Explore The Space

Shoshana Ungerleider is a Hospitalist, founder of End Well & an educator focusing on end-of-life care. She joins us to discuss the evolution of her career, changing the narrative around how we talk about death, and her Oscar-nominated documentary "End Game." Key Learnings 1.  The origins of Shoshana's work and interest in end of life care and her feelings of "moral distress" in the ICU 2. Evolving from having an awakening to what's important to something scalable and impactful on a population level 3. How she broke from the usual way messages are exchanged in healthcare into public speaking, writing, and movie-making 4. Medical lingo and how it derails communication with patients 5. Is she experiencing any pushback to her work around end-of-life care? 6. The goal behind End Well and creating documentaries like "End Game" 7. The difficulty that comes when a patient is sick & there is lack of clarity around goals of care 8.  Barriers posed by social determinants of health, racial and gender biases asso

Aimee Gardner has a PhD in Organizational Psychology and is Assistant Dean of Evaluation & Research at Baylor College of Medicine. She joins us for a provocative discussion of how residency programs select medical students. This is a fraught issue for our profession and the concepts around recruiting are generalizable across any organization. Key Learnings 1.  How we connected during the controversy surrounding standardized tests for medical students. 2.  The major criteria that make a candidate attractive to a residency program 3. Defining Step 1 of the USMLE and the stakes and stress associated with it 4. How the exam moved from a standard pass-fail to a variety of purposes it is neither intended nor designed for. 5. The rational steps that should be taken when assessing whether a candidate is right for any type of organization 6. The implications that the mis-application of USMLE has on fairness and diversity as well as why other industries stay away from standardized tests 7. The risks and stresse

Ingrid Nembhard is an Associate Professor of Health Care Management at the University of Pennsylvania and she is the definition of a pluripotent researcher, teacher & mentor. She studies and coaches around how we can improve team-based culture  & organizational learning. We discuss the importance of feeling part of a high-performing team, how team-based culture forms, and how it translates into patient-centered care. This is riveting stuff & her insights are amazing! Key Learnings 1.  What gets Ingrid up in the morning and what brought her to healthcare 2.  Being a pluripotent scholar, what "Eureka" moments her down the path of healthcare? 3.  The experience of stepping into healthcare organizational improvement and the reception when she starts working with a new team 4.  Why it's important to be at the front lines when she starts a project 5. The creativity that comes from "dissatisfied" people and the value of context 6. Understanding an organization's culture to determine what's possible, relevant,

Mark Hertling dedicated 37 years of service to the United States Army, serving in two wars before retiring as a Lieutenant General. He then stepped into developing physician leaders and has found tremendous success in this crossover. His book "Growing Physician Leaders" is superb and is applicable across many fields, not just medicine. We discuss his unique post-Army career, where the tension points exist within medical leadership, and how his curriculum works. Key Learnings 1   Transitioning from the United States Army into medical leadership development 2.  Why a retired General would be a good fit for medicine, according to Disney 3. First impressions looking under the hood & the importance of serendipity 4. The value of interdisciplinary learning to develop trust 5. First impressions of leadership in healthcare as he started his work, especially what is not working 6. Gaps and tension points in healthcare leadership and the reasons they exist 7. Overcoming "What the hell is the hospital trying to

Peter Hotez is a Professor of Pediatrics at Baylor College of Medicine and Dean of the National School of Tropical Medicine. He is the world's authority on vaccine science not simply because of scientific background, but because of his active and valuable advocacy work across many platforms. He joins us to discuss the measles explosions in the United States and Europe, the devastation wrought by the anti-vaccine movement Key Learnings 1.  Why your faithful host is angry 2.  The 3 vaccines that are being marginalized in the United States 3.  The 3 major forces behind the current public health crisis 4. The power of the anti-vaccine movement & the lack of clarity behind it's goals and funding 5.  The impact of vaccine exemptions at the state level 6. The lack of a powerful & organized pro-vaccine advocacy 7.  Dr. Hotez' evolution from scientist to advocate, finding his voice, & telling a very personal story 8. The pressing need for healthcare providers to become savvy with TV, writing, and social media

