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Cancer, Podcasts, Stanford News

“How cancer becomes us”: A conversation with author and anthropologist Lochlann Jain

"How cancer becomes us": A conversation with author and anthropologist Lochlann Jain

Associate Professor of Anthropology S. Lochlann Jain's new book weaves her research with memoir and aims to start a new conversation about cancer as a cultural, not just medical, phenomenon.I asked Stanford anthropologist Lochlann Jain, PhD, author of “Malignant: How Cancer Become Us,” why, when there are thousands of books on the market about cancer, we needed another one. She agreed there are many. There are superb histories, interesting and excellent memoirs, and penetrating looks at the environmental causes of cancer out there, but, she said, “what we’re missing is an analysis of how cancer is such a large part of America’s political, social and economic life.”

When we first met over coffee to talk about the book, I asked Jain how she  would define cancer, having been a member of its club. “It complicated,” she replied. “I didn’t expect to write about cancer. I just thought I’d get this treatment over with and go back to my work. But then I realized, the whole experience was just so full of paradox, I couldn’t just let it go.”

And paradoxes she does write about: We fight it, yet we produce it. Science, medicine, economics and policy are often at odds with each other. As she told me:

Each of America’s iconic industries – agriculture, oil and gas, cosmetics, plastics, pesticides, tobacco, medicine, construction, military – has undoubtedly led to tens of millions of cancer deaths. The unique way in which cancer presents, decades after exposure, makes it central to the growth of both the industries and the illness, in short to the existence of the United States, as we know it.

She also talked to me about the blame and shame game that accompanies a diagnosis of cancer. She brings clarity to the issue of why victims of cancer are dropped into a torturous inner debate of shoulds and coulds and woulds.

I was completely riveted by our conversation. ”Malignant” is an extraordinarily original piece of writing that takes a microscopic lens to the complex and confounding world of cancer. I hope you’ll find my 1:2:1 podcast with her of value. In my mind, Jain adds a truly unique voice to the literature of cancer.

Previously: Stanford professor dispels “too young for cancer” myth
Photo by L.A. Cicero/Stanford News Service

Ethics, Patient Care, Podcasts

What happened inside New Orleans’ Memorial Hospital? A conversation with Pulitzer Prize-winning author Sheri Fink

What happened inside New Orleans' Memorial Hospital? A conversation with Pulitzer Prize-winning author Sheri Fink

Memorial Medical Center is seen Monday, Sept. 12, 2005, in New Orleans, after more than 40 bodies were recovered Sunday at the 317-bed hospital. Hospital assistant administrator David Goodson said patients died while waiting to be evacuated over the four days after the hurricane hit, as temperatures inside the hospital reached 106 degrees.  (AP Photo/Rick Bowmer)What happened at Memorial Hospital in New Orleans after Hurricane Katrina struck and paralyzed the city? Pulitzer Prize winner Sheri Fink details the hospital’s struggles for survival in her new book, Five Days at Memorial. It’s a harrowing tale of colossal failures within Memorial and also outside as the federal, state and local governments bungled their response. I find myself still outraged eight years later, wondering how a tragedy of this magnitude could happen to an American city.

In addition to the horror of a hospital in chaos due to a storm of historic proportions, the story of Memorial is filled with ethical conundrums about what constitutes humane health care. Did health care workers choose life for some patients and death for others? Three health care workers were arrested and faced criminal allegations that they deliberately injected a number of patients with drugs to hasten their deaths. In the end, a New Orleans grand jury declined to indict even though the State Attorney General maintained to the end that a number of the dead were victims of homicide.

In her finely detailed investigative work, Fink brings the reader into Memorial for a minute by minute harrowing recounting of what happens when things fall apart in a hospital. Five Days at Memorial is a stunning read, and I was pleased to be able to talk with Fink at length for my latest 1:2:1 podcast. As I wrote in an earlier blog entry:

Put yourself [in place of the health care workers]. What would you have done? Are the ethical lines clear to you? Is what happened inside Memorial black and white? Or is it gray?

Fink holds an MD and PhD from Stanford’s School of Medicine.

Previously: Pulitzer Prize-winner Sheri Fink: the final hours at New Orleans Memorial, New York Times wins three Pulitzers for health stories and Murky waters: A look at Memorial Medical Center after Hurricane Katrina
Photo by ASSOCIATED PRESS

Pediatrics, Podcasts, Public Health

A conversation with “Children’s Defender” Marian Wright Edelman

A conversation with "Children's Defender" Marian Wright Edelman

EdelmanMarian Wright Edelman is a force of nature. Ask her a question and she reels off facts and figures rapid roll. When we were considering which noted individual to feature in a Q&A for our current issue of Stanford Medicine, which focuses on pediatrics, she stood out. Edelman’s leadership on children’s issues is awe-inspiring. I’ve listened to my 1:2:1 podcast with her and read our conversation, “The Children’s Defender”, numerous times during the editing process of the magazine – and I’m still touched by her passion, dedication and commitment.

