Explore The Space

"Being courageous is taking that step confidently without any guarantee of a result" Valorie Kondos-Field is one of the greatest coaches in history at any level, ever. She won 7 NCAA championships, 15, PAC-12 championships & coached hundreds of extraordinary athletes over nearly 3 decades as Head Coach of the UCLA Women's Gymnastics team.  She joins us & shares incredible wisdom around creating a high performing team, taking teammates to another level of performance, and sharing her breast cancer diagnosis as well as the best questions to ask children as they enter competitive sports. Key Learnings 1. When Mark first interviewed Coach Val 22 years ago 2. Building in a dynamic wherein new teammates can buy in quickly, find their voice, and take ownership 3. How to encourage a Growth Mindset as a leader without it sounding like a platitude. 4. Coach Val's approach to remediation and the single most important step to changing behavior 5. Taking extraordinarily talented people to a higher level than they t

Megan Ranney is an Emergency physician & a national leader in the gun violence prevention movement. She joins us after working overnight in the ED to discuss this growing movement, the gag rule on gun violence discussion since 1996 & the Dickey amendment, and her wish list to keep building momentum. Megan is an extraordinary leader & this is a vital discussion Key Learnings 1. Why Megan is my kind of leader 2. Getting physically, mentally, and emotionally ready to deal with gun trauma 3. The effect a bullet has on the team taking care of the person who's been shot. 4. An epiphany around how we haven't been talking about prevention with respect to gun violence in medical education 5. Wherein Megan shares being told she was not allowed to talk about gun violence and we learn about an unofficial gag order after The Dickey Amendment 6. Important turning points in igniting firearm research like Sandy Hook 7. Creating hope around gun violence prevention and sharing the weight in this heavy work 8. Breaking

"Doctors are looking for a place to put bigger ideas" Bryan Vartabedian is a bon vivant physician on social media. He's been active on Twitter for over a decade, he blogs, he podcasts. This is a wide ranging chat on hype cycles, technological determinism, & getting rid of stupid stuff. Fantastic stuff w/ tons of links below, enjoy! Also, Bryan will be onstage at the upcoming dotMD festival, widely reputed to be the most fun, interesting, and all-around wonderful medical conference on the planet. Key Learnings 1. The value of the unscripted podcast interview 2. On being an early physician adopter on Twitter, as Bryan started in 2008 3. Twitter use, overuse, and finding the sweet spot. 4. The explosion of social media and medicine and how we can engage with non-physicians who are seeking to learn more. 5. The fun & value of interacting with people who aren't physicians on Twitter 6. An epic battle over getting our best stuff out there and dumb medical journal publishing guidelines 7. The hierarchy of

"On the path to achieving something extraordinary, you will do extraordinary things." Rob Mitchell spent a career serving in the Navy SEALs & the CIA. He has since built a lengthy list of completed endurance events and ultramarathons. He joins me for a fascinating conversation around accessing toughness in different situations,  staying calm in a crisis & not comparing your toughness to your perception of anyone else's. Key Learnings 1. Rob's initial reactions to his being described as "tough" or having "toughness" 2. Different pathways that would call on someone to exhibit characteristics of toughness: internal & external 3. Walking an internal pathway where you can test yourself and your own toughness moving towards a goal & committing to an outcome. 4. How to tap necessary levers of toughness to walk towards a goal & fulfilling a commitment 5. What makes up the essence of focus 6. The other path requiring toughness where time is compressed & the need for toughness is thrust upon them by external fa

Shawna Pandya is pluripotent. Whether it's medicine, spacesuit testing, diving, or martial arts, she stays out on the sharp edge & has made a life out of pushing limits. Her stories and approaches to pushing past individual boundaries are that rare mix of accessible and inspiring. Another unique highlight: hearing her parakeets respond to her enthusiasm Key Learnings 1. Some quick-hitter questions 2. When did the spirit of adventure strike? 3. Living by the credo "this looks fun, let's try it, and I'm still here so let's do the next thing" 4. Mark's skydiving story (thanks Dave) & Shawna's skydiving story. Hers is crazier 5. How pushing one's limits helps define one's character 6. Pursuing boundaries so you can see what lives beyond them 7. Living according to Newton's Laws of Motion 8. Shawna's approach to fighting & this image 9. The importance of building fundamentals, setting goals, & focusing on values 10. The physiology of aerobatic flight and discussing this picture (and the parakeets went b

