This episode of my new Let's Talk Now LTN project is relevant to Generalist Medicine.

I really enjoy talking and being inspired with Marc-David Munk MD, a Canadian-American physician with a recent book release:  Urgent Calls from Distant Places: An Emergency Doctor's Notes About Life and Death on the Frontiers of East Africa.

We get to talk about writing the book, his work in East Africa with AMREF Flying Doctors, challenges working in the ER in North American health care system, and his retraining in Palliative Care Medicine. He has also worked as an innovator in health care delivery with, for example, CVS pharmacy and Iora Health, and he mentions some alternative ways of approaching primary care delivery.

Questions or comments? Email pleaseletstalknow@gmail.com

It is with a poignant sadness that I close the GeM Generalist Medicine Podcast - a project which has been filled with fun, learning and memories over the past 9 years.

If you have any feedback, please email me at gempodcast@gmail.com

I am moving on to a new podcast project - Lets Talk Now  (LTN)

Thank you so kindly for listening - it has been a true joy and pleasure to make these and be on this learning journey with you,

Aaron Rothstein

We are joined by local family and ER physician Jesse Zroback to discuss his passion and excitement for Space! We talk about his recent work with Canadian Space Agency, becoming one of the final candidates to become Canada's 4th generation of astronaut, as well as more generally the concept of Space Medicine -  medical considerations in space, application to life on Earth, and a bit on the current climate around Space travel! 

I had the opportunity to talk to Tonya Caylor, a family physician from Anchorage, Alaska with an inspiring interest in physician health. We talk about the important topic of Burnout as well as her interest in Coaching to help physicians in both their personal and professional lives. For more information on her, check out her site! https://www.joyinfamilymedicine.com/.

Lyrics:

Necrotizing Fasciitis/Necrotizing Fasciitis/So much pain/ React or be slain/ Necrotizing Fasciitis

Necrotizing Fasciitis/Dissolving don’t delight us/Pain out of proportion

I need a limb abortion/All from a sore shin!

I’m on the lookout when I see soft tissue/Is it going fast? Are you sick? I asked.

It feels like’s it’s a shark beneath the surface/The fascia elevator is at their service!

Oh no doc, is it do or die!?Why yes, TBH, lucky I’m your guy

Piptazo, Vanco, Clinda after cultures/ toxins swarming like in, like mini super vultures

What kinda mean bug got me through this wound?/First type’s a party cracking bubbly; stay tuned

Type two a hitman - strep pyogenes on your knees/ Or maybe Vibrio from the ocean seas!

<>

Call the surgeon in the middle of the night/Hey good sir could you join the fight?

What is the meaning of disturbing my slumber?/To Save a life. Glad you had my number!

CHORUS

When the surgeon arrives patient has less pain (of course)/ Is it effects of sepsis to the brain?

When I push he jumps not off the stretcher/Cutaneous anaesthesia is a late sign, I conjecture!

Youre a genius, hah, to the OR tomorrow!/Uhh good sir, but that could end in sorrow

Perhaps you could deign to operate stat/Steel and faciotimy would save him like that (snap)

We wheel him quickly down the hall/A little levofed makes his pressure not stall

Cut the leg theres necrotic goo/ compartments are relieved two by two

Thank you docs for saving my life/Everyone lauds you cept the ex-wife

No problem, mr patient, thats what we do/Watch for nec fash with soft tissue!

Ohhhh you got to save the day save the day save the day

Ohhh do serial exams you ll save the save the day

Ohhhh mr doctor got to save the day save the day save the day

Ohhhh give good discharge instructions for red flagsssssss and you will save the day

CHORUS!

Let's talk about Necrotizing Soft Tissue Infections, including primarily the really scary one - Necrotizing Fasciitis!  This is a topic to constantly keep in the back of your head... to really save some lives.

Update Sept 7th: Made some modifications to the surgical segment thanks to Dr. Matt Strickland

A conversation with Dr. Adam Moir, a generalist physician in Dryden, Ontario and a personal mentor about Teaching in medicine. We have an off the cuff conversation on our experience in teaching, the reciprocity of teaching, some pearls, and what can be learned and gained doing it!

Discussion with our local GP Anaesthetist Dr. Cory McFarlane around the Covid situation in Northern Ontario, oxygen delivery in Covid, Airway considerations, approaches to various critical scenarios and a bit on treatment

An unscripted, zany conversation with rural legend Mike Kirlew about airway and breathing ; ideas around who and how to intubate, who can be managed with Non-Invasive or High Flow, and about Ventilators

We talk to rural family medicine resident Dr. Tiffany Desruisseaux about the new IDSA 2019 guidelines on community acquired pneumonia, atypical pneumonias, some great pharmacology and a brief tidbit on VAPI (vaping-associated pulmonary injury)

Let's talk about AKI and what it means, how it is diagnosed, some key points and pitfalls, and also some focus on key diagnoses. 