Children’s Defense Fund, which Edelman founded forty years ago, has been at the forefront of overhauling public policy in child poverty, early childhood development, education and health. They’ve also worked to prevent gun deaths among children and teens for more than two decades. During our talk, Edelman said she wished they would have closed their doors long ago and that the myriad of issues that confront children would have been solved. But the struggle continues. She carries forth that mission extremely well.

Previously: From womb to world: Stanford Medicine Magazine explores new work on having a baby
Photo courtesy of Children’s Defense Fund

Cancer, Podcasts, Women's Health

Red Sunshine: One doctor’s journey surviving stage 3 breast cancer

Red Sunshine: One doctor's journey surviving stage 3 breast cancer

Red Sunshine cover - smallThere’s something so raw and intimate about Kim Allison’s cancer memoir, Red Sunshine, that as a reader at times you feel like you might be invading her privacy. But as the Stanford cancer pathologist told me in our 1:2:1 conversation, she mulled over what if anything might be too personal to share and decided that if she was going to write a book about her battle with Stage 3 breast cancer she would do it with candor.

I was curious. How does a cancer pathologist who peers through a microscope every day to analyze biopsies of strangers look at her own malignant cells? What’s it like to have the dual role of patient and cancer doctor? And, how does a mother of two young children even contemplate the question of death?

In person, Allison is as disarming and comfortable talking about her cancer as she is detailing it in the book. Now, five years cancer-free, she can look back and call herself a survivor. Her kids, nine and six, still too young to fully comprehend their mother’s journey from desperation to renewal, see the history of her illness through the scars on her body. The cancer may be gone now, but for Allison it’s certainly not forgotten.

I’m sure that her story will give hope and perhaps even solace to other women (and men too) looking down at the beast of cancer. Red Sunshine is a tale about weathering a storm, surviving the dark times and in the end coming out whole.

Medical Education, Medicine and Literature, Podcasts, Stanford News

Starting a new career in academic medicine? Here’s a bible for the bedside: The Academic Medicine Handbook

Starting a new career in academic medicine? Here's a bible for the bedside: The Academic Medicine Handbook

Roberts_book_coverWhen I spoke with Laura Roberts, MD, chair of psychiatry at Stanford, for a 1:2:1 podcast about the new book she edited, The Academic Medicine Handbook, I told her I thought every profession needs what she’s created, a hands-on guide on how to achieve success. Think about it. How much of our professional success is determined by skills we were never taught in college or grad school? In Chapter One, she writes, “…my sense is that nearly all early-career faculty members experience, as I did, an unsettling combination of feeling overly schooled and yet, still unprepared. Decades of formal education, as it turns out, are insufficient for some of the unexpected and labor-intensive everyday duties of the instructor/assistant professor…”

So here it is, a soup-to-nuts manual that gives academics in medicine a road map for how to excel.  It covers the basics, with chapters on how to manage time, how to give a lecture and how to prepare the best curriculum vitae. And it gets even more sophisticated, with how to evaluate an offer letter, how to understand flaws in clinical research and how to prepare an IRB application. The bottom line: If you’re a young professional just beginning a career in academic medicine, here’s a bible to have along your bedside.

Emergency Medicine, In the News, Patient Care, Podcasts, Stanford News

After the plane crash: Inside the command center with Stanford Hospital’s chief of staff

After the plane crash: Inside the command center with Stanford Hospital's chief of staff

Earlier today, we shared a video that provides a behind-the-scenes look at our emergency teams’ response to Saturday’s plane crash. Now, in a 1:2:1 podcast, Stanford’s Ann Weinacker, MD, provides even more details from Saturday morning: how officials here mobilized to establish a command center and initiate code triage, bringing together cross-functional teams from emergency, trauma, operations, security and others to coordinate the expected surge of patients. Among the things Weinacker shares in this 26-minute interview is the sense of calm and organization she arrived to at the hospital, and the uncertainties she and her colleagues later felt as they waited for patients to arrive:

It concerned us that we didn’t always knew who was coming or how many people were coming or what the extent of their injuries might be. We would get word that an ambulance was coming with several people or a bus was coming with 15 people… At one point we had heard what was being reported on the news, that there were 60 people unaccounted for; that of course caused a lot of anxiety for us in our minds. Are these people severely injured? Are they deceased? We didn’t really know what the situation was or how many of those people we would be getting.