I was fortunate to present a talk entitled "Hospitalists In A Disaster" at the 2019 Society of Hospital Medicine Annual Meeting on March 25th, 2019. This  is the audio version of that talk. The slides associated with it are in the Links section below. While the talk was directed towards Hospitalists, it is easily generalizable to any division or department within a hospital. Links Slides associated with the talk in PDF form: Hospitalists In A Disaster SHM final 2 "Hospital Leader Blog" post I wrote in advance of the talk: https://thehospitalleader.org/hospitalists-in-a-disaster/ "The Hospitalist" article published after the talk https://www.the-hospitalist.org/hospitalist/article/197476/mixed-topics #disaster, #wildfire, #hospitalist, #hospitalmedicine, #podcast, #publicspeaking

Bret Scher is a Cardiologist, author, and host of Diet Doctor podcast who has found a vital path in helping people understand the complex world of food through conversation and science. He joins us to discuss the importance of food discussion across all demographics, dealing with cravings and cheat days, and developing a sustainable individualized approach to eating that helps optimize health Key Learnings 1.  Tracking just how frequently people ask doctors about food and how confusing this area has become 2. Going up against the central dogma of the carbohydrate-based food pyramid from when we were kids 3. How Bret moved from feeling disillusioned to motivated as a practicing Cardiologist 4. Identifying the opportunity we now have to better connect patient and provider on a subject of tremendous interest and importance 5. The great breakthroughs that come with inquiring about the foods people like and why they like them 6. The correlation between nutrition and belief and the browbeating and arguments

Amitha Kalaichandran is a physician and a journalist who wrote a provocative and impactful piece in The Boston Globe about bullying in medicine. She joins us to discuss the astounding response to the article, writing as a physician who crosses into the public sphere, and levers to pull to reduce bullying behaviors Key Learnings 1. Understanding that the article is going to be a big deal 2. The surprising revelations that came her way in the wake of the article & being preparing for those stories 3. A key way that medicine and journalism are similar 4. Pitching the story to the Boston Globe editorial team 5. Writing an article that crosses over into universal readership as opposed to one that goes either behind a paywall or into PubMed hell 6. The impact of low psychological safety in a hospital 7. Does the nature of a hospital setting enable behaviors that are otherwise not tolerated 8. How "hot spots" and malignant sectors of medicine are able to develop wherein bullying can occur 9. The levers to

Avital O'Glasser is a leading physician on Twitter who is helping to drive a rapidly evolving revolution in medical information exchange. She is also Associate Professor of Medicine & Associate Program Director for Scholarship & Social Media at Oregon Health Sciences University. She joins us to discuss how Twitter & social media can help harness the positive & overturn outdates norms in communication and education. Key Learnings 1. What is actually happening in medicine with social media, using conferences as a specific example 2. How #MedTwitter has "harnessed the positive" of social media 3. The power dynamic change where student and teacher on social media are completely reversed in the hospital & how old norms are being detonated 4. Wherein Mark admits he doesn't know what "meta" means 5. Accessing conversations and personalities from all around the world just by using a hashtag 6. The standard way information in medicine is presented and the opportunity social media provides to upend this 7. Trac

Alin Gragossian was in the middle of her 3rd year as an Emergency Medicine resident when she became critically ill & required a heart transplant.  She joins us 10 weeks after surgery to discuss her extraordinary journey. I laughed the hardest and cried the most I ever have during a podcast. She's a wonderful storyteller & this story is like no other. Key Learnings 1. What it feels like to go into cardiogenic shock & think you're about to die 2. Being in the prime of life, and then a cough starts... 3. In the ED, knowing something is very wrong and not wanting to accept it 4. The experience of having doctors she knew and worked with and how she wanted the communication to work 5. Living like an anaerobe 6. Being "lined up" 7. Learning there's a heart for her and actually going to the OR for transplant 8.  High-fives to Linda 9. What it feels like to breathe and to walk again 10. How a near-death experience changed how she looks at life & showed how much a human being can overcome Links Alin's Twit