Laurie Garrett is a Pulitzer Prize-winning journalist who wrote an extraordinary article in The British Medical Journal on gender equity in healthcare called "The Trouble With Girls." She joins us to discuss the deep inequities she describes, the drivers behind them today and the extraordinary response the paper engendered. Key Learnings 1.  The impetus behind writing "The Trouble With Girls" 2.  The steps required for advancement and the demonstrable gender bias associated with each one laid out in the article 3.  Applying historical context with the stories of Elizabeth Cady Stanton and Eunice Foote to an immediate & current problem 4.  The challenge of resistance in researching the article 5.  Experiencing a roller-coaster getting the article published in the annual BMJ satire issue 6.  The article goes viral... 7.  Ms. Garrett's powerful and informative personal experience that underwrites this article 8.  Laying out the differing drivers for gender discrimination in healthcare & science in decad

It's Super Bowl week, so it's time to discuss Chronic Traumatic Encephalopathy in NFL players. Visar Berisha is an Associate Professor of Engineering at Arizona State University, focusing on speech and hearing science. He and his team completed an amazing study looking at changes in language complexity in NFL players. We discuss the study, it's findings, and the extraordinary potential for this work in neurodegenerative disease. Key Learnings 1. The cloud that hangs over the National Football League 2. Looking at neurological health and searching for biomarkers of cognitive decline through the complexity of speech generation 3. Creating a philosophy of lab as incubator for multidisciplinary neurodegenerative disease 4. Breaking down the study "Longitudinal Changes In Linguistic Complexity In Professional Football Players" 5. The two key markers: vocabulary size and idea density, what should happen over time, and what the study demonstrates happened to the NFL players.  (The study even looks at impact on l

Kristin Wikelius is a Senior Policy Director with United States of Care and she joins us to discuss the vision of the organization, how illness and sickness can provide common ground for progress, and why Medicaid at the state level is a good place to start Key Learnings 1. What is United States of Care and what is the mission & vision 2. Health and illness as a societal leveler independent of any other considerations 3. Initial goals of shifting healthcare debate from something defined by a single policy or party to something mission-driven 4. Defining Medicaid as a cornerstone of American healthcare 5. Dispelling misconceptions and negative connotations of Medicaid through personal stories. 6. Why a focus on Medicaid at the state level is the right approach in the near-term 7. How states are responding to possibility of Medicaid buy-in approach 8. What does success look like in this first phase & what's working so far 9. Where has pushback come from & how are physicians responding 10. Recognizing

Grace Farris is a Hospitalist, Chief of Division of Hospital Medicine at Mount Sinai West, and an accomplished cartoonist with works featured in Annals of Internal Medicine & Buzzfeed. She joins us to discuss the role cartooning plays in her career, the potential of graphic art as an accelerant to learning, and some serious comics discussion. A unique conversation with an incredibly talented physician! Key Learnings Unpacking a Calvin & Hobbes essay that freaked your host out Origins of the evergreen comics Dr. Farris creates Parenting as a stimulus for her work The colchicine experience and creating a comic around it Are cartoons more impactful than editorial articles? The power of  her pen to shape characters, events and ambiance The topics and characters she is creating and how she feels towards them The comics that influenced Dr. Farris throughout her life Reflecting on her superb series about handing off patients to a colleague What type of feedback she has received Cartooning as

Robert Pearl is a physician leader in the United States of the highest order. He is widely published and frequently featured on multiple TV networks. He joins us in our first episode of 2019 to lay out the great challenges facing physicians and patients in America, his incredible passion to drive change, and how we can move the needle in the right direction. Key Learnings 1. How his personal experiences with the problems of American healthcare led  to the creation of his Forbes article 2. What it feels like to have doctors confessing their fears and frustrations to him in the wake of his book 3. Some of the limitations and barriers physicians deal with when trying to provide great care for patients 4. The passion and optimism that Dr. Pearl brings to the table and where he draws it from 5. The 5 fears doctors confess to other doctors 6. The great sense of loss that physicians have to deal with 7.  Describing the 3 historical eras of medicine as a central dogma 8. Feedback Dr. Pearl has received from

