving on the clinical faculty at Yale Medical School and Yale New Haven Hospital. Her areas of specialty include depression, anxiety, eating disorders, trauma, relationships, parenting and ADHD as well as borderline and narcissistic personalities. She is also certified in Psychedelic Assisted Psychotherapy and has a particular expertise in psychopharmacology as well as several psychotherapeutic modalities, including Mentalization-based Psychotherapy and Relational Therapy. Dr. Coffey currently serves on the Mentalizing Initiative Board at UCLA and practices now here in Ojai, California. Listen in as I asked her some crucial questions when it comes to the diagnosis, labeling children, ADHD medications and more. For more information on this podcast, please visit www.adhdisover.com

Howie and Harlan are joined by Kate Heilpern, president of Yale New Haven Hospital, to discuss the innovation and adaption needed to lead NewYork-Presbyterian Hospital through the worst of the COVID-19 pandemic, and how Yale New Haven Health structures itself to provide quality care across five hospitals. Harlan reflects on the many biotech startups emerging from Yale; Howie responds to the Trump administration's assertion of a link between acetaminophen and autism.  Links: Biotech at Yale and Beyond “Investors Flock Back to Biotech After a Long, Cold Spell “Boom, Bust and Recover: What Happens Next as Biotech VC Cycle Resets”. “Pfizer to Buy Weight-Loss Drug Developer Metsera for Up to $7.3 Billion” Yale Ventures Health & Veritas Ep. 80: Josh Geballe: Turning Yale Innovation into Startups Yale Ventures Annual Report 2025 Cloverleaf Bio Allyx Therapeutics EvolveImmune Therapeutics Normunity Inozyme Pharma “BioMarin to buy rare disease drugmaker Inozyme for $270M” “Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018” Kate Heilpern “Yale New Haven Hospital announces new president” “Yale New Haven Health announces Katherine Heilpern, MD, as the new president of Yale New Haven Hospital” “Heilpern sees society reflected in the busy ER” “Meet the Heroes Fighting on the Front Lines Against Covid-19” “'Adrenaline, Duty, and Fear': Inside a New York Hospital Taking on the Coronavirus” Health & Veritas Ep. 116: Christopher O'Connor: Hospital Leadership in Trying Times “Saving America's ERs” “The 600 Pathways Yale New Haven Health Takes to Improved Care Delivery” Tylenol and Autism “Trump Issues Warning Based on Unproven Link Between Tylenol and Autism” “Trump links autism and Tylenol: is there any truth to it?” “Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability” “Study reveals no causal link between neurodevelopmental disorders and acetaminophen exposure before birth” “Does Stress Cause Ulcers?” “The Effect of Vitamin E and Beta Carotene on the Incidence of Lung Cancer and Other Cancers in Male Smokers” “The U.S. government has jumped the public health shark” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Kate Heilpern, president of Yale New Haven Hospital, to discuss the innovation and adaption needed to lead NewYork-Presbyterian Hospital through the worst of the COVID-19 pandemic, and how Yale New Haven Health structures itself to provide quality care across five hospitals. Harlan reflects on the many biotech startups emerging from Yale; Howie responds to the Trump administration's assertion of a link between acetaminophen and autism.  Links: Biotech at Yale and Beyond “Investors Flock Back to Biotech After a Long, Cold Spell “Boom, Bust and Recover: What Happens Next as Biotech VC Cycle Resets”. “Pfizer to Buy Weight-Loss Drug Developer Metsera for Up to $7.3 Billion” Yale Ventures Health & Veritas Ep. 80: Josh Geballe: Turning Yale Innovation into Startups Yale Ventures Annual Report 2025 Cloverleaf Bio Allyx Therapeutics EvolveImmune Therapeutics Normunity Inozyme Pharma “BioMarin to buy rare disease drugmaker Inozyme for $270M” “Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018” Kate Heilpern “Yale New Haven Hospital announces new president” “Yale New Haven Health announces Katherine Heilpern, MD, as the new president of Yale New Haven Hospital” “Heilpern sees society reflected in the busy ER” “Meet the Heroes Fighting on the Front Lines Against Covid-19” “'Adrenaline, Duty, and Fear': Inside a New York Hospital Taking on the Coronavirus” Health & Veritas Ep. 116: Christopher O'Connor: Hospital Leadership in Trying Times “Saving America's ERs” “The 600 Pathways Yale New Haven Health Takes to Improved Care Delivery” Tylenol and Autism “Trump Issues Warning Based on Unproven Link Between Tylenol and Autism” “Trump links autism and Tylenol: is there any truth to it?” “Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability” “Study reveals no causal link between neurodevelopmental disorders and acetaminophen exposure before birth” “Does Stress Cause Ulcers?” “The Effect of Vitamin E and Beta Carotene on the Incidence of Lung Cancer and Other Cancers in Male Smokers” “The U.S. government has jumped the public health shark” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Send us a textAt 28 weeks, Jessie found out her baby was breech—but instead of panicking, she trusted her gut. She felt strongly that her baby was meant to be born this way. After initially planning a home birth, Jessie began exploring other options and considered traveling to Pennsylvania for a hospital birth with experienced breech providers.But when labor started at 39 weeks, everything shifted. Mid-drive to Pennsylvania, Jessie and her husband decided to turn around and head to Yale New Haven Hospital. There, an OB team unexpectedly supported her birth plan, and her baby was born breech and vaginally—with ease.In this episode, Jessie shares her story of intuition, flexibility, and trust in her body and baby. It's an inspiring reminder that sometimes birth doesn't go according to plan—and that's exactly what makes it beautiful.**********Our sponsors:Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy. Use this link to save 20%DrinkLMNT -- Purchase LMNT with this unique link and get a FREE sample packUse promo code: DOWNTOBIRTH for all sponsors.Primally Pure: From soil to skin, Primally Pure products are made with down-to-earth ingredients that feel and smell like heaven for the skin. Promo code: DOWNTOBIRTH for 10% off. ENERGYBits: Get the superfood Algae every mother needs for pregnancy, postpartum, and breastfeeding. Promo code: DOWNTOBIRTH for 20% off. Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Watch the full videos of all our episodes on YouTube! Work with Cynthia: HypnoBirthingCT.com Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Fairfield First Selectman Bill Gerber passed away yesterday at Yale New Haven Hospital, where he had been receiving treatment for a brain tumor. In his honor, Melissa spoke to many of his fellow city and townleaders and had them send a message of what he meant to them. Image Credit: Melissa Sheketoff

In this episode of Behind the Breath, Marjorie Cullinan, MSHA, RRT, RRT-NPS, RPFT, Operations Manager of Pulmonary Function Testing at Yale New Haven Hospital, sits down with AARC Vice President of Membership and Customer Care, Monique Kimmel to discuss the importance of AARC resources and networking in the Diagnostics Specialty Section, her journey in adult and pediatric respiratory critical care, and how her mentors help shape her career.Additional Resources AARC Diagnostics Specialty SectionBehind the Breath Video with Marjorie Cullinan and Monique KimmelSend us a textSupport the show

Comment on the Show by Sending Mark a Text Message.The alarming reality of physician burnout has reached crisis levels, with six out of ten doctors now experiencing burnout—up significantly from pre-pandemic numbers. Behind these statistics are real people and real stories that demand our attention.This episode takes a deep dive into the disturbing allegations contained in Dr. Allison Schmeck's legal complaint against Yale University and Yale New Haven Hospital. Read a copy of the federal complaint HERE. As a triple board-certified anesthesiologist, Dr. Schmeck's experience reveals the dark underbelly of academic medicine: alleged gender discrimination where female physicians were assigned double the workload of male colleagues, disability discrimination where her disclosed history of depression was labeled as "baggage," and devastating retaliation when she reported unethical practices and requested mental health accommodations.The most heartbreaking aspect of this case is how systemic failures allegedly drove a talented physician to the brink of suicide—making concrete plans including updating her will and arranging for her pets' care. Dr. Schmeck's journey exposes how institutions might weaponize mental health history against physicians who speak up, while simultaneously denying them opportunities granted to less qualified male colleagues. When leadership allegedly defines "positive faculty experience" as making superiors happy rather than supporting staff wellbeing, it reveals fundamental flaws in medical culture.This powerful examination connects one doctor's personal nightmare to nationwide physician mental health statistics, where 80% of doctors acknowledge the stigma preventing them from seeking help. What must change in our medical institutions to protect those who dedicate their lives to healing others? How many talented physicians are we losing to these systemic failures? Listen and consider what responsibility we all share in demanding better for those who care for us at our most vulnerable moments. If you enjoyed this episode of the Employee Survival Guide please like us on Facebook, Twitter and LinkedIn. We would really appreciate if you could leave a review of this podcast on your favorite podcast player such as Apple Podcasts. Leaving a review will inform other listeners you found the content on this podcast is important in the area of employment law in the United States. For more information, please contact our employment attorneys at Carey & Associates, P.C. at 203-255-4150, www.capclaw.com.Disclaimer: For educational use only, not intended to be legal advice.

Navigating Medicine and Faith: A Conversation with Dr. Sharon Stoll In this episode, Dr. Sharon Stoll discusses her background growing up in a modern Orthodox Jewish community in Philadelphia, her journey to becoming a neuroimmunologist, and her professional experiences working at Yale and now in Philadelphia. The conversation touches on her approach to patient education, especially around COVID-19 and various medications, including GLP-1 agonists like Ozempic and SSRIs for mental health. Dr. Stoll also speaks about her role in JOWMA (Jewish Orthodox Women's Medical Association) and the importance of educating her community on medical issues.    The discussion covers her views on IVF, the ethical considerations of genetic selection, and the interplay of anxiety and genetic predispositions within the Ashkenazi Jewish community. Dr. Stoll shares personal anecdotes and insights into balancing professional and personal life, making this an in-depth and enlightening conversation.   00:00 Introduction and Background 01:19 Professional Journey and Achievements  02:08 Balancing Media and Medicine 03:48 Involvement with Jowma 05:40 Views on Vaccination 14:26 Discussion on SSRIs and Ozempic 28:16 Challenges in the Frum Community  34:38 Debunking Misconceptions About Diabetes 35:07 Educational Gaps and Community Efforts 36:43 Health Education in Schools 39:06 Challenges of Motherhood and Societal Expectations 43:43 Genetic Risks and Mental Health in Ashkenazi Jews 54:38 IVF, Genetic Selection, and Ethical Dilemmas  01:02:34 Concluding Thoughts and Personal Reflections   About Our Guest: Dr. Sharon Stoll is a board-certified neurologist, neuro-immunologist. She currently serves as Director of Neurology at Stoll Medical Group in Philadelphia. For the past 8 years she worked as assistant professor, in the department of neurology at Yale School of Medicine. She completed her neurology residency training at Thomas Jefferson University Hospital in Philadelphia and her Neuroimmunology fellowship at Yale New Haven Hospital. Dr. Stoll played an active role in academic development and continuing medical education. She currently serves on several steering committees and advisory boards. She has been published in numerous peer-reviewed journals and served as Principal Investigator on several clinical trials. Dr. Stoll has received numerous awards, including Top Neurologist, 40 under 40, the Rodney Bell teaching award, and is a national multiple sclerosis society grant recipient. Dr. Stoll is also a medical editor for Medscape and Healthline and previously worked as a medical editor for ABC News. She is also a medical commentator for several national and local news outlets, including ABC, NBC, and CBS News, and has been on a variety of shows, including “The Doctors”. She is an internationally renowned speaker and patient advocate.   https://www.drsharonstoll.com https://www.instagram.com/drsharonstoll/?hl=en https://www.jowma.org  

In this episode of 'Inspire to Lead,' host Talia Mashiach interviews Dr. Sharon Stoll, a board-certified neurologist and neuroimmunologist from Philadelphia. Sharon discusses her upbringing, her unwavering passion for medicine despite societal discouragement, and how she navigated through medical school and residency while managing family life. She shares the pivotal role her supportive husband played in her success and addresses the challenges and triumphs of balancing a demanding career with motherhood. The conversation also delves into the expectations placed on Jewish women in their communities and the importance of pursuing fulfilling careers to maintain overall happiness and effectiveness as both mothers and wives. Sharon's story is an inspiring testament to resilience, determination, and the impact of supportive relationships.   00:00 Introduction to Inspire to Lead Podcast 00:29 Meet Sharon Stoll: A Journey to Medicine 02:38 Balancing Media and Medicine 08:44 Personal Life and Family Dynamics 15:15 Navigating Career and Marriage 37:12 Parenting in Modern Times 39:14 Balancing Career and Family Aspirations 42:43 The Journey to Motherhood 43:16 Navigating Medical School and Motherhood 54:24 Support Systems and Community 01:01:46 Reflections and Advice 01:16:09 Biggest Accomplishments and Lessons Learned     About Dr. Sharon Stoll: Dr. Sharon Stoll is a board-certified neurologist, neuro-immunologist. She currently serves as Director of Neurology at Stoll Medical Group in Philadelphia. For the past 8 years she worked as assistant professor, in the department of neurology at Yale School of Medicine. She completed her neurology residency training at Thomas Jefferson University Hospital in Philadelphia and her Neuroimmunology fellowship at Yale New Haven Hospital. Dr. Stoll played an active role in academic development and continuing medical education. She currently serves on several steering committees and advisory boards. She has been published in numerous peer-reviewed journals and served as Principal Investigator on several clinical trials. Dr. Stoll has received numerous awards, including Top Neurologist, 40 under 40, the Rodney Bell teaching award, and is a national multiple sclerosis society grant recipient. Dr. Stoll is also a medical editor for Medscape and Healthline and previously worked as a medical editor for ABC News. She is also a medical commentator for several national and local news outlets, including ABC, NBC, and CBS News, and has been on a variety of shows, including “The Doctors”. She is an internationally renowned speaker and patient advocate. https://www.drsharonstoll.com   Powered By Roth & Co The JWE For guest suggestions, please email Talia: podcast@thejwe.org

