Episode 015: Chuck Huss and Wilderness Medicine

Mt. Everest, part of the Himalayan Mountain range is the highest mountain on the planet.  Those who attempt to climb to the 29,000-foot-high peak are a pretty hardy bunch; past 26,246 feet, climbers are challenged not just to climb but to survive.  Exhaustion can occur just from the effort of breathing, never mind the dangers associated with lack of oxygen, extreme cold, and falling off the mountain.  Climbers who die near the top are most often entombed there, because to bring their bodies back would entail too great a risk for other climbers.

Iowa City emergency medicine physician Chuck Huss is a veteran mountaineer who has participated in expeditions to high peaks across the globe, including four expeditions to Mt. Everest.  He has served as expedition physician on several trips, and has an incredible wealth of knowledge on international travel, mountaineering, and global medicine.  He sat down recently with med student Asitha Jayawardena to talk about his experiences in the wilderness.

Listen: Episode 015: Chuck Huss and Wilderness Medicine

Episode 014: Doctors Without Borders, Part 2

Welcome back for Part 2 of Dr. John Lawrence's discussion on Doctors Without Borders (here's Part 1).

In 1971, a group of doctors and journalists in France got together to create Medecins Sans Frontieres.  Today, MSF, or Doctors Without Borders, boasts more than 27,000 committed individuals representing dozens of nationalities who provide assistance to people caught in crises around the world. They are doctors, nurses, logistics experts, administrators, epidemiologists, laboratory technicians, mental health professionals and others who work in more than 60 countries helping people whose survival is threatened by violence, neglect, or catastrophe.  They also bring attention to neglected crises, challenge inadequacies or abuses of the aid system, and to advocate for improved medical treatments and protocols.

In the second part of this two-part episode of The Short Coat, Dr. John Lawrence, formerly associate professor of surgery at the University of Iowa and now at the University of Vermont, continues to discuss his work in Doctors Without Borders.

Special thanks to the Carver College of Medicine's Global Programs department, and to Mo Yacoub for production assistance! 

Listen: Episode 014: Doctors Without Borders, Part 2
Or, start with Part 1.

Episode 014: Doctors Without Borders, Part 1

In 1971, a group of doctors and journalists in France got together to create Medecins Sans Frontieres.  Today, MSF, or Doctors Without Borders, boasts more than 27,000 committed individuals representing dozens of nationalities who provide assistance to people caught in crises around the world. They are doctors, nurses, logistics experts, administrators, epidemiologists, laboratory technicians, mental health professionals and others who work in more than 60 countries helping people whose survival is threatened by violence, neglect, or catastrophe.  They also bring attention to neglected crises, challenge inadequacies or abuses of the aid system, and to advocate for improved medical treatments and protocols.

In this two-part episode of The Short Coat, Dr. John Lawrence, formerly associate professor of surgery at the University of Iowa and now at the University of Vermont, returns to the Carver College of Medicine to discuss his work in Doctors Without Borders.

Special thanks to the Carver College of Medicine's Global Programs department, and to Mo Yacoub for production assistance! 

Listen: Episode 014: Doctors Without Borders

Episode 013: Rising From the Ashes

Failure is a difficult topic for medical students.  It's not something they're used to, after earning undergrad degrees near the tops of their classes, and generally being the smartest people they know.  But science is all about failure.  Scientific experiments, part of the foundation upon which evidence-based medicine rests, fail again and again before they make the discoveries that change our understanding of the world in which we live.

Doctors must make their peace with failure.  Even the best cannot always help those counting on them.  This time on the Short Coat, we got a group of students together to discuss their experiences with failure and what they learned from it. 

Given the sensitive nature of the discussion, everyone was given the opportunity to remain anonymous, and they were cautioned to speak only of their own experiences.  Officials of the Carver College of Medicine reviewed the recording before it was released to ensure that no student's right to confidentiality was violated.

Listen:  Episode 013: Rising From The Ashes

Episode 012: Dr. Mansoor Ali Khan, Clubfoot, and The Ponseti Method

Clubfoot is a congenital deformity of the foot, and affects between 150,000 and 200,000 babies each year worldwide. Extensive surgery was once the standard of care for clubfoot, improving the appearance of the foot but resulting in poor mobility and pain in midlife. Dr. Ignacio Ponseti, a Univeristy of Iowa Physician, pioneered what has become known as the Ponseti method. It involves manipulation of the newborn's feet via casting and splinting, and has replaced surgery as the standard of care.
While the Ponseti Method doesn't involve expensive surgeries or equipment, it does require detailed knowledge of both the anatomy of the foot and the method itself. In the case of clubfoot, the key to a cure is the education of physicians. Easy enough in the US and other developed countries. But 80% of cases occur in the developing nations, and most babies are left untreated or receive substandard care. it is difficult for physicians there to get the information they need to perform the method correctly.

To date, spreading the Ponseti Method involved visits by physicians from the developed world to the developing world to teach and perform the method. But Carver College of Medicine student Asitha Jayawardena'shealthcare experiences in South America lead him to the notion that educating one leader on the topic would allow them to spread the method among his colleagues in a culturally appropriate manner. At his urging, The American Medical Student Association created the Ponseti Scholairship to help spread the technique.

Recently, Asitha sat down with Dr. Mansoor Ali Khan, an orthopaedic surgeon from The Indus Hospital in Karachi, Pakistan, and the Ponseti Scholarship's first beneficiary, to talk about Khan's experiences at the University of Iowa as he learns more about the Ponseti Method.
 
Listen:  Dr. Mansoor Ali Khan, Clubfoot, and The Ponseti Method

Episode 011: Medical Student Syndrome

Medical Student Syndrome is a common problem for students.  In 1998 Howes and Salkovskis noted that "medical students frequently develop fears and symptoms of illness. This has been termed medical student's disease, nosophobia, hypochondriasis of medical students, and medicalstudentitis."  They cited older studies which concluded that 70% of med students have 'groundless medical fears' during their training, and that 78% had a history of medical student disease.   They surveyed students at Oxford University and found that medical students were less aware of bodily sensations or changes and experienced a lower perception of the risk of illness.  They also were more likely to think that treatment for their illnesses would be effective.

Nevertheless, medical student syndrome is something that students do experience.  We got together with a group of students to talk about their own health anxieties.

Listen: Medical Student Syndrome

Episode 010: Delivering High-Quality Healthcare in Poor Countries, With Dr. Paul Farmer

Recently, the University of Iowa was lucky enough to get a visit from Dr. Paul Farmer. Farmer, a medical anthropologist and physician, is a founding director of Partners In Health, an international nonprofit organization that provides direct health care services and has undertaken research and advocacy activities on behalf of those who are sick and living in poverty. Dr. Farmer is the Chair of the Department of Global Health and Social Medicine at Harvard Medical School; chief of the Division of Global Health Equity at Brigham and Women's Hospital; and the United Nations deputy special envoy for Haiti, under Special Envoy Bill Clinton.

Farmer and his colleagues in the United States and in Haiti, Peru, Russia, Rwanda, Lesotho and Malawi have pioneered novel community-based treatment strategies that demonstrate the delivery of high-quality health care in resource-poor settings.

The medical students were able to get some time with Dr. Farmer for a little Q&A on the challenges he and Partners in Health face when working in such settings.

Listen:  Delivering High-Quality Healthcare in Poor Countries, With Dr. Paul Farmer