A weekly podcast about the people, issues and ideas that are shaping health care.
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95: Racism infects neuroscience’s past and present. What about its future?
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De-Shaine Murray is working at the cutting edge of neurotechnology. As a postdoctoral fellow at Yale, he is developing a device to monitor the brain following traumatic brain injury or stroke. He is also trying to fight the long legacy of racism in neuroscience. He sees a direct line from racist pseudoscience like phrenology to disparities in neuro…
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94: When do tests hurt more than they help?
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Manil Suri and Daniel Morgan are an unusual team: Manil is a mathematics professor and author, while Daniel is a physician and professor of epidemiology, public health, and infectious diseases. But they recently teamed up for a First Opinion essay, “Diagnostic tests for rare conditions present a mathematical conundrum,” in which they write about ho…
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93: Rep. Raul Ruiz on going from the emergency room to Congress
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Before he joined Congress, Rep. Raul Ruiz, a Democrat from California, worked in another chaotic environment: the emergency department. Today, he says, he tries to bring his background in medicine and public health to policymaking. In particular, he has turned his attention to a shortage of infectious disease physicians that threatens U.S. prepared…
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92: What we take for granted after 30 years of Prozac
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When Prozac first entered the psychiatry scene in in the late 80s, the profession was still Freud's territory. Meaning: it was considered by many a failure to take medication to cure depression. But that was all about to change, with early stewards like psychiatrist Peter Kramer, who refused to shy away from the new drug's potential. These days, he…
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Fifteen years ago, Mara Buchbinder and colleagues came up with the concept of the “patient in waiting.” The concept described a new category of patients created by cutting-edge testing for conditions that may never appear. The patient in waiting was, quite literally, someone who was waiting to see if they would become ill. Mara's husband, Jesse Sum…
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90: The true costs of mediocre insurance plans for medical students
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This week, medical student Amelia Mercado and her professor J. Wesley Boyd talk about the stressors of medical training, privacy concerns within academic institutions, and how high insurance costs affect access to mental health care. The conversation is based on their co-authored First Opinion, "How medical schools are failing students who need men…
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89: Putting an end to a racist "diagnosis"
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The term "excited delirium" has been used for years by law enforcement and other first responders, including health care workers, to describe people who exhibit behavior that is considered "out of control." This diagnosis has been applied again and again, even posthumously, as a justification for extreme and sometimes deadly, interventions by law e…
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88: Sniffing out the power, and limits, of the placebo effect
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Have you ever taken phenylephrine for a stuffed-up nose and then felt better? If so, you might have been perplexed when Food and Drug Administration experts recently said that that the drug — which is in some versions of DayQuil, Sudafed, and other medicines — is no more effective than a placebo. But to Michael H. Bernstein, an assistant professor …
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87: Why don’t the rules of war protect health care workers and facilities in Gaza?
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In just two weeks, the brutality of the Israel-Hamas conflict has shocked the world. But one of its most heartbreaking aspects — the destruction of the already-struggling health care system in Gaza — is part of a decades-long pattern during war both in the region and around the world. Leonard Rubenstein is a distinguished professor of practice at t…
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85: How the Wegovy shortage is hurting one patient's health
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After physically debilitating cancer treatment, Laurie Brunner encountered another medical hurdle: She had developed lymphedema that required surgery, but her BMI was over the cutoff. To receive the necessary treatment, she would have to lose weight. I spoke with Laurie and her physician Jody Dushay about how the ongoing shortages of GLP-1 medicati…
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Introducing: The Nocturnists: Post-Roe America
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We're popping into your feed on a Sunday because we wanted to share an episode of The Nocturnists: Post-Roe America. You may have already heard the First Opinion Podcast interview with Ali Block, an abortion provider and executive producer of The Nocturnists, and Nikki Zite, an OB/GYN in Tennessee. (If you haven't listened yet, please do!)On this e…
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84: How two abortion providers grapple with their post-Roe reality
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Physicians Alison Block and Nikki Zite knew what they were getting into when they became abortion providers early in their medical training. Family planning has long been a politicized, divisive area of medicine. And even though they knew that Roe v. Wade — the 1973 Supreme Court case that protected abortion access across the country — was being th…
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Introducing: Say More, from Globe Opinion
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From our colleagues at Globe Opinion comes a new podcast: Say More. Say More, hosted by Globe columnist Shirley Leung, is all about exploring our backyard for the cultural trends, scientific discoveries, and breakthrough startups that are shaping the nation.Av STAT
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83: Why physicians should let patients call them by their first names
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Stephanie W. Edmonds and Ginny L. Ryan are both doctors. Edmonds, a registered nurse, has a Ph.D., while Ryan is a traditional M.D. But as part of a fight over “scope creep” in health care, many medical doctors might bristle at the idea of calling Edmonds “doctor.” In the last episode of the season, Edmonds and Ryan speak about the health care hier…
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82: How dance helped one nurse heal from trauma, and help others
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"You can't pour from an empty cup" is what registered nurse Tara Rynders learned the hard way after two decades of work and one heartbreaking, life-threatening experience of being a critical care patient herself. Before that experience, she'd always found found that dance, play, and other types of movement helped her express and heal from the traum…
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81: One Duchenne patient's bittersweet hope for new treatment
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Duchenne muscular dystrophy is a devastating disease and, until very recently, was one without much hope. When Hawken Miller was diagnosed at age 5, the physician told his parents to enjoy the time they had with him, as there wouldn't be much. Over 20 years later, Miller is a journalist and content strategist for CureDuchenne, an organization start…
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80: Is the medical system ready for Alzheimer's drugs that work?
