Dr. Rick Pescatore was driving to Pittsburgh with a woman he had met on Hinge, describing a kind of patient he sees every ER shift: pain, nausea, vomiting, and tests that all come back normal. She said the person he was describing "sounds exactly like my mom." A few weeks later her mother was dying in an ICU, and nobody could solve her mystery illness. The missing piece turned out to be vitamin B1 (thiamine). The woman from that drive is now his wife, Katie.
Dr. Pescatore is a board-certified emergency physician. He went through the U.S. Naval Academy, studied aerospace engineering, and served in the Navy's submarine force before medical school. He trained at Cooper University Hospital, served as Delaware's chief physician during the COVID-19 pandemic, is editor-in-chief of Emergency Medicine News, still works shifts in a community ER, and co-founded Belly MD.
In this conversation with Dr. David Spiro, he talks about helping diagnose his future mother-in-law, why so many ER patients are told they are normal when their lives are not, and how that pattern helped burn him out of full-time emergency medicine. They also get into what night shifts cost physicians, his Navy call sign, his time leading Delaware's pandemic response, and why an ER doctor who used to roll his eyes at supplements now sells them.
In this episode:
– The drive to Pittsburgh: "sounds exactly like my mom"
– An ICU stay nobody could explain, and the vitamin B1 answer
– "We tell them that they're normal, but their lives aren't"
– Disorders of gut-brain interaction and the ER
– Why he calls GLP-1 drugs some of the most revolutionary in history
– Burning out of emergency medicine, and the night-shift toll at every age
– F-18s, submarines, and the call sign "Aquaman"
– Chief physician for Delaware during COVID-19
– An ER doctor selling supplements: his answer to the eye-rolls
Chapters
(00:00) Cold Open: "Met a Girl on Hinge"
(01:05) Welcome & Meet Dr. Rick Pescatore
(03:16) The Drive to Pittsburgh: "Sounds Exactly Like My Mom"
(04:30) Decades of Symptoms, Then the ICU
(06:19) Vitamin B1 and Gastrointestinal Beriberi
(07:03) "We Tell Them That They're Normal"
(08:12) Saving Her Mom's Life With a Vitamin
(10:03) Belly Pain: What the ER Can't Fix
(11:27) Disorders of Gut-Brain Interaction
(13:09) Should Emergency Medicine Change?
(14:21) Diet and the American Food System
(16:47) Sulfite Preservatives and Vitamin B1
(19:31) GLP-1s, Falls, and the Toenail Question
(22:50) The Naval Academy, F-18s, and the Call Sign "Aquaman"
(27:24) "I Burned Out of Emergency Medicine"
(29:26) The 3 a.m. Problem: Night Shifts and Physician Health
(30:40) Dr. Spiro on Night-Shift Anxiety
(33:04) Chief Physician for Delaware During COVID-19
(35:57) Building Belly MD
(40:33) Supplements: "I Used to Be That Guy"
(44:12) An ER Doctor Selling Supplements?
(45:43) Testing for Vitamin Deficiencies
(47:47) Closing
Learn more about Dr. Pescatore's work: bellymd.com
Check out the Inside HuMed Newsletter: https://www.humedpod.com/inside-humed
This episode is one physician's personal story and is not medical advice. Dr. Pescatore co-founded Belly MD, which sells supplements, as he discusses in the episode.
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