In this episode, join moderator Brea Burmeister and experts Dr. Scott Weiner and Dr. Arjun Venkatesh as they explore how quality measures can transform opioid use disorder (OUD) care in emergency departments. Discover innovative metrics, quality improvement initiatives, and EHR data integration to optimize patient outcomes. Learn about overcoming barriers like stigma and resource shortages and get key recommendations from recent OUD treatment studies. Perfect for healthcare professionals and anyone interested in advancing OUD care.What You'll Learn:Challenges and opportunities of addressing the opioid epidemic in emergency medicineACEP's work on metrics and the development of quality improvement measuresKey quality initiatives to enhance OUD care and reduce harmThe barriers to adopting these initiatives and strategies to overcome themRecommendations based on recent studies in OUD treatment and medicationMODERATOR: Brea BurmeisterMember, CHIME Opioid Task ForceBio: With 23 years in healthcare, Brea specializes in managing relationships within Integrated Delivery Network (IDN) Health Systems, regional Group Practices, and Specialty Pharmacy accounts. She strengthens value-based care models by developing strategic plans, analyzing performance data, improving care coordination, and implementing process improvements. Brea's work enhances patient outcomes and experiences while reducing costs. Additionally, her volunteer work with the Opioid Task Force reflects her commitment to public health advocacy and community well-being.GUEST: Scott Weiner, MD, MPH, FAAEM, FACEP, FASAMEmergency and Addiction Medicine Physician, Brigham and Women's HospitalAssociate Professor, Harvard Medical SchoolCo-chair, Clinical Advisory subcommittee, CHIME Opioid Task ForceBio: Dr. Weiner is the McGraw Distinguished Chair in the Department of Emergency Medicine at Brigham and Women's Hospital and an Associate Professor of Emergency Medicine at Harvard Medical School. He is board-certified in emergency medicine and addiction medicine. He is an active researcher, working on multiple projects that focus on prevention and treatment of opioid use disorder.GUEST: Arjun Venkatesh, MD, MBA, MHSChair, Department of Emergency Medicine, Yale University School of MedicineChief, Emergency Medicine, Yale New Haven HospitalBio: Dr. Venkatesh is Chair and Chief of Emergency Medicine at the Yale University School of Medicine and Yale New Haven Hospital. He has received over $ 12 million in funding by the NIH, CMS, AHRQ, and CDC to develop measures and interventions that improve acute care outcomes and value. He has supported CMS's development of the Overall Hospital Quality Star Ratings, has led the development of quality measures for the Clinical Emergency Data Registry, and is PI of the Emergency Quality Network (E-QUAL). His work has produced over 200 publications and been implemented in numerous national quality and value programs. He is a graduate of Northwestern University School of Medicine, a proud graduate of the HAEMR Class of 2012 often referred to as the Greatest Class Ever, and completed the RWJF Clinical Scholars Program at Yale.Additional Resources:ACEP E-QUAL opioid initiativeCedr

We're back with more exciting case reviews filled with many valuable lessons and this time, we explore cases that almost ended in disaster for the doctors involved. We are joined again by Oral and Maxillofacial Surgeon Dr. David Salomon – currently practicing at Yale New Haven Hospital, Connecticut – who begins by sharing his thoughts on our first case in review involving an accidental violation of the Hippocratic Oath. Then, we discuss a patient with hypertension who seized mid-operation, why leading with empathy is the foundation for avoiding possible lawsuits, the role of vulnerability between doctors and patients, and how two wrongs never make a right. We end with an extraction gone wrong for an 18-year-old high school softball player, communication and other referral problems that exist across the industry, fail-safes to improve referral protocols, how to address minor patients who feel they've been wronged, and why we need to implement more timeouts as standard practice. As a bonus final act, doctors Salomon and Stucki reminisce on when Dr. Salomon saved Dr. Stucki's life.  Key Points From This Episode:An unfortunate and accidental breach of privacy. The best practices for doctors engaging with patients online, especially on public platforms. Unpacking the malpractice case of a patient who had a seizure on the operating table. How to make amends when things go wrong, and the importance of leading with empathy.Why vulnerability matters, and how to avoid adding fuel to the fire. How a wrongful extraction highlights some of the key issues doctors face with referrals.  What practitioners can do to ensure referrals receive the same care as self-referrals. The ins and outs of timeouts and their undeniable importance. How Dr. Salomon intervened in Dr. Stucki's near-fatal encounter! Links Mentioned in Today's Episode:Dr. David Salomon on LinkedIn — https://www.linkedin.com/in/david-salomon-b8ab1431/ Yale New Haven Hospital — https://www.ynhh.org/ Coastal Connecticut — https://www.coastalctoms.com/ Risk Tips Archive | MedPro Dental — https://oms.medprodental.com/category/risk-tips  Dr. Ira Satinover on Healthgrades — https://www.healthgrades.com/physician/dr-ira-satinover-y8hpw Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Susan Allison-Dean is a Board Certified Advanced Holistic Nurse and Certified Clinical Aromatherapy professional with over thirty years of experience in nursing.  During the first half of her career, she practiced mainly as a Certified Wound, Ostomy, & Continence Clinical Nurse Specialist, holding a joint position with Yale-New Haven Hospital & Yale University.In 1999, she experienced the profound loss of two significant family members just two days apart.  This loss and the profound healing experiences that she experienced in nature led her to leave the disease-care model and shift her practice to health promotion, specifically nature and health.Sue is the Founder and CEO of TheNatureNurse.com, which focuses on connecting women with nature so they may live more joyous, vibrant, awe-inspiring lives in harmony with Mother Nature.  She is the co-chair of the Global Nature Nurse Network, connecting nurses who specifically partner with the natural world to enhance holistic health and prevent disease.Sue also enjoys writing, traveling with her husband, and dabbling in other creative arts.  She lives in New York and North Carolina in the US.How you became a Nature Nurse 4:12 deep level grief, profound loneliness, pain 6:02  mother nature 24/7 availability - transformative - helped me to live a joyous and productive life. Bring light into people's lives. 9:03 Florence Nightingale "nature itself is healing"14: Nurse Pioneers in Global Nature Nurse Network Verla cites podcast episode with Professor Andy Jones systematic review and meta analysis of green space exposure and health outcomes (103 observational and 40 interventional studies investigating 100 outcomes: green space exposure decreased heart rate and blood pressure, HDL cholesterol, increased HRV, decreased preterm birth, diabetes, and all cause mortality in particular cardiovascular mortality.  For transcript see verlafortier@substack.com  Nature Nurse on Instagram https://www.linkedin.com/in/susan-allison-dean-rn-ms-ahn-bc-ccap/  For peer reviewed research on how your time spent in green space can change your mindset, balance your nervous system and your heart rate please go to verlafortier@substack.com and check out my books Take Back Your Outside Mindset: Live Longer, Stress Less, and Control Your Chronic Illness and Optimize Your Heart Rate: Balance Your Mind and Body With Green Space

Why do bone defects occur, and how can we best manage them? In this episode, Dr. Frumberg joins us as we explain the intricacies of bone defect classifications, the role of host factors, and groundbreaking treatments like the Masquelet technique, vascularized fibula grafts, and distraction osteogenesis. From the smallest Type I defects to the most complex Type IV challenges, this conversation is packed with actionable insights for orthopedic surgeons and enthusiasts alike. Plus, hear Dr. Frumberg's expert take on when amputation might be the best option and the importance of preserving joint function and stability in treatment planning. Click here for show notes David Frumberg, MD, is an Assistant Professor of Orthopaedics and Rehabilitation at Yale School of Medicine. He is co-director of the Yale Limb Restoration and Lengthening Program. He is the Director of the Cerebral Palsy Program at Yale-New Haven Hospital. He specializes in complex orthopedic conditions that require more attention and care. He works closely with patients and their families to understand their needs and unique goals. He enjoys collaborating with other medical professionals to maximize the functioning and comfort of patients of all ages. Dr. Frumberg utilizes state of the art surgical techniques, and is devoted to providing his patients with innovative and compassionate care. His areas of expertise include: Limb lengthening and stature lengthening Limb deformity correction Cerebral palsy Arthrogryposis Neurologic conditions that cause joint contractures Fracture nonunions and malunions Musculoskeletal infections Goal of episode: To develop a baseline knowledge of bone defects. In this episode, we discuss: Causes of bone defects Classification Treatment and many more. This episode is sponsored by the American Academy of Orthopaedic Surgeons: Filled with content that has been vetted by some of the top names in orthopaedics, the AAOS Resident Orthopaedic Core Knowledge (ROCK) program sets the standard for orthopaedic education. Whether ROCK is incorporated into your residency curriculum, or you use it independently as a study tool, the educational content on ROCK is always free to residents. You'll gain the insights and confidence needed to ensure a successful future as a board-certified surgeon who delivers the best patient care. Log on at https://rock.aaos.org/.

What would you like to see more of? Let us know!In this episode of Discover Daily, we explore three compelling stories shaping our world. First, Amazon deepens its AI ambitions with a $4 billion investment in Anthropic, designating AWS as the company's primary cloud provider while allowing Anthropic to maintain partnerships with other tech giants. This strategic move positions Amazon more competitively against Microsoft's OpenAI partnership and Google's DeepMind.Second, scientists have discovered promising natural hydrogen reserves beneath the Midcontinent Rift, a 1,200-mile stretch of ancient volcanic rock under Lake Superior. The University of Nebraska-Lincoln's research team, supported by a $1 million National Science Foundation grant, is investigating how this geological formation could provide clean energy through natural hydrogen production, with test wells showing encouraging results.Our episode concludes with a fascinating historical journey from World War I to modern medicine, revealing how observations of mustard gas's effects on soldiers led to the development of chemotherapy. From the first clinical trial at Yale New Haven Hospital in 1942 to today's sophisticated cancer treatments, this story shows how careful scientific observation transformed a deadly weapon into a cornerstone of cancer therapy.From Perplexity's Discover Feed:https://www.perplexity.ai/page/amazon-invests-4b-in-anthropic-Y3ZOPzPzTxK0Q4d_MaTsswhttps://www.perplexity.ai/page/midcontinent-rift-s-hydrogen-t-UXzIbQh1RKGd91QoYDVdKwhttps://www.perplexity.ai/page/chemotherapy-s-precursor-D8oZDWLrSfu7mNh3rycoTQPerplexity is the fastest and most powerful way to search the web. Perplexity crawls the web and curates the most relevant and up-to-date sources (from academic papers to Reddit threads) to create the perfect response to any question or topic you're interested in. Take the world's knowledge with you anywhere. Available on iOS and Android Join our growing Discord community for the latest updates and exclusive content. Follow us on: Instagram Threads X (Twitter) YouTube Linkedin

Maternal health refers to the health of women during pregnancy, childbirth, and the postnatal period. Even though important progress has been made in the last two decades in this area, we still have a lot of work to do. The World Health Organization says about 287,000 women died during and following pregnancy and childbirth in 2020. To help us understand the things that need to be done in order to bring these numbers down, Nicole sought out Dr. Daileann Hemmings. She is a doctoral prepared perinatal nurse with a focus in the Community/Public Health sector, with over 20 years of nursing experience specializing in perinatal health at some of the country's top hospitals, such as Yale New Haven Hospital and Johns Hopkins. Right now, Daileann serves as the Program Director of Maternal Health Equity at Hartford Hospital in which she works to address health disparities that impact mortality & morbidity. Nicole and Daileann share in a very candid and open conversation about how we can better support mothers -- especially those of color, some of the inequities that individuals of color experience, the initiatives she has helped implement to address the issues, and the preventability of maternal deaths. You will walk away from this episode with not only more knowledge on this topic, but a greater understanding of what you can do to help other support other moms experiencing such inequality when it comes to their maternal health.-----------------------------------SHOW NOTES:Host: Nicole Nalepa | @NicoleNalepaTVGuest: Daileann Hemmings

Howie and Harlan are joined by Max Laurans, a Yale neurosurgeon and hospital administrator, and a founder of the healthcare staffing company Nomad Health. Harlan discusses the problem of doctors giving too much weight to suggestions from AI; Howie celebrates a milestone in the campaign to eliminate trachoma, a common cause of preventable blindness in the developing world.   Links: Automation Bias “Some doctors are using public AI chatbots like ChatGPT in clinical decisions. Is it safe?” “Measuring the Impact of AI in the Diagnosis of Hospitalized Patients: A Randomized Clinical Vignette Survey Study” “Automation Bias and Assistive AI: Risk of Harm From AI-Driven Clinical Decision Support” “Combining Human Expertise with Artificial Intelligence: Experimental Evidence from Radiology” Max Laurans Maxwell Laurans, MD, MBA, FAANS Nomad Health: Travel Nurse and Travel Allied Health Jobs 2003 residency placements for Yale medical students “Yale New Haven Hospital breaks ground on $838 million, 505,000 square foot Neurosciences Center” “Hospitals across the U.S. face IV fluid shortage after Hurricane Helene” Trachoma Mayo Clinic: Trachoma “Elimination of trachoma as a public health problem in India” The Carter Center: Waging Peace. Fighting Disease. Building Hope Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Ischemic heart disease is a leading cause of morbidity and mortality. While atherosclerotic coronary artery disease (CAD) is the focus of most outpatient and inpatient evaluations for cardiovascular symptoms, up to two thirds of patients suffer from myocardial ischemia with non-obstructive coronary arteries (INOCA). Patients with INOCA have unique symptoms and are more likely to have functional limitation and repeat presentations for cardiovascular evaluation. While there has been increasing recognition of INOCA there is no specific functional status measure, limiting our ability to evaluate the course of illness or effectiveness of therapies. In this presentation, Dr. Samit Shah, interventional cardiologist at Yale New Haven Hospital who recently gave grand rounds recently to the Mayo Clinic Department of Emergency Medicine, reviews the causes of ischemic heart disease, challenges with current symptom assessment, and proposes a new path for better diagnosis and treatment of heart disease.   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda; @SamitShahMD YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com

Medical debt has a strange and storied history in America. Stretching back to colonial times, physicians and patients alike have grappled with its harsh realities. In recent years, hospitals have resorted to selling medical debt to third parties, who then aggressively pursue patients. In today's episode, medical historian Luke Messac, MD, PhD, guides us through the past and present landscape of medical debt, examining perspectives from patients, providers, hospitals, and governments. We delve into a form of indentured servitude in the name of debt clearance, the birth of nonprofit hospitals, a pivotal shift in the 1980s, feasibility of operating healthcare under free market principles, medical economics in the 1600s, hospitals suing patients, and the emergence of medical debt as its own thriving industry.

This month we're joined on the TrainSmart Podcast by Dr. Melynda Barnes. As a a double board-certified Facial Plastic and Reconstructive Surgeon and Otolaryngologist and Chief Medical Officer at Ro, Dr. Barnes brings a wealth of perspective on physician training, how to best coach physician faculty, and the value of a medical device rep. Tune in for great insight, encouragement, and inspiration for working with physicians! Related Resources: Dr. Barnes is a double board-certified Facial Plastic and Reconstructive Surgeon and Otolaryngologist. Previously, she was an Assistant Professor at Yale-New Haven Hospital and Yale School of Medicine and also served on the board of directors for Yale Medical Group. She earned her BAS from Stanford and her medical degree from the Mount Sinai School of Medicine. Connect with us on LinkedIn:   ⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠Cumby Consulting⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠Rachel Medeiros⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Liz Cumby⁠⁠⁠⁠⁠About Cumby Consulting:   Cumby Consulting's team of professionals deliver innovative MedTech training services for physicians, sales representatives, teaching faculty, key opinion leaders and clinical development teams. Whether you need a complete training system developed to deliver revenue sooner or a discrete training program for a specific meeting, Cumby Consulting will deliver highly strategic, efficient programs with uncompromising standards of quality.