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Physician and professor Jason Karlawish argues that new promising drugs like lecanemab, an anti-amyloid antibody expected to be approved by the FDA July 6, will introduce complicated issues into the field of Alzheimer's care. These medications require a great deal of testing and patient monitoring, trained physicians, and other resources in a syste…
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79: Cancer drug shortages should be causing more outrage
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Drug shortages are a growing problem in the U.S., and a shortage of live-saving cancer drugs has reached crisis levels. Oncologist Kristen Rice explains that drug shortages have been happening for several years but have been getting progressively worse in the last few months. Oncologists are facing critical shortages of common, generic cancer medic…
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78: How to save PrEP access — and even expand it
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Under the Affordable Care Act, health insurers are required to cover all costs associated with preventive care — including PrEP, or pre-exposure prophylactic treatment for HIV. But now all preventive care coverage is under threat, thanks to a lawsuit filed by employers who believe they shouldn’t be required to pay for care that violates their relig…
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77: Physicians have an obligation to get into "good trouble"
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Just days after the end of Roe v. Wade, Caitlin Bernard, an OB/GYN in Indiana, told the Indianapolis Star a heartbreaking story: She had recently been asked to perform an abortion on a 10-year-old Ohio girl who had been raped. In late May, the Indiana Medical Licensing Board held a hearing on Bernard. While they did not revoke her license, they fin…
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76: Why forced treatment can't fix substance use disorder
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When a loved one is living with serious substance use disorder and refuses to get help, sometimes it seems like the only solution is to force them into it. In many states, people can be “arrescued” — that is, forced under penalty of law into a treatment program that is nearly identical to being incarcerated, down to orange jumpsuits. But Sarah Wake…
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75: Ezekiel J. Emanuel explains why cancer patients shouldn’t pay out-of-pocket costs
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The high cost of cancer treatment in the U.S. is literally killing people. “Over a quarter of cancer patients delay medical care, go without care, or make changes in their cancer treatment because of cost,” Ezekiel J. Emanuel, an oncologist and co-director of the Health Care Transformation Institute at the University of Pennsylvania, wrote in a rec…
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74: How 'screen and refer' systems fail to help patients
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We've all had the experience of a clinician staring at screen while asking us sensitive questions to fill out our electronic health records. But that frustrating experience is made even worse by a new trend in health care. As Sanjay Basu wrote in a recent First Opinion, hospitals are using so-called "screen and refer" systems to identify people wit…
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73: Do chatbots have more time to be empathetic than physicians?