Weinacker is chief of staff at Stanford Hospital & Clinics and a professor of critical care medicine at the medical school.

Previously: Behind-the-scenes look at treating SFO plane-crash survivors and “Everyone came together right away:” How Stanford response teams treated SFO plane-crash victims

Health and Fitness, Nutrition, Obesity, Pediatrics, Podcasts

Using hip hop to teach children about healthy habits

Using hip hop to teach children about healthy habits

At elementary schools around New York City, Harlem-based Hip Hop Public Health uses music videos, cartoons and interactive games to educate students about the importance of good nutrition, exercise and other healthy habits. This recent Scienceline podcast offers more details about the organization and how the program was implemented at Thurgood Marshall Lower Academy.

Previously: No bribery necessary: Children eat more vegetables when they understand how food affects their bodies, Free Stanford online course on child nutrition & cooking, Nutrition and fitness programs help East Palo Alto turn the tide on childhood obesity and Examining why instilling healthy eating and exercise habits in children may not prevent obesity later in life

Cancer, Patient Care, Podcasts, Science, Stanford News

Director of the Stanford Cancer Institute discusses advances in cancer care and research

Director of the Stanford Cancer Institute discusses advances in cancer care and research

Back in 2010, Beverly Mitchell, MD, director of the Stanford Cancer Institute and a professor of medicine, gave us an overview of the landscape of cancer research and treatment. Since that time, significant strides have been made - from the use of genomic analysis, molecular biology, imaging technologies and data management – and these advances have made cancer treatment less toxic and more tailored to the individual patient.

In his latest 1:2:1 podcast, Paul Costello, the medical school’s chief communications officer, talks with Mitchell about these advancements and new Stanford initiatives to transform care.

Previously: The big C

Pain, Podcasts, Stanford News

Exploring the mystery of pain

Exploring the mystery of pain

If I had to live with chronic pain, I’d be a pain to live with.

I’m a lap swimmer. A few years ago, I developed a pain in my neck (yes, an actual, cliched pain in the neck). It didn’t stop there: It radiated down my arm and moved from my arm to my head like a brushfire. I became totally consumed by the thought of pain, and the longer it lasted the more compulsively I thought about it. I began to wonder if I’d ever be pain free again. Through it all I developed a great sympathy for anyone who has to face chronic physical pain in their daily life.

For me, there weren’t any particular good medical solutions or relief. I wasn’t interested in pain meds so I didn’t go that route. Essentially, I toughed it out using intense massage therapy and switching to a swimmers snorkel so I wouldn’t have to turn my neck each time I gasped for air. I also started vigorously stretching my upper body after every workout. The pain soon vanished.

The memory of that pain is stamped in my brain, and I’ve wanted to revisit the mystery of pain in a podcast ever since that time. I came across a very cool TED lecture by Stanford Medicine’s Elliot Krane, MD, director of pain management services at Lucile Packard Children’s Hospital, and saw that – no surprise with a subject like pain – it’s been viewed nearly 700,00 times.

When I spoke to Dr. Krane I began with a simple question: What is pain? Listen in and you’ll find out not only that answer but also how pain still perplexes him – even though he has researched and treated it since the 80s.

(And if you want more about pain, go back to a 2011 podcast in which I interviewed Sean Mackey, MD, PhD, another of Stanford Medicine’s amazing physician-scientists focused on pain. He treats adult patients.)

Previously: More progress in the quest for a “painometer”, A call to fight chronic-pain epidemic, Relieving Pain in America: A new report from the Institute of Medicine, Elliot Krane discusses the mystery of chronic pain, Stanford’s Sean Mackey discusses recent advances in pain research and treatment and Oh what a pain
Photo by ashleigh290

Podcasts, Sleep, Stanford News

Stanford doc talks sleep (and fish) in new podcast

Stanford doc talks sleep (and fish) in new podcast

You know that famous song about love by Cole Porter with the lyrics, “Birds do it, bees do it. Even educated fleas do it.” Well, in addition to amour, Porter could have easily been referring to sleep. After all, even fish do it, as Rafael Pelayo, MD, with the Stanford Sleep Medicine Center, told me during my latest 1:2:1 podcast.

I hope you’ll listen in as Pelayo talks more about the mysteries of sleep, an endlessly interesting topic.

Previously: Catching some Zzzs at the Stanford Sleep Medicine Center, Ask Stanford Med: Rafael Pelayo answers questions on sleep research and offers tips for ‘springing forward’ and Catching up on sleep science

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