Join us for a thought-provoking discussion on diversity, equity, and inclusion in healthcare with Dr. Benjamin Mba, Vice Chair for Diversity, Equity, and Inclusion at Yale New Haven Hospital and Yale School of Medicine. Dr. Mba shares insights into challenges facing minority physicians, his experience with Yancy Forums, and his vision for the future of healthcare. Tune in for valuable perspectives on fostering inclusivity in medical practice.

Dr. Asima Ahmad discusses the significant role doulas can play in pregnancy, childbirth, and postpartum care, highlighting the importance of clear roles and communication between healthcare professionals, doulas, and birthing individuals for optimal outcomes. Dr. Asima's personal experience with a doula demonstrates the benefits of having tailored support for physical and emotional well-being, underscoring the potential for doulas to alleviate stress and anxiety, and contribute to a more positive birthing experience. The conversation also addresses controversies surrounding doula services, emphasizing the necessity of teamwork and understanding in medical settings to prevent miscommunication and ensure the safety and health of both the mother and baby, with research supporting the positive impact of doulas on reducing medical interventions and improving mental health outcomes. To learn more -- or read the transcript -- visit the official episode page. “So I think there's a lot of different roles that doulas can play. I don't think it's just like a copy and paste for all. Personally, I've had five pregnancies, I have four children, and I'm lucky that I've always had a good support system in place. But for this last delivery, I did have a postpartum doula, and even though I had gone through it three times before, I found her insight and support to be valuable to not only myself but also to my family and friends.” ~Asima Ahmad, MD, MPH Our guest, Asima Ahmad, MD, MPH, is a co-founder and the chief medical officer (CMO) of Carrot Fertility, the leading global fertility care platform. As Carrot's CMO, Ahmad leads clinical strategy, overseeing the company's expansive network and telehealth program, which offers access to more than 10,000 reproductive endocrinologists, urologists, adoption experts, mental health experts, OB/GYNs, doulas, and midwives.   In addition to her role at Carrot, Ahmad is a practicing reproductive endocrinologist and infertility specialist. She is double board certified in reproductive endocrinology and infertility and obstetrics and gynecology. Ahmad earned a combined medical and public health degree from the University of Chicago's Pritzker School of Medicine and the Harvard T.H. Chan School of Public Health in Boston. She completed her residency in OB/GYN at Yale-New Haven Hospital in Connecticut and her fellowship training in reproductive endocrinology and infertility at the University of California, San Francisco. She has worked alongside and received mentorship from former ASRM presidents Dr. Hugh Taylor and Dr. Marcelle Cedars. Ahmad's work has been published extensively in academic literature and internationally on various topics related to infertility, reproductive and hormonal health, gynecologic malignancies, and patient safety.  Ahmad has been recognized by Entrepreneur magazine and Fierce Healthcare on their Women of Influence lists and named to Business Insider's 30 under 40 in Healthcare list. She has also spoken at The World Economic Forum and has been featured in The New York Times, the “Today” show, “Good Morning America,” NPR, CNN, USA Today, Women's Health, and more. Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can't imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, I talk with orthopedic surgeon and sports medicine specialist, Dr. Jervis Yau, MD. We discuss a wide range of topics including hip impingement, rotator cuff tears, PRP and stell cell injections and ACL recontructions. Dr. Yau has a particular interest in minimally invasive techniques of the shoulder, knee, hip, elbow and ankle, as well as joint preservation and cartilage restoration procedures. He has published articles in peer-reviewed publications, books and orthopedic presentations dedicated to sports medicine and orthopedic conditions and treatments. Dr. Yau graduated from the University of California, San Diego and completed his Doctor of Medicine at New York Medical College where he was elected to the Alpha Omega Alpha Honor Medical Society. He completed his orthopedic surgery residency at Yale New Haven Hospital, Yale University School of Medicine, followed by his sports medicine fellowship at Sports Orthopedic and Rehabilitation (SOAR). If you enjoyed this episode, please consider leaving a 5-star review for my podcast. It really helps the podcast build momentum and reach more people.  Click HERE to learn more about Dr. Yau's clincial practice in Santa Barbara, CA. Click HERE to learn more about my book. 

Why are we so afraid of facing death? What's it like to regularly see death and dying as an aspect of your work? Is there a better way to die? In this week's episode, I talk with Nathan Patti, a BU School of Theology graduate and chaplain resident at Yale New Haven Hospital. We discuss Tillich, drug addiction, chaplaincy, and what it means to be "called."

Audible Bleeding editor Wen (@WenKawaji) is joined by second year medical student Nishi (@Nishi_Vootukuru), 3rd year general surgery resident Sasank Kalipatnapu (@ksasank) from UMass Chan Medical School, JVS editor Dr. Forbes (@TL_Forbes) and JVS-CIT associate editor Dr. O'Banion (@limbsalvagedr) to discuss two great articles in the JVS family of journals regarding endovascular management of acute limb ischemia and ultrasound-based femoral artery calcification score. This episode hosts Dr. Thomas Maldonado (@TomMaldonadoMD) and Dr. Raul J. Guzman, the authors of the following papers:   Articles:   Safety and efficacy of mechanical aspiration thrombectomy at 30 days for patients with lower extremity acute limb ischemia by Dr. Maldonado and colleagues. An ultrasound-based femoral artery calcification score by Dr. Raul Guzman and colleagues.     Show Guests: Dr. Thomas Maldonado is the Schwartz - Buckley endowed professor of surgery in the Vascular Division at New York University Langone Medical Center in New York,  Co-Director of Center for Complex Aortic Disease Dr. Raul J. Guzman is the Donald Guthrie Professor of Vascular Surgery, Chief of Division of Vascular Surgery at Yale New Haven Hospital. He is also Surgeon-in-Chief of Vascular Surgery, Heart and Vascular Center for the Yale New Haven Health System. (raul.guzman@yale.edu)   Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.  

ASCO: You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the voice of the world's oncology professionals. 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. Guests' statements on this 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. Cancer research discussed in this podcast is ongoing, so data described here may change as research progresses. In this podcast, the Reverend Jane Jeuland discusses what people with cancer should know about the role of chaplains in cancer care, including how chaplains are trained, the type of support they can provide for people with cancer and their family members and caregivers, and how someone with cancer can ask for spiritual support from their health care team. Ms. Jeuland received her Masters of Divinity from Yale Divinity School. She is an ordained Episcopal priest. She received her chaplaincy training from Yale New Haven Hospital and is a board-certified chaplain. She has served as an oncology chaplain and was the first palliative care chaplain at Yale New Haven Hospital. She has no relevant relationships to disclose.  Jane Jeuland: Hi, my name is Jane Jeuland, and I am the palliative care clinic chaplain at Yale New Haven Hospital. I'm here today to talk a little bit about what I do at Yale New Haven Hospital, and also, what is a chaplain? What is it that we offer and provide? How are we trained? And some other questions that people have for us as chaplains. So I'll start by just describing a little bit about what I do at Yale New Haven Hospital in my role. In addition to seeing patients in our clinic, I visit with patients one-on-one through video platforms, phone, and I also visit with patients in person for scheduled appointments. And in those appointments, we get to know each other, we build a rapport and a relationship. And I help people process how they make meaning, find purpose and belonging in their lives, and how that is impacting their cancer care, but also how their cancer is really impacting their meaning, purpose, and belonging. In addition to those individual meetings, I also visit with patients in group settings. I host several groups over Zoom where patients get to talk to one another and share deeply and support each other. And last but certainly not least, I also have started a podcast with my patients called In the Midst of It All, which you can find on Apple Podcasts and Spotify. And in that podcast, patients share their stories that they've written about their lives, about their cancer journey, and about their spirituality, and how that has helped them through all that they're going through. So, how do chaplains get trained? I think this is one thing that people ask me quite a bit. What is your training like? Our training is pretty extensive. We need to have a 3-year Master's degree, typically a degree of divinity. And then after that, we have a year of training called Clinical Pastoral Education, CPE for short. And in that year of training, we are with a cohort of about 4 to 5 other chaplains in training. And we are supervised by a highly trained supervisor as well who has quite an extensive and long process to get certified to do that. And what our supervisors do is they help us really go out, visit with patients, and then reflect on those visits. We do things called “verbatims.” So what is a verbatim? When we write up a verbatim, we're writing up word for word an interaction that we have with a patient. And obviously, we will keep the patient confidential. But we do this with our group and with our supervisor to really kind of drill down and see where are the places that we are inserting ourselves, our own beliefs, our own needs, and how can we really better meet the patient where they are? We talk a lot about positive use of self so that we become really aware of our own self in the midst of our interaction with patients. And over the course of the year, we really learn how to focus on the patient's spirituality, their beliefs, their values, what they need in that moment. And we're all about helping people discover their spirituality and their faith. I think sometimes a lot of people think that we might be coming in to convert someone or to make them believe a certain belief system or a certain religion. But actually, we're really here to help any patient and caregiver really figure out what it is that they believe, and how that's impacting their cancer care or how their cancer is impacting their beliefs. So that means that we do visit with people of all different faiths. We visit with people who are atheists and agnostic as well. And really, again, just try to help people discover, what is that value that you have? What are your beliefs? Where do you find meaning, purpose, and belonging? And so what are some things that come up as we meet with patients? I, again, work in palliative care in the clinic settings. I'm outpatient. But a lot of chaplains work inpatient in a variety of settings. And so you'll have chaplains in a medical intensive care unit (ICU), or you'll have a chaplain in an infusion suite or on a floor as well. And so we see patients at all different stages. We see patients who are just newly diagnosed and have a cancer that's highly treatable. We see patients who are doing really, really well on their treatments. And we also see patients who are starting to kind of struggle with lots of symptoms, pain through sometimes months or years of cancer treatments. And then on the other end of this spectrum, we see patients who are very advanced in their cancer, have a terminal diagnosis, and we really see them through all that that entails, the outpatient visits as well as the inpatient, and even as someone comes to the end of their lives. And so what can come up in our meetings as I meet with patients? When someone's diagnosed with a terminal diagnosis, there is a lot of discussion about fear of dying, what happens in the process of dying, and then also, of course, what happens after we die? What is there after we die? Is there anything after we die? Or what is the afterlife like? And so often, again, I try to help people really reflect on what they may think the afterlife is like, if there is one. And then we have rich discussions around that. For kind of that big question of what happens as we're dying, that's when I like to pull in other members of the team. But certainly, chaplains can help process that as well. We also really do help people articulate their thoughts about the divine and whatever name they give to the divine. And often, what I hear in my appointments is not so much, “Is the divine as God giving me this cancer?” but, “Why would God allow it?” So as I talk with folks, folks will say, "I really believe in a loving God and a God that heals and a God that helps us. Why would a God like that allow me to have this cancer? Why would God allow my loved one to have this cancer and for their lives to be taken far, far too soon?" And for that, it's a tricky one. We, as chaplains, don't have a pill that we can give you and send you home and say, "OK, here's your prescription. Take that, and you'll get all the answers to why would God allow this?" So it's really a process of talking through this. It's a process of kind of discovering a little bit more about what we believe God is, what the patient believes about God, and God's character in the midst of it all. And it's also just sitting in the mystery of it that we don't know. We don't know why a loving God would allow this, why a God that heals would heal some people and not others, why a God who heals would heal at this point in your life, and then not at a different point in your life, and why this happens at all. And so chaplains don't rush quick to give advice. We allow sitting in that grief, in that suffering, in the sorrow. But then again, as we talk about who is God for this person, I also like to help people see, OK, if God isn't healing right now, if we can't understand why God is allowing this to happen, where is God in the midst of it? And this is what I love about my job so much is that I hear from such a variety of faiths and people of different values and spiritualities, how they do see the divine working in their lives. And so for some, "I have a lot of pain, but I know that God is with me, and I don't feel alone in this." Or, "I was feeling grief and loss over a loved one and wondering what my afterlife's going to be like as I face the end of my life and I was having this turmoil. And all of a sudden, I felt this deep, deep, deep peace wash over me. And I feel like that might be God." Or for someone who maybe doesn't have a particular religion, they may say, "I know that the love of my family and friends is so powerful. It's helping me through this. It's getting me through the dark times. And I know that that is what holds us together. And it's more than just what we can see and taste and feel, that that love is something greater and bigger." So it's really rich conversations like that that I get to have. I think also some other topics that come up is cancer is grueling. Cancer, it can be long. And there are things, people talk about scan anxiety. Of course, the side effects and physical pain. I hear a lot about insurance and how that's just so difficult and such a struggle to get on the phone, talk about insurance when time is so precious and so short. And for others who are healing from cancer, it sometimes is a lot of conversation about, "Well, how do I get back to life? And I used to do this amazing job, but I don't think that I can do that anymore. I don't have the stamina. I don't know how I would be able to do that job." And so I help people process that a lot. And again, that goes back to how do we find purpose in life, that meaning, purpose, belonging. And a lot of us find our purpose in work, in what we do. And so chaplains can help people through topics like that as well. And for survivors, we're always so happy in our palliative care clinic to help people heal. A lot of people think palliative care is just end of life. It is not. I have a lot of survivors I meet with, and they'll talk about kind of always looking over their shoulder. Is it going to come back? And finding a way to give back and to help other patients. And that is something I really love helping people with is, how do we give back? What are some ways to help others after I've had cancer? How can I help people? And so I have to say, I've been really, really privileged in my work as I meet with patients and individually in groups and help them write their stories and read their stories and interview on the podcast. I've just been so, so struck by all of the beauty, the resilience, the strength that I hear, the really depth and the richness of people's spirituality as they go through cancer care and really do some hard work to unpack and process all that's going on. And some of the common themes that I've heard is people will talk about how cancer has completely changed their perspective. And so people will talk about how before they had cancer, they were focused on their wonderful job, but also the pay and making sure they get ahead and can have stuff, that newest car or that bigger home. And when they have come through cancer and all that that entails, they start to think, "Gosh, you know what? I like those things, but what's much more important is the people that are right in front of me. It's the things that are free. It's time. It's talking with a loved one. It's really sharing deeply what's on your heart and mind, knowing that time is precious." And so I really am so struck by some of the things that people will share with me about their loved ones, their caregivers. If you are a caregiver, you know that you are loved, and that everything you're doing is really helpful and so, so appreciated, and that the time that you spend together and the things that you're able to share is so important. It doesn't have to be a big trip or people think about bucket list things, and it doesn't have to be all that. It's sometimes just that conversation over coffee or as you're going to sleep at night, those words that are shared are so important. And so people's perspectives, I think, really do shift and change and deepen. And people also find God in the midst of everything that they're going through. I had a patient who heard stories on the podcast and said, "I really want to write my own." So we worked together. And we talked a lot about her faith, and she wasn't really sure what to believe. She had had a hard time growing up in terms of her spirituality. And through her writing, and also through her cancer journey, she was able to really articulate her sense of God as a loving companion to give her peace, not one that's punishing, but a God that's loving. And now, as she comes to the end of her life, she's really finding a great more deal of peace, thinking about God and knowing that God is with her. I think as I share stories like these, though, I'm always so mindful, too, that I think in our culture, we think a lot about things being 5 easy steps. You can do this, and you can get better, and you can find insight and meaning in 5 easy steps. And it's really not that. It's really a process. And so as you hear stories from other cancer patients who may be in that place of peace and accepting and belonging and you're not there, also know that they were not there at a certain point and that it is a process, and it does take time. And so, again, that's what chaplains are really here for. We're here to help unpack a lot of that, to help people process that. And so you might be actually wondering, "You know what? I am going through a lot of cancer care here where I am, and I really would actually like to talk to a chaplain. How do I do that?" So the best way is to simply ask for a chaplain. We're most often called chaplains, but sometimes we're called spiritual counselors, spiritual care providers. So maybe a different term where you're located. But you can ask a nurse, your oncologist, anyone on the team, your social worker, to contact a chaplain. There are different levels of care in different settings. So you may have a chaplain in an outpatient setting, but maybe not. And so most likely, most hospitals have inpatient chaplains. If you are outpatient, though, and you really want to talk to a chaplain, I still encourage you to ask for one. And in that case, call the spiritual care or chaplaincy department directly, and you should be able to do that through your information line in your hospital. But in the hospital, for the most part, the hospitals have inpatient chaplains. Many have 24/7 on-call chaplains. And so always don't hesitate to ask the nurse, and we're happy to come by. We also do provide support for families. And so this is something that we do quite often, especially in the inpatient setting, in an ICU setting, at those times when decisions are being made. What should we do? What we often call in our hospital setting “goals of care” conversations. What is the goal of care here? Are we going to continue with aggressive interventions? Are we going to start to move to aggressive comfort care? And so chaplains help talk through that as well. So you can always call or ask for a chaplain when you're inpatient, certainly when those decisions are being made. And we're there for you as a patient, but again, we're also there for your caregivers, your loved ones. And in those settings, we're often meeting with families sometimes outside of the room even. And we help your loved ones process as well. Just like I've mentioned, all the other things that I help patients process, we also help caregivers with a lot of those topics. In addition, of course, for a caregiver, we sit with them in the pain and the suffering and the loss and the anxiety, and talk through their ways that they find meaning, purpose, and belonging, and how they're processing all that's going on with their loved one, who's the patient. I've heard from more than one patient that they say, "I feel like as hard as cancer is, it's easier on me than it is on my loved one. I hate to see what they're going through. I sometimes feel like a burden." But whenever I talk to a caregiver about that, they always say, "Absolutely not. You're not a burden. I wouldn't want to be anywhere else in the world." If they're sitting there in the ICU, long hours, surviving on coffee, very little sleep, lots of interruptions, sleeping in a chair beside your bed. Every single time, those caregivers will say, "I would not want to be anywhere else in the world. I want to be here. This is what I want to be doing." If you're the patient, feeling like a burden, know that more often than not, your loved one is really wanting to do what they're doing. But caregiver burnout is real, too, especially if your care is going on for a long, long time. And so chaplains can help caregivers process that burden. And we also work with the team, sometimes social workers and others to find support systems so that if they need help, so that they can just have a moment to themselves, go for a walk, that we can help them think about resources that may be their faith community, their church, their synagogue, their mosque, their faith community can come and help give that relief or that respite for them, but also other resources in the hospital. So you may have an integrative medicine component. So I hope that you've been able to learn a little bit more about chaplains, about how we're trained, about what we typically hear from patients, and what we can provide support around. How we also support caregivers. We are inpatient, we are outpatient, we are 24/7 most often, and how you can get in touch with a chaplain. I really encourage you to reach out to a chaplain. We're always happy to help. It's what we're here to do. So thank you so much for having me on the podcast today. It was really a delight to be here. And I hope you have peace. I hope that you find strength, meaning, purpose, and belonging in the midst of it all. ASCO: Thank you, Ms. Jeuland. Learn more about the role of chaplains at www.cancer.net/palliative. Cancer.Net Podcasts feature trusted, timely, and compassionate information for people with cancer, survivors, and their families and loved ones. Subscribe wherever you listen to podcasts for expert information and tips on coping with cancer, recaps of the latest research advances, and thoughtful discussions on cancer care. And check out other ASCO Podcasts to hear the latest interviews and insights from thought leaders, innovators, experts, and pioneers in oncology. Cancer.Net is supported by Conquer Cancer, the ASCO Foundation, which funds lifesaving research for every type of cancer, helping people with cancer everywhere. To help fund Cancer.Net and programs like it, donate at CONQUER.ORG/Donate.