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As an oncologist, Jennifer Lycette gets to know her patients particularly well. She’s doubtful that artificial intelligence could replace that personal connection, but new research based on, of all things, Reddit Q&As, says otherwise. New study findings raised questions about the potential for using chatbots, like ChatGPT, to help physicians answer…
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72: The coercion built into medical privacy consent forms
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Alex Rosenblat is particularly careful when it comes to her digital privacy. She requests to fill out paper forms instead of digital ones; she documents and tracks what she signs. But even her diligence can't always save her. Rosenblat recently spent months retracing her digital steps after Phreesia, a company that collects demographic information,…
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71: Two medical residents debate their hospital's unionization drive
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In training to become a physician, medical residency can be a grueling period. Now, medical residents across the country have begun fighting to unionize their ranks. In Boston, residents at Massachusetts General Brigham — a major medical system — recently garnered enough votes to file for a union election. In her first episode as host of the "First…
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After two years as host of the First Opinion Podcast and many more as the founding editor of STAT's expansive, authoritative First Opinion platform, Pat Skerrett put down his editing pen and microphone to start a new chapter: retirement. But before he left, he sat down with Torie Bosch, who has just joined STAT as our new First Opinion editor. They…
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69: The real experts are people living with mental illness
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When Ken Duckworth was a child, his family didn't talk about mental health, especially not his father's bipolar disorder. It was an untouchable topic, but Duckworth knew his father shouldn't be seen as a lost cause. Instead, his father and others like him might actually have critical expertise on how to navigate the world with mental illness — expe…
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68: LIVE from Boston, Jay Baruch returns
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In a special event as part of STAT's Open Doors initiative, the "First Opinion Podcast" was recorded live this week in front of an audience with returning guest Jay Baruch. Not long after being a guest on the first episode of the "First Opinion Podcast" in February 2021 on the many stories he's written for STAT in his time working as an emergency r…
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67: Covid is not a 'racial equity success story'
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The idea that the narrowing gap between Covid-19 deaths among white Americans and Americans of color represents a racial equity success story is being bandied about. Not so fast, says Nathan T. Chomilo, a pediatrician and internist at the University of Minnesota Medical School. This conversation emerged from the First Opinion essay "Covid-19 is an …
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66: Will opioid settlement money actually go to opioid prevention? Here's hoping
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As states begin to receive money from the multitude of lawsuits and settlements the opioid makers and distributors have agreed to pay, the number of overdose deaths in the country continue to increase, reaching an all-time high in 2021. Researcher Linda Richter worries that not enough of the settlement funds, upward of $22 billion, are going toward…
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65: Home health care is facing devastating 'clawbacks'
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Terry Wilcox's grandmother lived in an isolated house at the top of a hill overlooking the magical mountains and valleys of the Ozarks until, as she tells it, "the day we literally had to drag her off of it." Home health care services have helped keep Wilcox's family healthy and safe — and reduce her stress — but they aren't equally accessible to e…
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64: What makes food 'healthy' and why nutrition isn't a priority in the U.S. economy
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After years of deliberation, the FDA recently announced a new set of rules it proposes to regulate claims on food packaging that a product is "healthy." The most basic rule: the product must actually contain food, not just ingredients. This may seem intuitive, but as professor and nutrition policy expert Marion Nestle points out, the food industry …
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63: The Supreme Court set public health back 50 years. The next term could be worse.
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It took the U.S. Supreme Court just seven days last June to set back public health by 50 years. Several cases before the court this term could continue that assault. This week, law professor Lawrence O. Gostin explores how these cases — some of which are not explicitly about public health — might worsen the myriad health inequalities that became so…
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62: Wheelchair users and Medicare disagree on what's "primarily medical in nature"
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Modern wheelchairs with standing technology have amazing capabilities that can be game-changing for wheelchair users looking to take care of themselves independently whenever they can. This week, two wheelchair users, Paul Amadeus Lane and Jim Meade, talk about how shortsighted it is that Medicare — the primary health insurer for older adults as we…
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61: How the Dobbs decision's could affect clinical trials
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The Supreme Court's decision to overturn Roe v. Wade opened the door to allow states to ban or severely restrict abortion. But as biotech CEO Aoife Brennan and her colleagues are coming to realize, it will also affect how — and perhaps where — clinical trials are conducted. This week on the "First Opinion Podcast," Brennan, of Synlogic, talks about…
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60: Polio is back in the U.S. Two physicians offer ways to fight its spread
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Polio has exploded back into Americans' consciousness after being out of the spotlight in the U.S. for half a century or so: In late summer, it paralyzed an adult in New York state, and the poliovirus has been detected in New York City's wastewater. This week on the "First Opinion Podcast," doctors Sallie Permar and Jay Varma make the case that ped…