UPDATE: The Social Media and Professional CV White Paper can be found here! Feedback is welcomed White Paper- Social Media, Podcasts and Blogs on a Professional Curriculum Vitae Vinny Arora and Charlie Wray, both hugely important scholars and personalities in the world of Hospital Medicine, join to discuss a hotly debated topic: do Social Media activities belong on a professional CV? We set out to write the White Paper, we were successful. This is an outstanding and important discussion! Key Learnings 1. The origins of the debate around putting social media activity on a professional Curriculum Vitae 2.  Leveraging impact as a major determinant of whether to place something on a CV 3. Changing the academic "coin" of how to differentiate yourself when applying for a position 4. The fundamental categories that could and should be included from social media onto your CV 5. The single most important thing you can do with content and your CV 6. Deep-diving into how to evaluate impact of Twitter feeds & co

Emily Gottenborg, Christine Jones, Marisha Burden and Anna Maw are  Hospitalists at the University of Colorado and all have had children at some point during their careers. They came on the podcast to discuss their paper "You Can't Have It All" which looks at the inequities and problems women face when they have children while practicing medicine. An unsparing and inspiring conversation, just like the paper itself. Note: co-authors Li-Kheng Ngov & Anastasiya Ponomaryova were not able to join this interview Key Learnings 1. The origins of this incredible paper, especially their shared memories around parental leave (or lack thereof) 2. Framing the paper as a scientific article, then rapidly evolving to one sounding an alarm 3. Using qualitative research and allowing the stories to guide the conclusion 4. The emotional rollercoaster of collecting data, doing the study and identifying inequities in the system 5. The impact of feeling like having children is a choice therefore all the inequities that follo

Vivek Wadhwa is a Silicon Valley futurist, renaissance man, & raconteur. He joins us for an provocative & rollicking discussion of artificial intelligence in healthcare, the current and future state of health data privacy, & how his personal journey spurs his work. He brings a sense of urgency and enthusiasm to this topic, and shares why he feels that way. Caution: hot takes ahead! Key Learnings 1. Laying out the underpinnings of a revolution in the next 5-10 years 2. The idea of having sensors on our bodies measuring and tracking our biometircs 3. Miniaturization and nano-bots providing targeted therapy 4. Genomics and the impact of massively decreased costs 5. Connecting these three components with artificial intelligence to build a data-driven revolution in healthcare 6. Are tech companies putting patients or plunder at the center? 7. Vivek gives the most succinct assessment of privacy concerns and health data you'll ever get. 8. How we can get a "Democratization of diagnostics" 9. Helping to def

Christina Farr covers digital health for CNBC and, between her scoops, her writing, and her epic Twitter feed, is the clear leader in this work. She is back for her 4th visit to Explore The Space; we discuss Apple's current moves, the difference between selling hardware and selling data, and some great biohacking stories. Key Learnings 1. The company and technology that is moving the needle the most in the digital healthcare space 2. The ways that Apple is wading into healthcare beyond wearable tech, including the one Christina thinks is "the holy grail" 3. Is the patient or the profit margin at the center of the pursuit of the holy grail of medical tech? 4. Why is Apple hiring doctors? 5. The difference between selling data and selling hardware in the medical-tech space 6. Concerns around the sale of patient data and her story on Facebook contacting hospitals to aggregate data on social determinants of health 7. Topics and scoops that draw Christina's interest and how she is able to diversify the rep

This episode contains adult language Garth Mullins is the host and executive producer of Crackdown Podcast. He also has opioid use disorder and a long struggle with heroin. He joins us for a unvarnished look at the opioid epidemic from street level and working as an activist. He also provides the most brutal description of dope sickness you'll ever hear as well as the importance of the physician/patient relationship for those struggling with recovery. Vital lessons for all, an important episode. Key Learnings 1.  Garth shares how "the howling alienation that had become the wallpaper of your life is gone" when he did heroin for the first time 2. How societal organization generates the precursors for problems people seek to solve with drugs 3, Carrying the fear of death, incarceration, & dope sickness 4. Crackdown Podcast as an activist model, a response to the frequent death of friends, and a pushback to media portrayal of opioid use disorder 5. Drawing parallels between the AIDS epidemic and the opioid