 Recent advancements in treatment and a multimodal approach to care are improving outcomes for patients with head and neck cancer, however access to therapies and unique patient challenges due to disease symptoms, difficulty eating, difficulty communicating, and other psychosocial factors can reduce patient quality of life. In this episode, CANCER BUZZ speaks with Angelea Bruce, RD, CSO, OPN-CG, registered dietician and head and neck program navigator at Sharp Memorial Hospital and Brittney Watts, RN, head and neck patient care coordinator at Yale New Haven Hospital, about the importance of head and neck nurse navigation and how a dedicated navigator can help address these unique patient needs and improve care for patients with head and neck cancer.  “I think looking at it through the eyes of the physicians, the health insurance, the organization [cancer program], and looking at what are the patient outcomes, success rates, delays in care, survivorship...I think those are important metrics to monitor and we [as head and neck patient navigators] can let a program know whether the patient's needs are being met.” –Angelea Bruce, RD, CSO, OPN-CG “Having a specific nurse coordinator for the head and neck community is vital to the patient's journey within the entire process. This is the point person for the patient, for the providers, and you are the connection for the patient to the healthcare facility.” –Brittney Watts, RN Guests Angelea Bruce, RD, CSO, OPN-CG Registered Dietician, Head & Neck Program Navigator Sharp Memorial Hospital San Diego, California   Brittney Watts, RN Head & Neck Cancer Patient Care Coordinator Yale New Haven Hospital New Haven, Connecticut  This episode, developed in connection with the ACCC education program Multidisciplinary Approaches to Head and Neck Cancer Care, was made possible with support by EMD Serono. Additional Reading/Sources Multidisciplinary Approaches to Head & Neck Cancer Care Head and Neck Patient and Caregiver Resources  

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Paul Feuerstadt MD, FACG, AGAF C. difficile is a major problem in the United States. On top of that, patients who are diagnosed with this infection have the chance of getting caught in a vicious cycle of recurrence. So how can we provide our patients with the best care and work with them to give them the best treatment option? Learn more with Dr. Peter Buch as he takes a deep dive with Dr. Paul Feuerstadt, Assistant Clinical Professor of Medicine at Yale-New Haven Hospital.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Paul Feuerstadt, MD, FACG, AGAF C. difficile is a major problem in the United States. On top of that, patients who are diagnosed with this infection have the chance of getting caught in a vicious cycle of recurrence. So how can we provide our patients with the best care and work with them to give them the best treatment option? Learn more with Dr. Peter Buch as he takes a deep dive with Dr. Paul Feuerstadt, Assistant Clinical Professor of Medicine at Yale-New Haven Hospital.

Curious about how to find an egg donor, sperm donor or surrogate? Gail Sexton Anderson, the visionary behind Donor Concierge, addresses all of these questions and provides insights about how  the process operates and who covers expenses.     Donor Concierge assists clients requiring third party fertility (aka donor or surrogacy support) in their family building journey. Choosing someone outside your family to enable your family to grow can be really complicated and emotional and together we explore all these nuances.  Gail and her team are dedicated to supporting clients through every step. If using a donor or a surrogate is on your mind, this episode is not to be missed—it's brimming with vital information.   IN THIS EPISODE: [2:51] Gail explains what services the Donor Concierge provides and defines language used in the field [6:36] Gail shares the details of how Donor Concierges operates, how they assist clients navigating through the donor field and what clients are looking for in their search [18:06] There are three types of searches: egg donor, sperm donor and surrogacy search. What kinds of information are shared, and what are good reasons for openness in the process rather than anonymity  [26:59] Where are surrogates found, and what are the trends [35:44] What is the future of the way fertility and third-party fertility are supported, and are there legal issues  [42:37] When should an intended parent seek the Donor Concierge [46:15] Gail shares what family means to her   KEY TAKEAWAYS: Finding the correct egg or sperm donor cannot be overstated. It does make a difference because an egg is not just an egg, and sperm is not just sperm. Every egg carries genetic information that forms who your child will be one day.  Multiple things can and do go wrong in the process of building a family through egg and sperm donation and surrogacy. Having a firm like Donor Concierge on your side is beneficial because they walk through those difficulties with you.  The process of egg and sperm donation or having a surrogate is not just a means to an end. It is your child's story; it is your family's story. Open communication is essential, and anonymity should be a thing of the past. There is too much information lost when anonymity is a factor.    RESOURCE LINKS: Stork'd - Facebook Stork'd - Instagram Stork'd - YouTube  Donor Concierge - Website   BIOGRAPHY:  Gail Sexton Anderson has dedicated her career to helping intended parents from all walks of life build families. She founded Donor Concierge as a compassionate approach to helping intended parents sort through the gauntlet of egg donor, sperm donor and surrogacy options. Gail is a Harvard-trained counselor with 25 years of experience helping intended parents have the baby they always dreamed of.   After graduate school, Gail joined a research group in the Psychology Department at Yale University. Later, she joined a group of researchers in pediatric neurology at Yale New Haven Hospital doing developmental testing with children born prematurely of very low birth weight. Gail is also a graduate of Alice Domar's Mind Body Fertility Program through Boston IVF and has served on a Radcliffe panel with other fertility experts. In her career in the fertility industry, Gail has been the Executive Director of one of the leading surrogacy agencies and helped start two different egg donor agencies. Gail is an empathic listener who brings a calming influence to what can often be an emotionally stressful process.

Joining us on Well Said is Dr. Paul Desan, Director of the Psychiatric Consultation Service for Yale New Haven Hospital, Associate Professor at the Yale University School of Medicine, where he leads the Winter Depression Research Clinic and co-founder of Pursuit of Happiness Project, a nonprofit, data-driven enterprise that provides science-based information on life skills needed to fight depression and experience greater psychological well-being. Dr. Desan will be talking Seasonal Affect Disorder, also known as SAD, a condition that can for periods of the year affect how we feel, think about ourselves, and interact with others.

Listen to our episode on Diagnosis of Acetabulum Fractures as Dr. Leslie gives us an excellent overview. Click here for show notes Michael P. Leslie DO, FAOA, is an orthopaedic surgeon who specializes in the care and treatment of patients with complex orthopaedic injuries and complex hip replacement needs. He has particular expertise in hip reconstruction, replacement and revision surgeries. He cares for patients in collaboration with the multidisciplinary trauma team at Yale New Haven Hospital. Dr. Leslie chose his field because he wanted to help people of all backgrounds and situations manage traumatic events, which can be among the most difficult experiences they will face. “I am able to provide a calm presence and bring the skill of many subspecialties to the patient,” he says. Dr. Leslie said he became a doctor of osteopathy—a specialist who treats patients using a holistic approach to patient care—because it allows him to take into account every aspect of his patient's condition. He believes this is especially important in trauma, where patients often have medical problems in that need to be addressed in addition to their injury. Goal of episode: To develop a baseline knowledge on the diagnosis of acetabulum fractures. In this episode, we discuss:  Anatomy Mechanism of injury Associated injuries Physical exam Imaging Evaluating Xrays AP + more Enjoy!

Welcome to the Derm Club Podcast, where I recently had the pleasure of hosting Dr. William Damsky, a leading figure in cutaneous sarcoidosis. In this session, Dr. Damsky, from Yale New Haven Hospital and a recipient of the American Academy of Dermatology's Young Investigator Award, shares his extensive knowledge on sarcoidosis. We dive into what cutaneous sarcoidosis is, its causes, and risk factors like genetics and environmental exposures. Dr. Damsky also sheds light on the intriguing roles of epigenetics and occupational factors in sarcoidosis. Join us for this insightful conversation exploring the complexities and current treatments of this multifaceted autoimmune disease. Please SUBSCRIBE to the Derm Club Podcast wherever you like to listen whether on YouTube, Apple, or Spotify. Together, let's explore the fascinating secrets of dermatology and skincare. Connect with me across Social: Twitter: https://twitter.com/drhankopelman Instagram: https://www.instagram.com/doctor.han/ TikTok: https://www.tiktok.com/@drhankopelman Blog: https://www.hannahkopelman.com/blog/ The content of this podcast is for entertainment and educational purposes only. This content is not meant to be a substitute for medical advice or treatment for any medical condition. --- Send in a voice message: https://podcasters.spotify.com/pod/show/hannah-kopelman/message

Dr. Nojan Bakthiari graduated from New York University College of Dentistry in 2011, followed by a 1-year General Practice Dentistry Program at Kingsbrook Jewish Medical Center. He then completed a 2-year CODA-accredited Orofacial Pain program at New York University College of Dentistry. He started a private practice part time while teaching part time at Yale New Haven Hospital, Oral Surgery Department. Later on, he led the Orofacial Pain didactic and clinical curriculum at the University of Connecticut, School of Dental Medicine. Currently, he has an academic appointment at Columbia University but spends the majority of his time in his own private practice. His practice is one of the few ones which from it's inception was limited to evidence-based care of temporomandibular disorders, orofacial pain and associated headaches. He also serves on the Board of Directors at the New York University Dentistry Alumni Association and the Executive Council of the American Academy of Orofacial Pain.

For Chris O'Connor, becoming president and CEO of Yale New Haven Health was something of a homecoming. “I was born at Yale New Haven Hospital,” O'Connor told the CBIA BizCast. “I was a little premature, so I needed their special care unit and grew up here in New Haven.” He joins the CBIA BizCast to share his story and what is ahead for the health system.