In our final episode of 2018, we have a proper A-list MD, Dr. Gurpreet Dhaliwal, joining us. He is a master diagnostician who never fails to dazzle an audience with his process for evaluating and solving the most challenging cases. We discuss how he learns and trains, the need to look for "desirable difficulty" and how his mistakes are his most valuable tool. This is our first Grand Slam episode! All 4 Pillars of Explore The Space are fully engaged in this conversation! Key Learnings 1. Why Dr. Dhaliwal should be an A-list celebrity in medicine 2. Is Sherlock Holmes the right popular culture comparison for Dr. Dhaliwal? 3. What Dr. Dhaliwal does that gets such a response from an audience 4. How practice and his training program allow him to reach his maximal potential 5. Shifting information from short term memory to long term memory and how to extract it when needed 8. What is the number #1 enemy of learning... 8. The importance of tempo in optimizing his process to provide patient care in a busy en

Dr. Keith Murray is an Emergency Physician at University of Pittsburgh Medical Center and serves as Medical Director for Pittsburgh SWAT. He was a part of the first responder units that entered the Tree Of Life Synagogue during the mass shooting that occurred there on October 27th. He joins us to discuss becoming a SWAT Medical Director as well as his experiences before, during and after the shooting. Key Learnings 1.   Defining the role of a Medical Director for a SWAT team 2. Finding a niche in being part of a First Responder unit as a physician 3. The scope of responsibility for a SWAT Medical Director 4. The things Dr. Murray carries when going into the field 5. Drilling and training for a mass shooting 6. Notification about the Tree Of Life Synagogue shooting 7. What allows Dr. Murray to drive towards danger 8. Arriving at Tree Of Life and entering the building 9. Ready to fight versus ready to save lives: tactical versus medical awareness 10. Assessing the wound patterns from an AR-15 assault

Eric Byrnes comes back after writing a book and completing the Triathlon Across America. We cover transitioning from Major League Baseball, how his definition of mental toughness has changed, and creating Team Go-Hard. Key Learnings 1. Eric & I start the podcast saying nice things about one another 2. Being asked to talk about The Mental & Physical Edge 3. How Eric using triathlons to dig out of a post-baseball career rut 4. The Triathlon Across America: 55 days from San Francisco to Manhattan 5. Creating Let Them Play Foundation to help address the lack of physical activity programs for America's children 6. Dopamine Jumps in Philadelphia! 7. Eric's definition of mental toughness 8. How we create a feeling of confidence in ourselves 9. "Don't Take Your Feelings So Personally" 10. Eric's personal philosophies and how his father helped define them 11. The book, the blog, the Tri Across America, and what's coming up for Team Go-Hard 12. What Eric and I will discuss next time he comes on the show (h

Rabbi George Gittleman is the Senior Rabbi at Congregation Shomrei Torah in Santa Rosa, CA. Over the course of navigating crises like September 11th, the Sonoma County Wildfires, and the recent Tree of Life Synagogue shooting, he has run the gamut of experiences in leadership under pressure. He joins us to discuss the extraordinary insights he has gathered and the tools he uses to be at his best when it is needed most. Key Learnings 1. Recognizing when the normal parameters around leadership go away 2. Learning to handle a community crisis and his own fight or flight response 3. Dealing with his community needs after 9/11 and what he learned to do differently 4. The desire to flee when the Sonoma County Wildfires broke out and how he pushed through 5. How Rabbi George overcomes the flight response so he can lead effectively 6. The power of using the emotion within an environment as a leadership tool 7. How self-discovery informs effective leadership 8. Recognizing and dealing with leadership failures