Whether you're in healthcare or seeking healthcare, the electronic medical record will impact your experience. We are joined by the anonymous creator of the viral and hilarious @EPICparodyEMR Twitter account to discuss this brilliant satire, the impact the EMR has on every encounter between provider and patient and the central tension: billing platform vs communication tool Key Learnings 1.  Just what the heck is going on with this account? 2. Being anti "bad electronic medical record" 3. The shared experience and the data demonstrating how much the EMR pulls doctors and patients apart 4. Connecting the EMR, learned helplessness, and physician burnout 5. Workflow disruption and being at odds with colleagues and patients due to the EMR 6. How it feels to be sent into "duplicate order hell" and being evaluated based upon what goes into an EMR instead of outcomes 7. The fundamental problem with electronic medical records 8. Why this will never become repetitive Links Twitter: @EPICparodyEMR

Adam Rodman is a Hospitalist, a podcaster, and host of Bedside Rounds. His podcast is the most wonderful journey into the history of medicine, connecting all of us in and out of medicine with our shared past. We talk about creating resonant content, sharing bizarre stories, & how social media allows us to elevate medical history out of the doldrums Key Learnings 1.  The origin story of Bedside Rounds and the removal of Episode Zero 2. Filth Parties and finding resonance not just through the bizarre, but also through events that inform what we're doing now 3. The need for medicine to elevate our shared history as something reflective of our shared ethos 4. The American Civil War as a test case for extraordinary, innovative history 5. Battlefield trauma as a direct link, with the minie ball as the connective tissue 6. How Adam moved from sharing interesting anecdotes to using history to elevate his experience in medicine (with a fun Tulane story thrown in) 7. Responses from people who are hospitalized a

Des Shapiro is a physician with a 40-plus year career in medicine and an incredible legacy under his belt. He's also my Dad and I'm delighted to have him join me for the 100th episode. We discuss finding joy in medicine, being a Foreign Medical Graduate, and the extraordinary manner in which he always put patients at the center. Key Learnings 1. A few words to celebrate Episode 100 of Explore The Space podcast 2. The 4 Pillars of Explore The Space 3. What the future holds for the podcast 4. Introducing the guest for Episode 100, my father Des Shapiro 5. How Des started his journey into medicine and starting medical school at 16 6.  Realizing early on that medicine was a calling and never looking back 7. A crazy story about handwashing and the world's first heart transplant 8. The impact of a commitment to observation, physical exam and narration in becoming an excellent physician and elevating connection to patients 9. Ensuring the beauty and importance of holding a patient's hand as connection, as

Nick Watts is a physician & Executive Director of Lancet Countdown. He joins us to discuss a defining issue for humanity: climate change. We discuss how climate change is a threat multiplier to human health, the role of the individual in responding to climate change, & how Game of Thrones & climate change are interconnected. Key Learnings 1.  How climate change became Nick's calling after finishing medical training 2.  Defining the scope of Lancet Countdown and goals of the project 3. Recognizing how climate change is a threat multiplier of determinants of human health and the response can serve as an enormous opportunity to impact health 4. The role of the individual in driving humankind's response to climate change & tangible steps we can all take today 5. The incredible carbon footprint that healthcare has and the positive impact of reducing emissions in the industry 6. Increasing recognition that a low carbon footprint has a positive effect on public health 7. Why I don't care about pushback to th

I've been waiting for the right time and person to discuss the importance of coffee to our daily lives. Larry Istrail is a Hospitalist and a coffee aficionado (like your faithful podcast host) who has started a new coffee roasting company called Pheo Coffee. We discuss coffee as a ritual in medicine, connecting to our shared past through coffee, and the laudable intentions behind his business. Key Learnings 1. What's in our cups as we start the episode 2. The role of coffee in the day-to-day in the hospital 3. Why coffee is so tightly bound into the culture of healthcare 4. Surprising someone with a coffee 5. The origin of Pheo Coffee and the importance of social impact 6. Being affiliated with Watsi to help fund surgical procedures overseas & connecting each coffee purchase with a patient's story 7. How Larry tries to make coffee delivery part of the overall experience of enjoying coffee & honoring medical history 8. Creating awesome coffee-medical fusion swag, especially the caffeine deficiency dia