Dr. John Krystal is McNeil Professor and Chair of Psychiatry at Yale and Yale-New Haven Hospital. He studies the neurobiology and treatment of psychiatric disorders. He directs the Yale Center for Clinical Investigation, Center for the Translational Neuroscience of Alcohol, and Neuroscience Division of the National Center for PTSD. Today on the show we discuss: The biggest risks people are overlooking with cannabis, why cannabis can be harmful for the brain and increase your risk of psychosis or schizophrenia, Dr. Krystal's thoughts on how cannabis impacts mental health and PTSD, why maintaining a healthy lifestyle is so important for your mental health, why cannabis is so addictive, whether or not the brain can heal itself after coming off cannabis and much more. ⚠ WELLNESS DISCLAIMER ⚠ Please be advised; the topics related to health and mental health in my content are for informational, discussion, and entertainment purposes only. The content is not intended to be a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your health or mental health professional or other qualified health provider with any questions you may have regarding your current condition. Never disregard professional advice or delay in seeking it because of something you have heard from your favorite creator, on social media, or shared within content you've consumed. If you are in crisis or you think you may have an emergency, call your doctor or 911 immediately. If you do not have a health professional who is able to assist you, use these resources to find help: Emergency Medical Services—911 If the situation is potentially life-threatening, get immediate emergency assistance by calling 911, available 24 hours a day. National Suicide Prevention Lifeline, 1-800-273-TALK (8255) or https://suicidepreventionlifeline.org.  SAMHSA addiction and mental health treatment Referral Helpline, 1-877-SAMHSA7 (1-877-726-4727) and https://www.samhsa.gov Learn more about your ad choices. Visit megaphone.fm/adchoices

Join Kristine Olson, Director of Work-life Well-being Analytics at Yale New Haven Hospital, and Mike Ivy, Deputy Chief Medical Officer, in this episode of the Becker's Healthcare Podcast as they dive into their innovative efforts to combat physician burnout at Yale. Discover the insights they gained during forum discussions, explore the strategies that have proven most effective in recruiting and retaining top talent, and get an exclusive sneak peek into what's on the horizon for Yale New Haven Hospital. Tune in for an enlightening conversation on healthcare workforce well-being and the future of this renowned institution.

* Hamas' Brutal Attack on Israel Provokes New Cycle of Bloodshed and Vengeance; John Nichols, The Nation magazine's National Affairs correspondent; Producer: Scott Harris. * Azerbaijani Military Operation Succeeds in the Ethnic Cleansing of Nagorno-Karabakh; Sharon Chekijian, MD, MPH, associate professor of Emergency Medicine at Yale New Haven Hospital; Producer: Scott Harris. * Major ‘Stop Cop City' Protest Action Planned for November 10-13; Jamie Peck, a Stop Cop City organizer; Producer: Melinda Tuhus.