Dr. Taylor Brana is a Psychiatry resident and the host of The Happy Doc podcast. He joins us to discuss bringing fresh eyes to key challenges facing physicians, some key drivers of happiness & fulfillment, and creating his fantastic new project. Key Learnings 1. The origins of The Happy Doc and asking the question "are there happy doctors?" 2. Focusing on both rebuilding and maintaining physicians at all stages of their careers, especially early on 3. What is consistent among medical students, residents, and attendings who are still happy in medicine 5. How the evolution of confidence, especially at career transition points, can build or erode happiness 6. Moving from an awareness phase to a solution phase 7. The importance of rebuilding culture through teams in medicine 8. The Happy Doc and emphasizing happiness, regardless of your profession 9. The Voice Project and expanding ways we can learn #happiness, #satisfaction, #physicianburnout, #burnout, #medicalschool, #residency, #depression, #podcast

Dr. Mary Brandt is a Professor of Surgery, Pediatrics, and Medical Ethics at Baylor College of Medicine in Houston, Texas and is in full-time clinical practice as a Pediatric Surgeon at Texas Children's Hospital in the Texas Medical Center. She joins us to discuss the rapidly growing physician response to a tweet around gun violence in America and the #thisismylane movement. Key Learnings 1. The power of doctors sharing pictures of the aftermath of gun violence with #thisismylane, #itisourlane, #itisourlane 3. What really enraged physicians in the wake of the NRA's tweet about physicians and gun violence. 5. Using the power of these stories to move the conversation about gun violence from a political issue to a public health issue. 6. Stories of gun violence from a Pediatric Surgeon. 7. The disconnect between the perception and reality of what bullets do to a human body 8. How managing bullet trauma degrades physician wellness 9. The steps needed to push this movement forward in the right direction 1

Dr. Nina Shapiro is a Professor of Surgery specializing in Pediatric Otolaryngology at UCLA. She is also a highly sought-after speaker on medical topics across the media spectrum. She joins us to discuss her new book "Hype" and how we discuss controversial topics with the public and with patients. Key Learnings 1. Dealing with the question of "who are you to write a book about general health issues?" 2. The rocket fuel of hype in medicine and choosing the title of her book. 3. The value of rational conversations physicians can have with patients on topics their patients feel are important. 4. The missed opportunity of not explaining the science behind a medical recommendation. 5. Similar skills for communicating to a general audience and in the office with patients. 6. Avoiding a "me against them" dynamic and building one of shared decision-making. 7. What's been the most popular topic for discussion on her book tour and are we training doctors to answer that question. 8. A surprising topic she was r

We are proud to welcome you to the new home of Explore The Space. The url is the same, the site is entirely different. We've defined the 4 Pillars of Explore The Space, we've got the entire archive of 80 shows, there's a new blog, more social media, and resources from the interface of healthcare and society. Please come look around www.explorethespaceshow and let us know what you think by emailing mark@explorethespaceshow.com. Please subscribe to the show and leave a rating and review on iTunes or wherever you download episodes. We couldn't be happier with the new site and are delighted to have you stay on this great adventure with us.

Dave Berke is a retired Marine fighter pilot and Top Gun instructor who now is a part of the leadership team at Echelon Front. He is back for a fourth time on Explore The Space to continue our exploration of team based culture. Every time we have these conversations, I'm fired up for the next one. Key Learnings We start off with another round of Quick Hitters! When work spills over into life Why excelling at work is a recipe to do well elsewhere Keeping friends and family informed as a cornerstone of work-life balance Communication skills as a hard-won lesson in maintaining relationships and building a successful career #leadership, #TopGun, #culture, #medicine, #relationships, #podcast, #worklifebalance

Lizzie Johnson is a reporter for the San Francisco Chronicle who covers wildfires in California. She joins us on the eve of the one-year anniversary of the Wine Country Wildfires of 2017 to reflect on what happened, how the community has rallied, and the challenges still facing the recovery. Key Learnings Becoming the "Fire Girl" Arriving in Santa Rosa after the fires started Reporting from the ruins of Coffey Park How this wildfire impacted the sense of safety for people across the world Being a reporter and allowing people speak their truth about their experience How communities respond to a disaster and how it evolves over time Impressions of the recovery in Sonoma County at one year Global perceptions of the wildfire, climate change and an international "voyeuristic sense of horror" The one-year anniversary coverage