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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

Neuroscience, Podcasts, Stanford News

Brain’s gain: Stanford neuroscientist discusses two major new initiatives

Brain's gain: Stanford neuroscientist discusses two major new initiatives

The brain has gotten a lot of attention lately. Last month, President Obama announced a $100 million decades-long research initiative to “unlock”, as he called it, “the mystery of the three pounds of matter that sits between the ears.” And, in the arena of jaw-dropping science, Stanford’s Karl Diesseroth, MD, PhD, and Kwanghun Chung, PhD, recently unveiled CLARITY – a process that rendered a mouse brain transparent. Thomas Insel, MD, director of the National Institute of Mental Health, called the Stanford researchers’ work, “frankly spectacular.”

Primed for this moment of brain fame is Stanford’s Bill Newsome, PhD, who has been toiling in the field of neuroscience for nearly three decades. His international renown as a research scientist catapulted him to two new key brain posts: vice chair of the federal BRAIN initiative and director of a new interdisciplinary neuroscience institute at Stanford.

I talked with Newsome about both efforts for my latest 1:2:1 podcast. I began by asking him, “Why now?” What has propelled the brain to the front of the food chain in federal funding?

He called the Obama administration “prescient” for putting forth the federal effort. “There has never been a bigger moment of progress for brain research than there is now,” he told me. He describes this time as a “tipping point” where putting the pedal on the accelerator will make a whole new world of research possible.

Newsome is also cautious. Over-promising breakthroughs is clearly not in his vernacular. Yet he see this moment with clarity and admits that accelerating what we’re already doing will allow us “to get new data about the brain that we never dreamed possible.”

Previously: Co-leader of Obama’s BRAIN Initiative to direct Stanford’s interdisciplinary neuroscience institute, Lightning strikes twice: Optogenetics pioneer Karl Deisseroth’s newest technique renders tissues transparent, yet structurally intact, Experts weigh in on the new BRAIN Initiative and A federal push to further brain research

Aging, Medicine and Society, Podcasts

A conversation about the end of life

A conversation about the end of life

My sister, Cathleen, recently passed away. She had been in a coma for nearly a year from an accidental fall while visiting her daughter in New York. She lay on a sidewalk after apparently tumbling down the stairs and bled out for nearly 20 minutes until an ambulance arrived. She never regained consciousness.

Many, many times over the past year I wondered what she would have wanted if she had known of her cruel predicament. It was hard to imagine that a woman whose credo was ‘live, live, live’ would have wanted to waste away in a nursing home unconscious with little chance of recovery. Yet she was a fighter. Would she have wanted to grasp for every final bit of air before she breathed her last? Or at some point would she have wanted to just die peacefully?

I never had a conversation with my sister about end-of-life matters. Thankfully I also never had to make any fateful decisions since I wasn’t her legal guardian. Her husband and two daughters were ultimate authorities. But the question still gnaws at me even today, several weeks after her death. What would she have wanted? And in that time, I’ve thought a lot about what I would want if I were in that situation.

Ellen Goodman, the Pulitzer Prize winning columnist from the Boston Globe, never had a conversation with her mother about the end of life either. In the last years of her mother’s life, Goodman found herself swirling in a fog of decisions. They were basic decisions about care, treatment and survival – decisions that her mother was incapable of making:

In the last year of my mom’s life, she was no longer able to decide what she wanted for dinner, let alone what she wanted for medical treatment. So the decisions fell to me. Another bone marrow biopsy? A spinal tap? Pain treatment? Antibiotics? I was faced with cascading decisions for which I was wholly unprepared. After all the years I had written about these issues, I was still blindsided by the inevitable.

After her mother’s death, having keenly observed numerous great social movements throughout her years of reporting, Goodman wanted to create another movement. And so The Conversation Project – an initiative “dedicated to helping people talk about their wishes for end-of-life care” – was born.

I spoke with Goodman for a 1:2:1 podcast when she was out west to evangelize her project and to meet with VJ Periyakoil, MD, director of Stanford’s Palliative Care Education and Training. As a great journalist Goodman knows how to communicate, and she articulately laid out why The Conversation Project is landing at the right moment to launch another historical social movement.

Previously: Talking about a loved one’s end-of-life wishes, The importance of patient-doctor end-of-life discussions, KQED health program focuses on end-of-life care and Facing mortality

Cancer, Dermatology, NIH, Podcasts, Research, Stanford News, Women's Health

New findings on aspirin and melanoma: Another outcome of the Women’s Health Initiative

New findings on aspirin and melanoma: Another outcome of the Women's Health Initiative

There has been a lot of interest in the Stanford study suggesting that aspirin reduces the risk of melanoma in women; dermatologist Jean Tang, MD, PhD, spent much of her day today discussing the findings with reporters from NPR and the three networks’ evening news programs. Earlier, in a 1:2:1 podcast, Tang talked about her work and described the importance of the Women’s Health Initiative (WHI), from which she and her co-investigators pulled their data:

The Women’s Health Initiative was funded by the National Institutes of Health and American taxpayers’ dollars…  This was a huge investment of taxpayers’ dollars, and it has incredibly paid off, [producing] many published papers and, more importantly, many important messages and conclusions about the health of American women.

Women were enrolled [in the WHI] to reflect the multi-ethnic population of the U.S. So American Indians are represented, Mexican-American women are represented, black women are represented. You are never going to get the richness and diversity of the women represented in this database anywhere else in the world.

Previously: New research shows aspirin may cut melanoma risk

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