Welcome back to Analyze Scripts, where a psychiatrist and a therapist analyze what Hollywood gets right and wrong about mental health. Today, we are analyzing the 2007 film "Awake." This movie stars Hayden Christensen, Jessica Alba and Terrence Howard. There is a nefarious plot to kill Clay who finds out during surgery. According to our guest, Dr. Gonzalez from the Yale Anesthesia Department, Clay experiences intraoperative awareness AKA "awareness" during surgery. The movie is filled with plot holes and some pretty inaccurate medical information. We learn so much from Dr. Gonzalez about anesthesia and patient pain. PTSD, medical factiods and financial stressors are topics in this episode. We hope you enjoy! Dr. Gonzalez Podcast Episode on Interoperative Awareness Website TikTok Instagram Dr. Katrina Furey, MD: Hi, I'm Dr. Katrina Fieri, a psychiatrist. And I'm Portia Pendleton, a licensed clinical social worker. And this is Analyze Scripts, a podcast where two shrinks analyze the depiction of mental health in movies and TV shows. Our hope is that you learn some legit info about mental health while feeling. Portia Pendleton, LCSW: Like you're chatting with your girlfriends. Dr. Katrina Furey, MD: There is so much misinformation out there, and it drives us nuts. And if someday we pay off our. Portia Pendleton, LCSW: Student loans or land a sponsorship, like. Dr. Katrina Furey, MD: With a lay flat airline or a major beauty brand, even better. So sit back, relax, grab some popcorn and your DSM Five, and enjoy. Welcome back for another very exciting episode of Analyze Scripts. As part of our Halloween month today, we are covering the 2007 thriller mystery movie called Awake with our wonderful guest, Dr. Antonio Gonzalez. And I cannot think of anything scarier than being awake during a surgery, so this is perfect for our Halloween month. But just as a quick bio, dr. Gonzalez is an associate professor of anesthesiology and the director of the Obstetrics anesthesia Fellowship at Yale New Haven Hospital. He completed his residency program at Rutgers in New Jersey and decided to pursue a fellowship in obstetric anesthesia at Columbia University in New York. And I will actually be joining one of his podcasts in the near future to talk about eternal mental health and anesthesia, which I'm really excited about. But thank you so much, Dr. Gonzalez, for joining us. Dr. Antonio Gonzalez, MD: Thank you so much for the invitation. I'm really happy to be here with you today. Dr. Katrina Furey, MD: So, Portia, where do we even get started with this movie? Have you seen it before? Portia Pendleton, LCSW: I have not seen the movie ever. I think that something like this would probably have been a little scary to watch. Yeah, I think a lot of people who are not in medicine and maybe people who are in medicine, I think it's a common fear to wake up during surgery. I think a lot of people going in get really calmed down once talking to the anesthesiologist or telling them that this is their process or this is. Dr. Katrina Furey, MD: How it's going to be. Portia Pendleton, LCSW: And all of the machines and monitors that they now have, you were saying a little bit before we got started today. So I think this is just like a pretty common fear that people have going into surgery. Dr. Katrina Furey, MD: What do you think, Dr. Gonzalez? Dr. Antonio Gonzalez, MD: Yes, I think that definitely introvertive awareness. It's definitely a fear of our patients. And unfortunately, this movie actually may have hyped that fear. But fortunately, the reality is that introvertive awareness is relatively rare, particularly these days. We have way better medications, way better monitors that help us to prevent intraperative awareness. The incidence has been documented to be somewhere around 0.1% to 0.2% in the United States. Dr. Katrina Furey, MD: So what is that, like, one to two out of 1000 cases? Something like that? Dr. Antonio Gonzalez, MD: That is correct, yeah. Because there are so many surgeries in the united States, that's about 20,000 to 40,000 cases a year, which still a lot. Right. The consequences of interoperative awareness can go from just having fear of future surgeries, even withholding surgeries for some of their relatives, particularly their kids, because they are so scared of what happened to them, they may actually be very fearful of letting their relatives go through surgery. Yeah. So that is one of the consequences. But, again, it's relatively rare these days. Dr. Katrina Furey, MD: Okay. Dr. Gonzalez. Portia Pendleton, LCSW: Is there anything in common. Dr. Katrina Furey, MD: That the people who this happens to. Portia Pendleton, LCSW: With each other, or is it just kind of like yeah. Dr. Katrina Furey, MD: Is there, like, a way to predict it that it could? Dr. Antonio Gonzalez, MD: So we don't have particularly great ways of predicting who will have operative awareness. We do know that there is a certain patient population or certain surgeries. So there are surgeries like trauma, cardiac surgery, and Obstetric. Anesthesia. Obstetric cases seem to be and when I mean Obstetric cases, Caesarean deliveries, particularly. These are cases that are very well known to have an increased risk of intraperative awareness. The reason behind it is because trauma patient and cardiac patients have a very delicate hemodynamics, meaning their blood pressure, it's low, tends to be on the lower side. They have a high risk of coronary vascular disease. So having their blood pressure too high or too low, it's at extreme risk. So in order to maintain that balance between the anesthesia that it's provided and the hemodynamics, those patients tend to be at a higher risk. And that implies for both trauma patients and cardiac patients. Now, the Obstetric patient population is at increased risk because of the risk that the anesthesiologist may perceive from the drugs transferring to the baby. So all the medications we give to mom will go to baby, and that increase in medications has been thought to be pretty dangerous to the baby. So anesthesiologists at some point, we're very scared of giving extra medications to mom nowadays. Again, I think that because our monitoring and the drugs that we have available and the awareness that introvertive awareness in this particular patient population, it's higher, we have improved the techniques that we have for providing general anesthesia. Now, that being said, we do a lot of our anesthesia under regional, and having pain during a surgery, even with epidural or a spinal, can be equally as scary, if not even more scary than having introvertive awareness while asleep. Dr. Katrina Furey, MD: I was wondering that. So, before we get into this a little further, I just want to give a quick recap of the plot of this movie. So, in the movie Awake, we see Hayden Christensen playing the main character, Clay Bearsford Jr. Who is, like a fancy pants financial person, super uber rich. He does something with stocks, probably, that I don't understand. And you see this interesting relationship with his mom early on, who's played her name's Lilith, and she's played by Lena Olin. And then we see Jessica Alba. This is one of her big roles, playing Sam Lockwood, who's his fiance. They get married very quickly because he is waiting for a cardiac transplant due to history of cardiomyopathy, which is something that happens. That seemed pretty accurate. And then we see Terrence Howard playing his friend and surgeon, Dr. Jack Harper. And spoiler alert, turns out all of the medical professionals on the team, including his fiance, were in on this plot to murder him during the transplant in order to inherit all his money and pay off some malpractice debt. Luckily, I think it was the anesthesiologist. The original one backed out. So this other guy was there, and somehow he figured out the plot, and he alerted authorities. And eventually, I think Dr. Harper injected the heart with adriamycin. I believe the Clay did, I guess, technically die on the table. When they delivered that news to his family, the mother committed suicide. I can't remember what she overdosed on. I'm assuming maybe Digoxin, which was in his bag. And then they wheeled the mom in and gave him her heart. And so he survived, and all the people got arrested. The end. That's basically the plot. Really quick. So getting back to what you were saying, Dr. Gonzalez, about the intraoperative awareness. So when you were saying that with these certain cases, trauma, cardiac, and OB with regional anesthesia, I'm thinking like an epidural, like for a C section or something like that. Like, if they give the epidural and it fails either in a C section or a regular delivery, vaginal delivery, would that be considered interoperative awareness? Dr. Antonio Gonzalez, MD: Well, if the patient is experiencing pain, yes, that can be as traumatic as experiencing intraperative awareness, because the patient mentally is completely there, but the patient is completely feeling the experience of the pain. And the definition of pain, actually, it's not only physical, but there is an emotional component to pain. Right. So what you describe as pain, you can only be the person that knows what pain is for you. So what we've learned through the years is that we are not the best judge of what pain is. The patient is the best judge of what pain is because pain is what the patient tells you pain is. Portia Pendleton, LCSW: I'm so glad you said that. Dr. Katrina Furey, MD: I think that's really important and to keep in mind the emotional side of it. Portia Pendleton, LCSW: I like that also, just as I don't know a similarity right. In mental health, like pain mental pain, emotional pain is, like, what the patient is describing versus my definition in the DSM. But I really like that. Or just validating their experience. Well, this is what they experienced. Maybe someone else's was different. Dr. Katrina Furey, MD: Right. Portia Pendleton, LCSW: I really like that. Dr. Antonio Gonzalez, MD: Yeah. I think that it's a great opportunity, because, as you mentioned, sometimes if, as physicians, we try to give an explanation to pain, right. We may actually minimize the patients. And at the end of the day, what ends up happening is that the patients feels that their feelings, they're being gaslighted. So the patient is telling you, this is what I feel, and you say, well, it's not that big of a deal. Right. But it is to the patient, it is. So pain is, again, what the patient tells you pain is. Dr. Katrina Furey, MD: No, I think that's great. And in my line of work, in private practice, I do end up seeing well, I see primarily women around pregnancy and postpartum. So I've heard many cases where the epidural failed, or it only took on half the side, or someone had a history of back surgery, so they met with the anesthesiologist ahead of time to talk about pain management options. And it is a super important aspect of prenatal care, especially delivery, and I'm sure that extends to other surgeries as well. So, Dr. Gonzalez, what are your thoughts about the way anesthesia was depicted in this movie? What they get right, what they get wrong? Dr. Antonio Gonzalez, MD: Well, there are so many things that they well, the one thing that they got right was to select the patient that was having a cardiac surgery. As we mentioned, patients with cardiac surgery have an increased risk of having introvertive awareness. So they got that one part right. Then the other thing is that it seems like they have a substitute anesthesiologist that's coming from another institution. It doesn't quite happen that way. You need to have privileges at that place. It's a little credentialed. Yeah. Unless he's a traveler. Sometimes we have anesthesiologists that are considered what is the term? Locums. That's correct, yes. So locums might have been a locums that they call in to substitute, but it's actually quite hard to find locums for very specific cardiac surgery. So I think that the other thing that I think was very wrongfully depicted was how easy he may look. The induction. The induction was basically he took this three CC syringe or four CC syringe. He gave it to the patient. He said, count back to ten. Cardiac inductions are very complicated. It requires a balance of many medications. Again, because there is this hemodynamic balance that you want to maintain. You don't want the patient's blood pressure to go too high. Do you want the patient's blood pressure to go too low? So that also it seems like it was completely off. And there is a point where the surgeons are discussing, like, well, we won't need you for a little bit, so go get a drink. We never leave the operating room. Dr. Katrina Furey, MD: Right. Dr. Antonio Gonzalez, MD: I know there is always somebody from anesthesia in the room that be like the anesthesiologist or anesthetist, but we just don't leave the patient in the or. Just because the surgeon tells us that they're not going to need us for a bit. So that was totally wrong. Dr. Katrina Furey, MD: Right. In my experience in medical school, rotating through that's exactly right. Even these long cases like cardiothoracic surgery, the anesthesiologist, maybe a resident, maybe the nurse, anesthetist. These words are hard to say. Someone's always there watching the monitor. They might be doing something else at the same time. I remember one time there was a resident practicing his golf swing, and I was like, this seems pretty unprofessional. But they're always watching the monitors. And I would imagine like this, especially watching the blood pressure, the heart rate, things like that. And they're always checking. They kept checking, at least in the cases I would be in, they would do things to check. The patient was still under enough. Not too far under. Not coming out of it either. Dr. Antonio Gonzalez, MD: Yes. And as you mentioned, sometimes the anesthesiologist, a lot of what we do, we may not be actually looking at the monitors, but because we're actually trained for so it's a three year program. By the sound of the machines, you actually know what is wrong. Like the pulse oximeter has a very typical sound. When the saturation drops, the alarms on the monitors are set off to go at X levels. Right. So you can set up your alarms. So even if we're like, let's say, fixing our medication drips or we're working on something that it's not necessarily looking at the monitor, just hearing the monitor, we are aware of what actually the vital signs are, and of course, the alarms are ever present. So we're always very aware of these alarms and everything that surrounds. We use pretty much all our senses when caring for patients. Dr. Katrina Furey, MD: That makes a lot of sense. Portia Pendleton, LCSW: It's interesting. I think there was an episode on Grey's Anatomy years ago about the anesthesiologist at the hospital was like, has a substance use disorder. And he was, like, falling asleep next to the patient. And of course, it's a drama, so the young resident had to do something and didn't want to get in trouble by the attending or something. But I feel like I've seen not a lot of medical dramas. I mean, that's not like my jam. But the couple that I have there seems to always be the anesthesiologist is like sometimes a villain. I don't know. Dr. Katrina Furey, MD: Is that a stereotype? Yeah. Is that a stereotype? Portia Pendleton, LCSW: Or like, maybe just in TV, the. Dr. Katrina Furey, MD: Psychopath is often the villain too, so we can empathize. Portia Pendleton, LCSW: Yeah, it seems like it's a lot of risk with that job. Dr. Antonio Gonzalez, MD: I think that psychiatrists, dentists, and anesthesiologist seems to be the highest the physicians with the highest incidence of substance use. Dr. Katrina Furey, MD: Disorder, I believe that's right, yeah. Dr. Antonio Gonzalez, MD: And suicide as well, I think. Yeah. Maybe media has picked up on that. Maybe. Dr. Katrina Furey, MD: Interesting. I think in my training, I was taught that in those specialties, you have the easiest access to controlled substances in terms of the risk of substance use disorders. So that's one reason the rates are higher. And then suicide. I didn't know anesthesiologists also had a high rate of suicide. Dr. Antonio Gonzalez, MD: Yeah. I haven't reviewed the statistics on this, but I think that it used to be that way. I think actually, dentists might be number one. For some strange reason, anesthesiologists are high up in there. Dr. Katrina Furey, MD: One big issue I had with this movie was the plot, because I feel like they went to great lengths to pay off a prior malpractice lawsuit. And I feel like they'd all have malpractice insurance, right? Even if I know there's certain specialties. Like, I think OB, for example, has a really high rate of malpractice insurance. Wouldn't they have malpractice to cover any claims? Dr. Antonio Gonzalez, MD: Yes, they would. Dr. Katrina Furey, MD: Think. And Portia, I think you were reading some criticisms of the movie. I think the general public also caught on to that, like, wow, this is like a really intricate plot to go through to pay off prior lawsuits. Portia Pendleton, LCSW: I don't know. Murdering someone, you have to be so backed into the corner hopeless, like no other options. And it's like, I mean, A, yeah, like, you're right about the malpractice. You should have an insurance through the hospital. You're not even in private practice paying for your own, and that maybe you cut corners with that. It just seems OD that they taking going to these lengths of murdering a patient that Dr. Jack Harper was, like, friend. And it's like, at what point did the friendship turn into this? Was it fake? The whole, like, I think that's know, I watched the movie, you know, taking. Dr. Katrina Furey, MD: Notes because we're professionals. Portia Pendleton, LCSW: We're professionals at watching TV here, and I was just lost with a lot of the line, so I'm glad to hear it know, I guess just me, but pretty gaping holes in some of it. Dr. Katrina Furey, MD: Yeah. And what did you think about that relationship of the friendship between Dr. Harper and Know? Because at least in psychiatry, we are big and not just psychiatry, but mental health in general, we are big boundary people. We really talk about boundaries and how to maintain them, especially in professional settings. I think in some other fields of medicine, I'm thinking more like primary care pediatrics in the old school days when you'd have the family doctor who took care of everyone in the town, I think the boundaries would have been a little different. But I always thought, especially when it came to things like surgery, it was really important not to operate or doing a seizure on people you're close to. Is that still the case? Dr. Antonio Gonzalez, MD: Well, I think it's probably the right thing to do because your feelings for your significant other or friend may actually interfere with your judgment. But again, I think it's more of a judgment call than a set rule. I do think that there are certain surgeries and certain procedures that we probably shouldn't be doing for our family members or for close friends, because, again, our judgment may be cloud by our feelings for that person. You may not necessarily take the best decision when you're put in that place. Dr. Katrina Furey, MD: Yeah, I think suturing up a superficial wound like your child cuts their knee. Oh, I can suture that up real quick. Feels very different to me than doing cardiac anesthesia or surgery on your buddy that you go fishing with. Yeah, right. Yeah, I would agree. Portia Pendleton, LCSW: I could see I was thinking just, like, what would I be comfortable with a friend doing? But maybe I don't know. I mean, I'm thinking of specialties, like, ortho I could see a friend doing but not OB. It's, like, all private, and then definitely not psychiatry, but I don't know. Cardiac surgery? I don't think cardiac no, it's like your heart opening my chest. I don't want you I think it's. Dr. Katrina Furey, MD: Important you feel like you trust the surgeon and the anesthesiology team, but to have it be like your buddy, that's risky. And what an ultimate betrayal. Portia Pendleton, LCSW: I mean, he trusted this person. He chose to have this procedure done by, I guess, at least rating wise, like a doctor with a lower success rate than right. The mom brought in this specialist who was operating on presidents and had all. Dr. Katrina Furey, MD: This prestige play picked Dr. Harper. Portia Pendleton, LCSW: And then right. To have this nefarious plot going on was just I was really shocked. I was also really shocked that Sam was in on it, his fiance, because at first, I think the movie kind of sets you up to not, like the mom. Right. Like, Lilith seems, you know, like, she doesn't have his best interests at heart. Dr. Katrina Furey, MD: It's controlling. Maybe they're enshring and not letting him. Portia Pendleton, LCSW: Live or be independent. Right. But then know, I was like, wow, really weaseled her way in. So I don't but she was a nurse, I think, so she had some info about his medications, which the mom, Lilith, was first, really surprised and pleased. Like, wow, like, you really have been taking care of him. I see all the medications in your bag. But then that's also ultimately how she found out that Sam was in on it. Right. Dr. Katrina Furey, MD: She saw, like, I think Sam left her purse behind, and the medications fell out. And when she went to go put everything back in the purse, she saw some mail where the name didn't match up, and then somehow she put it. Portia Pendleton, LCSW: Together, but that wasn't clear. Dr. Katrina Furey, MD: But again, also like, okay, so the names don't match up. That wouldn't automatically make me think, like. Portia Pendleton, LCSW: Oh, no, you're in on it to. Dr. Katrina Furey, MD: Murder my son while he's in this heart transplant. The plot was a little far fetched, but I did think it was entertaining, and I did know with Clay on the table, often the anesthesiologist is, like, the first person you meet when you're coming in for surgery that day and. Portia Pendleton, LCSW: The first person you see when you wake up. Dr. Katrina Furey, MD: So I think that's very important, as well, to your whole experience of surgery. And can you tell us a little bit, Dr. Gonzalez, about in your role, what that entails and how you sort of take care of the patient in broad strokes. And if this movie we've already talked about how the induction was totally off, but what the movie sort of got right and wrong. Dr. Antonio Gonzalez, MD: Yeah. So I think that the role of the anesthesiologist is very important. And I think that as anesthesiologist, we realize that, as you mentioned, unfortunately, the way our system is, we usually meet our patients just the day of surgery, right? So what that entails is that we actually need to create rapport with our patients very quickly. We know that the patients are coming in for a very stressful moment in their life. Sometimes it's very big surgery, sometimes it's very minor surgeries, right? But independently of what type of surgery the patients are coming for, we need to create that rapport and we need to bring the confidence to the patient. And as anesthesiologist, I think that we try to do that the moment we're talking to the patient. The first time we talk to the patients, it's all about creating rapport and creating a team experience in which you let me know what are your goals and we can try to meet those goals and expectations. What are your fears? Some patients tell you that their major fear is pain. Some patients tell you their major fear is throwing up because all the nausea, they've experienced so much nausea after. So then you can reassure the patient, okay, so this is our plan. This is going to be our plan to address the pain. This is going to be our plan to address the nausea. And again, we do this for all types of surgery. And I think that's very important as anesthesiologist to try to create that rapport and always be, when talking to the patient, basically addressing what are your major fears and how this is our plan to address those. Portia Pendleton, LCSW: That's such an important question. I think such an important part of the team. I think other people are just kind of part of the team, which makes sense. Like, okay, this is a surgery. They ask you a million questions like why are you here? What's your name? What's your birthday? Over and over again. So they're doing the right thing. But then for someone to ask, right, what are you scared of? Dr. Katrina Furey, MD: Right? Portia Pendleton, LCSW: What are you scared of today? How can we help you? Do you have any questions? Is really helpful. And I think just lets see the patient feel like they're a part of the team, like they're being validated, listened to, important, which of course they are. But I think in the system when you have maybe two to five, maybe surgeries that day, it's just like it becomes for everybody that's working, there just procedure. So I think those questions just stand out as really helpful and nice, good patient care. Dr. Katrina Furey, MD: And the anesthesiologist is the person who you really meet at the beginning, who asks you all these questions, checks on your allergies, looks in your mouth to see like, okay, how big are those tonsils? How are we going to sort of intubate? You most comfortably asks you what you're worried about, and then they walk with you in most of the time, and they're with you, getting you on the table, getting you positioned, making sure you're comfortable, saying, okay, it's going to be cold in here, let's put a blanket on. They do a lot of that caretaking right away. I think when people are really scared, even if it's a minor surgery, I don't know who's not scared when they're going into a surgery. And of course, the surgeon comes in and they're really focused on the surgery, and of course, they want to make the experience good, too. But you're usually, like with the anesthesiologist, I think, the longest as you're consciously awake and then coming out of the surgery, that's who's also waking you up and making sure you're okay. That's who's checking on you in post op and things like that. So it is interesting that such an important member of the team and you're right, you really meet them that day and then you don't see them again, right? Like at the follow up for the surgery and stuff, you never get to see them. Is that a part of the job? Do you mind that, or do you wish that you could check on these people again? Dr. Antonio Gonzalez, MD: Well, it's actually very interesting that you ask because one of the things that actually inspired me to become an obstetric anesthesiologist, particularly, was I sometimes felt that I was in these very long surgeries, and when I went to see the patients post op, they would not remember me. And there wasn't really a problem with the patient not remembering me. It wasn't really an ego thing. It was more like, I don't feel like he thinks I'm part of this team taking care of him. I didn't feel like I was part of the team again. But on the other hand, I just happened to see a patient in a hallway and he's like, oh, you did my epidural for labor. And I'm like, oh, I did. And that was like, oh, these patients do remember me. Do appreciate what we're doing. And although, again, it's not an ego thing, but it's just that feeling of being part of something more, like, you know, that you help somebody and they actually remember that you were part of that, alleviating the pain, and it just feels good. It makes you feel like you're really part of a team that addresses the patient's pain and all this. And that's what really brought me into obstetric anesthesia. Going back to what we were talking about, the patients, the pre op part. Again, because of my obstetric anesthesia background, most of the literature that I've reviewed is on that field. And there is a very interesting article that has changed the way I practice that basically addressed what we were just discussing, which was basically, you ask the patients would you rather have better analgesia or more side effects, depending on the dose? And the interesting thing it's a very interesting study, but the outcome of the study was that patients actually knew exactly what they wanted. The patients that were overly concerned about pain ended up consuming more pain medication. And the patients that were overly concerned with the side effects did not consume as many medications. So the patients always know. And that's why always asking your patients, what are your weigh the risk and benefits, or what are your main outcomes? What do you want to experience here? More pain, slightly less pain, slightly more side effects of the medications, or you're okay with pain knowing that your side effects are going to be less? Dr. Katrina Furey, MD: The patients know that's actually really interesting and really important to keep sort of their autonomy and their preferences. So, Dr. Gonzalez, I know you're not like a transplant surgeon, but I thought it was pretty unlikely that the mother would just be, like, wheeled in, especially after having overdosed on something and her heart would be given right to her son. Dr. Antonio Gonzalez, MD: Yeah, absolutely. Dr. Katrina Furey, MD: What do you think about that? Dr. Antonio Gonzalez, MD: Yeah, absolutely. I think you're absolutely right. And at some point, I was hoping to bring that up. First of all, as you mentioned, there is a battery of tests that the donor needs to go through before they can be a donor. Portia Pendleton, LCSW: That's number one blood type, right? Dr. Katrina Furey, MD: It's not just like, oh, it's a blood type match. There's like, so many more things they have to check. Dr. Antonio Gonzalez, MD: There's so many more tests. And it seems from the movie that the mom have actually taken the purse from Sam, right? So presumably she took medications that could have actually make her heart stop. Right, which means that the period of ischemia of the heart may not have make her a good donor for her heart. She might have been able to donate her cornea and other things that actually don't have a very specific ischemia time. But there are organs that have a very limited ischemia time, meaning that the time that the organ is without perfusion or without oxygenation, without blood flow. And that is very important. The heart is one of the organs that needs perfusion for very crucial timing. It's a very small window of ischemia for the heart yes. Dr. Katrina Furey, MD: That she'd take, again, cardiac medication that likely stopped her heart. It does seem like she called her surgeon of choice ahead of time and was like, get here now. We only have so much time. But still, it's just completely unlikely that that would have happened. It was kind of a beautiful, I guess, part of the story that they could both, in this other realm, connect with each other and she could talk to him and they got to say this goodbye. That was pretty beautiful. But in terms of accuracy, there's no way that would have happened. And so getting. Back to the title of the movie Awake, and the whole premise that he's awake in surgery and aware of everything that's going on. I think a fascinating question that comes to my mind is like, how do we define awake? Is it consciousness? Is it memory? Is it feeling? And then how do you assess it during and after something like a major surgery? Dr. Antonio Gonzalez, MD: Yeah, that's a very interesting question. And I was thinking myself the same thing throughout the movie. And at the end, I'm still not even clear that either he was awake. We probably will never know the answer, according to the movie. But interoperative awareness, it's basically the incidence of a failure to suppress arousal, experience and episodic memory. So for you to have recall, in order for you to have introoperative awareness, there has to be recall. There are some incidents of patients actually hearing things, but they may not have necessarily distress about it because hearing and depth of sedation, the depth of sedation goes anywhere from hearing to actually not even being able to have recall. So you're going to see the worst cases of interoperative awareness when there is recall, and the patient can actually tell you how stressed they were about the experience. So they've come up with some classification. It's called the Michigan Awareness Classification, and it goes from zero, class zero, which is basically no awareness, to class one, which is auditory perceptions, class two, which is tactile perception. So they feel the surgical manipulation, they feel the endotracheal tube. And then there is class three, which is they actually feel pain. Class four, they actually have paralysis. And this is what seems to actually be happening here. He's experiencing paralysis because he said, just move something, right? He's trying to move something. He can't move anything. So he probably is there at a class four. Later on, we know that he's definitely at class five, where he's probably experiencing pain and paralysis. And then you can actually assign a D if the patient tells you that it was very stressful. They have the fear, they had fear, they had anxiety, a sense of suffocation or doom. So basically all these classifications, you can actually add a D to them. And the higher they are, and especially if they have a D next to them, the more likely these patients will have sequela. As in your profession, you can probably talk about what happens to these patients that have interpreted awareness. Right? And you were talking about moms that have pain during surgery. So that could lead to post traumatic stress disorder. But I'm not the expert there. Dr. Katrina Furey, MD: I would imagine it would. Right. I would imagine when we think about post traumatic stress disorder, I like to think of that as a disorder of Stuckness. And I always tell my patients, like, it's normal after you've lived through something traumatic, to have the symptoms of PTSD, the hyperarousal, the hyper, vigilance, intrusive thoughts, altered avoidance, altered mood, altered line of thinking and things like that initially, because who wouldn't? We sort of call that an acute stress response. But then once it persists, usually after, like, a month or continues beyond that, then we start to think of it as something called PTSD or post traumatic stress disorder. And there's some really great treatments out there for that, including things like cognitive processing therapy or CPT, EMDR, different types of psychotherapies and medications, and patients can really get a lot better. I love treating PTSD for that reason. But I would imagine the first criterion to meet diagnostic criteria for PTSD is to have a life threatening situation happen to you or to be vicariously exposed to it, which I think is really important as a new addition to the DSM criteria. I think this will qualify. Portia Pendleton, LCSW: Yeah, I'm just even imagining a patient coming in and describing this. I would expect a person to develop PTSD from it, and then it's like. Dr. Katrina Furey, MD: Is that a disorder, or is that, like, a normal human response to being consciously awake but paralyzed during cardiac surgery? Right. Portia Pendleton, LCSW: That's where you're like, well, like, trouble sleeping following. I would imagine maybe some nightmares. Might be afraid to fall asleep 100%. Or obviously, like you were saying before, Dr. Gonzalez, afraid of returning for future medical care or surgeries or telling loved ones to not do it, or their experience. So it feels really serious. And obviously, many traumas can be, but also unique. I haven't worked with someone that this has occurred to, obviously, because it is rare, but I'm just imagining, like, poor Clay when he wakes up, and if he does recall at one of those levels that you described, then what? And also write the murder plot. I mean, that was like taking the cake, let alone feeling pain. Dr. Katrina Furey, MD: I know. Like, such intense pain, right. And being so paralyzed and helpless. I almost can't imagine anything worse. Portia Pendleton, LCSW: He's standing up. We talked a little bit about the dissociation. That being an interesting way to show it. So sometimes when somebody's experiencing a trauma, they might dissociate and kind of see. Dr. Katrina Furey, MD: Themselves from up above. And they did show that when he sort of zoomed out, then it took a turn where he's then solving the. Portia Pendleton, LCSW: Plot, like, walking around, figuring it out. Dr. Katrina Furey, MD: Like, I don't think yeah, that's not quite dissociation, but up until that point. Portia Pendleton, LCSW: It was a great depiction of. Dr. Antonio Gonzalez, MD: It. Portia Pendleton, LCSW: Just it was wild. Dr. Katrina Furey, MD: It was wild. What a wild movie. Dr. Gonzalez, as we wrap up, is there anything else you'd like to add or anything we haven't touched on that you think is important? Dr. Antonio Gonzalez, MD: What it's really important here is for the patients to really voice out their experience. Right. One of the things that we see as physicians, we're not necessarily, particularly not psychiatrists or psychologists, we are not necessarily very well versed in how to deal with the consequences of what happens interoperatively. And it's important for the patients to say, hey, this is what I felt. But equally as important is for physicians to actually avoid minimizing what the patient felt and actually acknowledge that something happened and say, hey, I'm really sorry that you went through this. Let's try to figure out what resources we have to help you to get better, to get through these. It's actually something that I've always wondered is when is the best time to reach out for the patients? When, for example, in our case, we do C sections, right? And the patients are telling us that they're feeling pain, so they actually quickly voice out their experience so we can quickly do something about it. And even then, it's hard to figure out if you should approach the patient, shouldn't approach the patient, because not every patient won't consider a short time of discomfort or pain as traumatic. So it's a thin line in which basically we rely on the patient telling us, this is what I felt, this is how I feel now, so that we can actually look for help again, because as anesthesiologist or, surgeons may not be the best person to deal with it, but we can look for the resources. Dr. Katrina Furey, MD: And I do think, actually, at least in my clinical experience, given what I do, it has been I can tell you without a shadow of a doubt, it has been so validating and healing for my patients who have experienced trauma within previous childbirth deliveries or IVF procedures or other things like that, who felt minimized by the team at the time when they go in for the next thing and their anesthesiologist is the one who asks them just the questions you're mentioning. Now, I'm wondering if it was you. Portia Pendleton, LCSW: Or if you've just trained, like, some. Dr. Katrina Furey, MD: Really good team members. But when they ask them about these things and they share their prior traumatic experience, which is very hard for them, right, like, to even share, period, but then, especially if they've felt minimized or invalidated in the past, when they share it this time, and it's met with compassion and validation, it goes so far in their healing. And so I think you're spot on, and I hope this can serve and your continuing education can serve to just keep reinforcing that to the anesthesiology team that that is really important and such a crucial time to give that validation to patients who might really need it. And I think that would go for any patient, but especially any patient with a history of PTSD prior to that. And that's a hard thing to ask about. Portia Pendleton, LCSW: Yeah, I could definitely see it in pregnancy traumas. I think it's a pretty common experience with just, like, whether or not it's their perspective of something happening. Everything moves fast sometimes, as both of you know, I'm sure if it's supposed to be a regular delivery and all of a sudden it's not like that can be scary. And sometimes you have to prioritize saving a patient so things aren't explained slowly. It's the after of, like, okay, I know. That was really scary. Dr. Katrina Furey, MD: Kind of debriefing. Portia Pendleton, LCSW: Yeah, the debrief I would imagine being really helpful. Dr. Katrina Furey, MD: And we always I think in mental health, we always assume our patients have a trauma history rather than assume they don't. And I don't think that's because there's like I mean, maybe there is a higher incidence given the patients we're seeing. But I think then if you can just sort of approach it in more of like a trauma informed framework and just assume, like, okay, let's just assume this person has had some experience in their life where they felt helpless or stuck or not heard. How do we approach them here so that they don't feel that you don't even have to ask, do you have a trauma history? You could just assume. And then I think that just goes a really far away. So I'm so glad, Dr. Gonzalez, to hear that you're just doing know that makes this psychiatrist very happy. Dr. Antonio Gonzalez, MD: Yeah, well, I think that a lot of it has to do with the fact that some time ago, we actually read this very nice article that came out that was titled Failure of Communication, and it was actually written by a patient who experienced interoperative pain. I actually had the pleasure to have a podcast with Susanna Stanford, who is a patient who experienced introvertive pain, and she shared with us through that paper that was a couple of years ago, her experience. And from the time I read that paper, I started realizing how important that communication part is and not minimizing their pain and actually trying to address the situation in the moment and offering alternatives. Right. The most important thing, as you mentioned, is the patient needs to feel that first of all, they're being heard and that their concerns will be addressed. The worst we can do is tell them that it's not that big of a deal. Baby is okay. That's usually what we hear. Oh, the baby's okay. So it's going to be fine. The means doesn't justify the end. Dr. Katrina Furey, MD: Well, that's wonderful. Thank you so much, Dr. Gonzalez, for joining us today. I think we will try to link to that paper in our show Notes. If anyone is interested in reading that. Portia Pendleton, LCSW: Further and maybe also your podcast, if you want to tell us, give us. Dr. Katrina Furey, MD: A little shout out yeah. Portia Pendleton, LCSW: Where they can find your podcast. Dr. Antonio Gonzalez, MD: Yes, the podcast is Yale Anesthesiology, and I will share the link as well. Dr. Katrina Furey, MD: Thank you. And we want to thank all of our listeners for joining us today. You can find us at Analyze Scripts podcast on Instagram and TikTok. We recently updated our Instagram handle, so now it's Analyze Scripts podcast across the board, and we hope that you will join us next week as we cover the Nightmare Before Christmas on our Halloween month. Portia Pendleton, LCSW: Yes. Dr. Katrina Furey, MD: So we'll see you next Monday. Portia Pendleton, LCSW: Thank you so much for joining us. Dr. Katrina Furey, MD: Bye. Dr. Antonio Gonzalez, MD: All right. Thank you so much for having me. This was great. Thank you. Dr. Katrina Furey, MD: This podcast and its contents are a copyright of analyzed scripts, all rights reserved. Any redistribution or reproduction of part or all of the contents in any form is prohibited. Unless you want to share it with your friends and rate review and subscribe, that's fine. All stories and characters discussed are fictional in nature. No identification with actual persons, living or deceased places, buildings, or products is intended or should be inferred. This podcast is for entertainment purposes only. The podcast and its contents do not constitute professional mental health or medical advice. Listeners might consider consulting a mental health provider if they need assistance with any mental health problems or concerns. As always, please call 911 or go directly to your nearest emergency room for any psychiatric emergencies. Thanks for listening and see you next time. Dr. Katrina Furey, MD: Our don't.