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59: A pediatric doctor on the life-or-death decisions some prospective parents must make
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Christopher Hartnick never expected his work as a doctor to intersect with political discussions about abortion and the right of pregnant people to make choices about their own bodies. Yet as a pediatric ear, nose, and throat physician who specializes in treating babies and children who have difficulty breathing, he's had up-close looks at how pros…
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58: A doctor with ALS laments a slow pace for drug approval
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During his long career as a pediatric oncologist and cancer researcher, William Woods thought highly of the FDA's work evaluating and approving new cancer drugs. But his opinion of the agency changed when he was diagnosed with amyotrophic lateral sclerosis, or ALS, a progressive disease that damages nerves in the brain and spinal cord. This week on…
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57: Covid-19 is leaving millions of orphaned children behind
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The number of children who become orphans because of Covid-19 rises each week: over 10.5 million children around the world have lost a parent or other caregiver living in the home, a staggering and heart-breaking figure. For comparison, it took 10 years years to create as many orphans as Covid-19 created in just two years. Seth Flaxman and Susan Hi…
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56: The double standard of discipline between nurses and physicians
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For two decades, nurses have been considered the most trustworthy professionals in the country, above physicians. Yet the rigid hierarchy within hospitals and health systems places physicians at the top, creating a fraught power dynamic and a double standard when it comes to discipline. This week, nurses and educators Michelle Collins and Cherie Bu…
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Episode 55: The faces of Covid after one million deaths
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When Covid-19 began tearing across the U.S. in March 2020, Alex Goldstein started posting on Twitter the pictures and stories of people who had died from the disease. Over two years later, as the U.S. marks the grim milestone of 1 million people dead from Covid-19, Goldstein is still at it. The account, @FacesOfCovid, has now memorialized more than…
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Episode 54: Get sick, go to the doctor, incur debt, repeat
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Sickness can beget debt, which can then turn around and beget more sickness. That's the all-too-unfortunate cycle for people across the country who find themselves with overwhelming medical debt, the most common reason a debt collector might come after someone, with 1 in 5 households going into debt to pay for medical care. This week, Michelle Pros…
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Episode 53: How should doctors treat pain in the wake of the opioid crisis?
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Clinicians walk a tightrope when trying to help their patients with chronic pain. They want to be able to ease a patient's suffering with medication, but must be mindful of the risks of addiction. There are some non-medication treatments for pain, but they're often hard to access or not covered by insurance. Finding the balance can be challenging a…
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52: A new hotline could save lives during mental health crises — if someone answers the phone
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The roll out of a new mental health crisis line for the entire U.S., is scheduled to happen on July 16 — the blink of an eye in bureaucratic time. People in mental health crises or their family members will soon be able to dial 988, instead of 911 or the harder-to-remember 800-273-8255, the number for the National Suicide Prevention Lifeline. The t…
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Episode 51: Covid turned the nation's eyes to nursing homes. Have we already looked away?
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When the Covid-19 pandemic began tearing across the country, it hit nursing homes hard. More than 200,000 residents and staff members at long-term care facilities have died from the disease. But as this week's guests point out, the care of nursing home residents and support for those providing that care have been long-standing issues. Jasmine Trave…
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Episode 50: Where are all the psychiatrists?
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As a psychiatrist, Christin Drake has to turn away potential new patients every day — there just aren’t enough hours in the day to take them on. She doesn’t relish the rejection, especially when it’s for another Black woman who is looking to find one of the few psychiatrists who shares that identity and experience. But with the mental health crises…
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Episode 49: Should gender dysphoria be a required stop en route to gender euphoria?
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For trans people who want to receive gender-affirming medical care such as hormone treatments or surgery, one requirement is often a diagnosis of "gender dysphoria," which the Diagnostic and Statistical Manual of Mental Disorders defines as deep psychological distress around one's gender. But not all trans people experience gender dysphoria. Many a…
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Episode 48: Tom Sequist on mirrored Covid tragedies — thousands of miles apart
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Like many of us, Tom Sequist had no idea what was about to happen as he began his new job as chief medical officer of Mass General Brigham hospital system in Boston during the first weeks of 2020. Through his position, he saw firsthand how Covid-19 tore through low-income communities like Chelsea, just north of Boston. From 2,000 miles away, he als…
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Episode 47: Pharma markets drugs to young adults, so why aren't they included in trials?
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Sneha Dave has been living with a chronic disease for 17 years — almost her entire life. Diagnosed with ulcerative colitis when she was 6 years old, she has experienced firsthand the frustrating and often terrifying side effects of drugs that were not tested on people her own age. So when she sees Instagram posts and TikTok videos from pharmaceutic…
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