It was nothing short of a miracle. A woman was barely hanging on to life at Yale-New Haven Hospital in 1942. She had been running a fever of 106 degrees for four weeks, and doctors were out of options. A new treatment – never before tried in the U.S. – brought her back to life in less than 24 hours. Hear the incredible story about the first use of penicillin in the U.S. from the Director of Infection Prevention at Yale-New Haven Hospital, Dr. Richard Martinello.

This episode is very personal and special for Arden. She is joined by Gail Sexton Anderson and Gloria Li from Donor Concierge, and together, they explore the invaluable services offered to women aspiring to become mothers. Donor Concierge has played a pivotal role in bringing countless families into existence by serving as dedicated advocates. They collaborate with many agencies involved in sperm and egg donation and surrogacy. This intricate and sensitive process is a remarkable journey of creation. Anyone interested in parenthood or donation will find this episode enlightening and informative.   IN THIS EPISODE:   [01:18] Gail explains why she founded Donor Concierge, and Gloria shares how she became involved [03:36] Arden explains her personal story and asks what are the challenges in finding egg or sperm donors [07:36] What are the realistic expectations of a concierge business in this field [11:59] How Donor Concierge serves the affluent family and answers questions they may have [17:57] Do donors do this for the money and an explanation of the process involved for intended parents [26:09] Are some want-to-be parents excluded from the process [29:29] Discussion of clients who are recognizable by the public or extremely wealthy families, where the field is going in the future, and being open about how your family was created    KEY TAKEAWAYS:   Finding a surrogate, a sperm donor, and an egg donor is not as easy as it may sound. It is a crucial decision, and hiring experts to guide you is best. Affluent parents have the option of a direct search program where they create a landing page to share with potential donors who they are.  Surrogacy allows you to give joy to a mother who otherwise would not have a child.   RESOURCES: Beyond the Balance Sheet Website   Donor Concierge - Website   BIOGRAPHIES:  CEO & Founder Gail has dedicated her career to helping intended parents from all walks of life build families. She founded Donor Concierge as a compassionate approach to helping intended parents sort through the gauntlet of egg donor and surrogacy options. Gail is a Harvard-trained counselor with 25 years of experience helping intended parents have the baby they always dreamed of. After graduate school, Gail joined a research group in the Psychology Department at Yale University. Later, she joined a group of researchers in pediatric neurology at Yale New Haven Hospital doing developmental testing with children born prematurely of very low birth weight. Gail is also a graduate of Alice Domar's Mind Body Fertility Program through Boston IVF and has served on a Radcliffe panel with other fertility experts. In her career in the fertility industry, Gail has been the Executive Director of one of the leading surrogacy agencies and helped start two different egg donor agencies. Gail is an empathic listener who brings a calming influence to what can often be an emotionally stressful process. A frequent speaker at fertility conferences, Gail consults with organizations creating fertility service programs. She is a former board member of SEEDS, The Society for Ethics in Egg Donation and Surrogacy, and the Co-Founder of TULIP, a new online platform for third-party fertility. Married since 1984 with two wonderful children, Gail says having the privilege of being a mother has ignited her passion for helping others experience the joy of parenting.   Gloria Li, BA, PMP Executive Director Gloria is responsible for managing the Donor Concierge, overseeing all aspects of the company. Gloria has worked in fertility since 2013 and is an expert on egg donation, gestational surrogacy, and fertility care management. Her vision, passion for the mission, and attention to detail have set a high mark in our commitment to excellence, and her leadership has helped Donor Concierge become the premier resource for intended parents worldwide.

Have you ever wondered about the hidden truths of the pharmaceutical industry? Well, you're not alone. Today, I had a powerful conversation with Dr. Neda Ashtari, a dedicated resident at Yale New Haven Hospital, who is bravely challenging the Big Pharma. We plunged into the depths of the system and its practices, shedding light on how the drugs are developed, the role of marketing in promoting drug safety, and where all the money actually goes. Neda's personal connection to this fight against Big Pharma and her commitment to the University's Allied for Essential Medicines adds an extra layer of passion and authenticity to our discussion.Delving deeper, we examined the cost implications of the current pharmaceutical system. It's shocking to discover how taxpayer money funds drug development without necessarily ensuring affordability for consumers. The stark reality of how pharmaceutical companies exploit market dynamics to set skyrocketing prices was a topic that we couldn't ignore. As a consequence, we uncover the crisis of unaffordable drugs in the US and the global lack of access to essential medicines. Dr. Ashtari gave an insider's perspective on these pressing issues that will leave you questioning the system as you know it.In the final stretch of our conversation, we zeroed in on the surrogate endpoints, conflicts of interest, and marketing tactics used by the pharmaceutical industry. We also discussed the industry's impact on drug pricing and the public's role in drug development. The most shocking revelation was perhaps the fact that pharmaceutical companies spend more on marketing than on research and development. This episode is a deep dive into the pharmaceutical industry, its practices, and its implications. So, plug in your earphones and join us in this enlightening journey with Dr. Neda Ashtari. Trust me; you won't look at your medicine cabinet the same way again.Check out the shownotes to learn more!__________________Click here to join the exclusive GHP online community!Support the PodcastClick here to send in a one time or monthly donationJoin the Podcast Mailing list: https://www.globalhealthpursuit.com/mailing-list Make sure to follow Hetal on LinkedIn, Instagram and Facebook!Email her at hetal@globalhealthpursuit.com.Thank you so much. We deeply appreciate you.

In 2020, over a 5-month period, 65 women entered The Yale Fertility Center, which is part of Yale New Haven Hospital for fertility care. Their experience can only be classified as horrific. These women were perplexed by their unexplained excruciating pain during the procedure, and even the doctors and clinic staff were unable to provide answers. In the absence of concrete information about the true cause of the pain, patients, families, and even the staff seemed to restore to creating their own narratives to make sense of it. Join us in the first episode of a three-part series exploring How is this Possible?----------------------------------------------------------------------Link to the Patient No Longer Podcast Brandon was interviewed on: Put your mask on first A warrior's tale on how to provide great careNew website: https://www.purposedrivenpx.com/real-nurses-real-talk-podcastInterest form to tell your story: https://form.jotform.com/230685346709060Be sure to connect with us on Instagram:@realnurses_pcSend questions, topic ideas, and/or comments to realnursespc@gmail.com.

Howie and Harlan are joined by Alan Friedman, chief medical officer at Yale New Haven Hospital, to talk about the organizational and cultural changes that the hospital has made to minimize medical errors and unprofessional behavior that harm patients. Howie reports on a Yale study showing a gap in excess deaths between Republicans and Democrats after the COVID-19 vaccine was introduced; Harlan discusses the continued problem of financial toxicity for patients, and a new study casting doubt on the effectiveness of “neuroprotective” diets. Links: “Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic” “State-Level Excess Mortality in US Adults During the Delta and Omicron Waves of COVID-19” “Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study” “To Err is Human: Building a Safer Health System” “The Safety of Inpatient Health Care” “We're Already Paying for Universal Health Care. Why Don't We Have It?” “Out-of-Pocket Annual Health Expenditures and Financial Toxicity From Healthcare Costs in Patients With Heart Failure in the United States” “Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

The Cardiorenal Syndrome is commonly encountered, and frequently misunderstood. Join the CardioNerds team as we discuss the complex interplay between the heart and kidneys with Dr. Elliott Miller (Assistant Professor of Medicine at Yale University School of Medicine and Associate Medical Director of the Cardiac Intensive Care Unit of Yale New Haven Hospital), and Dr. Nayan Arora (Clinical Assistant Professor of Medicine and Nephrologist at the University of Washington Medical Center). We are hosted by FIT lead Dr. Matthew Delfiner (Cardiology Fellow at Temple University), Cardiac Critical Care Series Co-Chairs Dr. Mark Belkin (AHFTC faculty at University of Chicago) and Dr. Karan Desai (Cardiologist at Johns Hopkins Hospital), and CardioNerds Co-Found Dr. Dan Ambinder. In this episode we discuss the definition and pathophysiology of the cardiorenal syndrome, explore strategies for initial diuresis and diuretic resistance, and management of the common heart failure medications in this setting. Show notes were developed by Dr. Matthew Delfiner. Audio editing by CardioNerds Academy Intern, student doctor Akiva Rosenzveig. The CardioNerds Cardiac Critical Care Series is a multi-institutional collaboration made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Mark Belkin, Dr. Eunice Dugan, Dr. Karan Desai, and Dr. Yoav Karpenshif. Pearls • Notes • References • Production Team CardioNerds Cardiac Critical Care PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - Management of Cardiorenal Syndrome in the CICU Cardiorenal syndrome (CRS) represents a range of clinical entities in which there is both heart and kidney dysfunction, and can be driven by one, or both, of the organs. CRS is caused by reduced renal perfusion, elevated renal congestion, or a combination of the two. Treatment therefore focuses on increasing perfusion, by optimizing cardiac output and mean arterial pressure, and reducing congestion through diuresis. Patients should be monitored for an adequate response to the initial diuretic dose within 2 hours of administration. If the response is inadequate, the loop diuretic dose should be doubled. Diuretic resistance can be managed via sequential nephron blockade, most commonly with thiazide diuretics, but also with amiloride, high-dose spironolactone, or acetazolamide, as these target different regions of the nephron. In cases of refractory diuretic resistance, hypertonic saline can be considered with the help of an experienced clinician. Continuation or cessation of renin-angiotensin-aldosterone system (RAAS) inhibitors in the setting of CRS should be made on a case-by-case basis. Show notes - Management of Cardiorenal Syndrome in the CICU 1. Cardiorenal syndrome (CRS) is a collection of signs/symptoms that indicate injury to both the heart and kidneys. Organ dysfunction in one can drive dysfunction in the other. Cardiorenal syndrome can be categorized as: Type 1 - Acute heart failure causing acute kidney injury Type 2 - Chronic heart failure causing chronic kidney injury Type 3 - Acute kidney injury causing acute heart failure Type 4 - Chronic kidney injury causing chronic heart failure Type 5 - Co-development of heart and kidney injury by another systemic process. These categories can be helpful for education, discussion, and research purposes, but they do not usually enter clinical practice on a regular basis since different categories of cardiorenal syndrome are not necessarily treated differently. 2. CRS is caused by either reduced renal perfusion, elevated renal congestion, or a combination of the two. When dealing with CRS, note that: CRS can be caused by poor kidney perfusion,

If you've ever wanted to heal from illness, or feel better about your life, then do we have the Humor and Healing show for you.   I'll be talking with Dr. Bernie Siegel, about how to laugh your way to self-healing, and happiness.   Bernie Siegel is an American writer and retired pediatric surgeon, who writes on the relationship between the patient and the healing process and the best selling author of numerous books including Love, Medicine and Miracles, Love Animals and Miracles, The Art of Healing, and a phenomenal little audiobook Humor and Healing.   Topics Include: What does it mean to become a love warrior? What it means to send someone love and help change their life? What is 365 Prescriptions for the Soul? How do we heal from the feeling that we are a failure? What we can learn from stories about our life? What we can learn from Simon and Garfunkel? Why you want to wear a bandage when you are not injured! What is the importance of sharing what is ailing you with others? Why people never die, and what it means for you? What laughter means for our health? Why your attitude is so important for your survival? What we can learn from people who have a few months to live? What people have done when they were told they were dying that dramatically extended their lives? What does it mean to choose to live? What does it mean to take back the reigns of your life? How can parents “use love as your weapon”? What does it mean to breathe peace?   Dr. Bernie Siegel was born in Brooklyn, NY. He attended Colgate University and Cornell University Medical College. He holds membership in two scholastic honor societies, Phi Beta Kappa and Alpha Omega Alpha and graduated with honors. His surgical training took place at Yale New Haven Hospital, West Haven Veteran's Hospital and the Children's Hospital of Pittsburgh. He retired from practice as an assistant clinical professor of surgery at Yale of general and pediatric surgery in 1989 to speak to patients and their caregivers.   In 1978 he originated Exceptional Cancer Patients, a specific form of individual and group therapy utilizing patients' drawings, dreams, images and feelings. ECaP is based on “carefrontation,” a safe, loving therapeutic confrontation, which facilitates personal lifestyle changes, personal empowerment and healing of the individual's life. The physical, spiritual and psychological benefits which followed led to his desire to make everyone aware of his or her healing potential. He realized exceptional behavior is what we are all capable of.   Bernie, and his wife and coworker Bobbie, live in a suburb of New Haven, Connecticut. They have five children and eight grandchildren. Bernie and Bobbie have co-authored their children, books and articles. Their home with its many children, pets and interests resembled a cross between a family art gallery, museum, zoo and automobile repair shop. It still resembles these things, although the children are trying to improve its appearance in order to avoid embarrassment.   www.dailywoohoo.com - Sign up for my FREE daily newsletter for high-vibration content.   To find out more visit: https://amzn.to/3qULECz - Order Michael Sandler's book, "AWE, the Automatic Writing Experience" www.automaticwriting.com  - Automatic Writing Experience Course www.inspirenationuniversity.com - Michael Sandler's School of Mystics https://inspirenationshow.com/ -  www.dailywoohoo.com - Sign up for my FREE daily newsletter for high-vibration content. ……. Follow Michael and Jessica's exciting journey and get even more great tools, tips, and behind-the-scenes access. Go to https://www.patreon.com/inspirenation   For free meditations, weekly tips, stories, and similar shows visit: https://inspirenationshow.com/   We've got NEW Merch! - https://teespring.com/stores/inspire-nation-store   Follow Inspire Nation, and the lives of Michael and Jessica, on Instagram - https://www.instagram.com/InspireNationLive/   Find us on TikTok - https://www.tiktok.com/@inspirenationshow

Dr. John Krystal — All Things Ketamine, The Most Comprehensive Podcast Episode Ever | Brought to you by Athletic Greens all-in-one nutritional supplement, Helix Sleep premium mattresses, and Allform premium, modular furniture. Dr. John Krystal is the Robert L. McNeil, Jr., Professor of Translational Research; Professor of Psychiatry, Neuroscience, and Psychology; Chair of the Department of Psychiatry at Yale University; and Chief of Psychiatry and Behavioral Health at Yale-New Haven Hospital.Dr. Krystal is a leading expert in the areas of alcoholism, post-traumatic stress disorder, schizophrenia, and depression. His work links psychopharmacology, neuroimaging, molecular genetics, and computational neuroscience to study the neurobiology and treatment of these disorders. He is best known for leading the discovery of the rapid antidepressant effects of ketamine in depressed patients.He directs/co-directs the Yale Center for Clinical Investigation (CTSA), NIAAA Center for the Translational Neuroscience of Alcoholism, and Clinical Neuroscience Division of the National Center for PTSD (VA).Dr. Krystal is a member of the U.S. National Academy of Medicine; co-director of the Neuroscience Forum of the U.S. National Academies of Sciences, Engineering, and Medicine; Fellow of the American Association for the Advancement of Science (AAAS); and editor of Biological Psychiatry, one of the most selective and highly cited journals in the field of psychiatric neuroscience.He is the co-founder and Chief Scientific Advisor of Freedom Biosciences, a clinical-stage biotechnology platform developing next-generation ketamine and psychedelic therapeutics that recently emerged from stealth in August 2022.ONE VERY IMPORTANT DISCLAIMER: I'm not a doctor, nor do I play one on the Internet. None of the content in this podcast constitutes medical advice or should be construed as a recommendation to use ketamine or psychedelics. There are psychological, physical, and sometimes legal risks with such usage. Please consult your doctor before considering anything we discuss in this episode.Please enjoy!*This episode is brought to you by Helix Sleep! Helix was selected as the #1 overall mattress of 2020 by GQ magazine, Wired, Apartment Therapy, and many others. With Helix, there's a specific mattress to meet each and every body's unique comfort needs. Just take their quiz—only two minutes to complete—that matches your body type and sleep preferences to the perfect mattress for you. They have a 10-year warranty, and you get to try it out for a hundred nights, risk-free. They'll even pick it up from you if you don't love it. And now, Helix is offering up to 200 dollars off all mattress orders plus two free pillows at HelixSleep.com/Tim.*This episode is also brought to you by Athletic Greens. I get asked all the time, “If you could use only one supplement, what would it be?” My answer is usually AG1 by Athletic Greens, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. I do my best with nutrient-dense meals, of course, but AG further covers my bases with vitamins, minerals, and whole-food-sourced micronutrients that support gut health and the immune system. Right now, Athletic Greens is offering you their Vitamin D Liquid Formula free with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit AthleticGreens.com/Tim to claim this special offer today and receive the free Vitamin D Liquid Formula (and five free travel packs) with your first subscription purchase! That's up to a one-year supply of Vitamin D as added value when you try their delicious and comprehensive all-in-one daily greens product.*This episode is also brought to you by Allform! If you've been listening to the podcast for a while, you've probably heard me talk about Helix Sleep mattresses, which I've been using since 2017. They also launched a company called Allform that makes premium, customizable sofas and chairs shipped right to your door—at a fraction of the cost of traditional stores. You can pick your fabric (and they're all spill, stain, and scratch resistant), the sofa color, the color of the legs, and the sofa size and shape to make sure it's perfect for you and your home.Allform arrives in just 3–7 days, and you can assemble it yourself in a few minutes—no tools needed. To find your perfect sofa and receive 20% off all orders, check out Allform.com/Tim.*For show notes and past guests on The Tim Ferriss Show, please visit tim.blog/podcast.For deals from sponsors of The Tim Ferriss Show, please visit tim.blog/podcast-sponsorsSign up for Tim's email newsletter (5-Bullet Friday) at tim.blog/friday.For transcripts of episodes, go to tim.blog/transcripts.Discover Tim's books: tim.blog/books.Follow Tim:Twitter: twitter.com/tferriss Instagram: instagram.com/timferrissYouTube: youtube.com/timferrissFacebook: facebook.com/timferriss LinkedIn: linkedin.com/in/timferrissPast guests on The Tim Ferriss Show include Jerry Seinfeld, Hugh Jackman, Dr. Jane Goodall, LeBron James, Kevin Hart, Doris Kearns Goodwin, Jamie Foxx, Matthew McConaughey, Esther Perel, Elizabeth Gilbert, Terry Crews, Sia, Yuval Noah Harari, Malcolm Gladwell, Madeleine Albright, Cheryl Strayed, Jim Collins, Mary Karr, Maria Popova, Sam Harris, Michael Phelps, Bob Iger, Edward Norton, Arnold Schwarzenegger, Neil Strauss, Ken Burns, Maria Sharapova, Marc Andreessen, Neil Gaiman, Neil de Grasse Tyson, Jocko Willink, Daniel Ek, Kelly Slater, Dr. Peter Attia, Seth Godin, Howard Marks, Dr. Brené Brown, Eric Schmidt, Michael Lewis, Joe Gebbia, Michael Pollan, Dr. Jordan Peterson, Vince Vaughn, Brian Koppelman, Ramit Sethi, Dax Shepard, Tony Robbins, Jim Dethmer, Dan Harris, Ray Dalio, Naval Ravikant, Vitalik Buterin, Elizabeth Lesser, Amanda Palmer, Katie Haun, Sir Richard Branson, Chuck Palahniuk, Arianna Huffington, Reid Hoffman, Bill Burr, Whitney Cummings, Rick Rubin, Dr. Vivek Murthy, Darren Aronofsky, Margaret Atwood, Mark Zuckerberg, Peter Thiel, Dr. Gabor Maté, Anne Lamott, Sarah Silverman, Dr. Andrew Huberman, and many more.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.