Also: check out www.worrykit.com for our new Mental Health App. We are always looking for feedback and ways to improve it -- email me at gempodcast@gmail.com

Fast Facts about Procedures Including:

• Pericentesis
• Thoracentesis
• Pericardiocentesis
• Lumbar Puncture
• Seldinger Technique eg: for Central Lines/ Pigtails
• Peri-Mortem C- Section
• ED Thoracotomy

A discussion through the challenging topic of ECGs - how to put it in clinical context, some key pearls and approaches. If you find this hard, you are not alone!

Fast Facts about Sick Kids including:

• Key Kid Concepts
• Febrile Neonates
• Bronchiolitis
• Croup
• Epiglottitis
• Sepsis/Septic Shock

Mike Kirlew returns to have an energetic conversation about some clinical considerations in Atrial Fibrillation.

Dr. Justin Bell gives the basics of LGBT2SQ definitions and what our role is as health care providers for this diverse population.

Resource:

https://www.rainbowhealthontario.ca/TransHealthGuide/

Dr. Schreiber is an Infectious Disease specialist based in Sioux Lookout Ontario to shed some light on pneumonia. The focus is community acquired pneumonia (CAP) in adults.

Learn about the ins-and-outs of adapting to various rural medical environments.  

We're back! After a year sabbatical, Dr Rogy Masri and Dr Aaron Rothstein discuss finding meaning in medicine.  This talk deals with how to cope with the current challanges, finding purpose and how two people are navigating their medical careers. We hope this will give you food for thought on building and enriching your own career.

A discussion on the in vogue topic of meditation.

We get to have a discussion about  some of the evidence for care around a healthy delivery. Much of the discussion is taken from the SOGC (Society of Obstetricians and Gynaecologists of Canada) guidelines. 

Discussion around essentials of Prenatal care and some of the current practices that are changing!

Discussion on the background, diagnosis and treatment of rheumatic fever - and also the public health aspects of the disease.

Full review of Sepsis integrating new Sepsis 3 guidelines. No need to listen to last episode on Sepsis to follow!

Here is a bit of a refresher on some resilient concepts!  Also feel free to check out the new website at : growingresilient.com

More episodes to follow soon!

Learn about the basics of HIV medicine from Lucy Manchester, a family doctor with fellowship training in HIV medicine! Perfect for anyone wondering how to treat the rare patient with HIV in their practice, or just anybody interested.

Check out the website at:

www.gempodcast.ca

So much talk on it but ... What the heck is it really? We continue our Psychology Binge.

General conversation on the concept of resilience, and whether it is relevant and learnable. Some back and forth banter!

Check out our new site: growingresilient.com. It's aimed at growing resilience through mini-interventions. We are passionate about this subject!

I'm here with Dr. Blake MacKay to discuss the basics of ultrasound. Blake is a generalist with a strong interest in ultrasound and training through CPoCUS.  We discuss ultrasound basics including an array of clinical uses which can help guide management. Motivates me to do more ultrasound!

Cognitive Biases and Heuristics and how these fold into the complex world of decision making and learning.

Starting practice can be scary and exciting. Let's hear from Generalist and Emerge focused Dale Edwards on his first year in practice!

Habits are fundamental to tasks performed everyday - they drive routines, addictions, work flow and productivity, and many other things in the day to day. This is a recorded conversation of Amar Singh and myself having an off the cuff conversation about habits.

Importance of psychology with respect to patient health and well... our health.

Appreciate any Feedback at : gempodcast@gmail.com , thanks!

Dr. Eric Contant CCFP and EM doc shares his passion and knowledge of High Altitude Medicine

Acute Stroke

- Microphone troubles; working on it sorry about the clicks in the background

A Short on Diabetic Ketoacidosis and a Smidge of HHS

This is a discussion on the resurgent topic of Psychedelic Medicine. I talk with Dr. Ryan Patchett-Marble, a generalist physician with strong interest in addictions and mindfulness who has recently become interested in this emerging field. 

Additional Info:

Ryan and a patient he treated with Psilocybin:  https://nosm.brightspacestreaming.com/1/Watch/660834.aspx

Resources PDF - https://genmed.libsyn.com/

Accompanies GeM 20 The Liver!

Off the cuff pearls!

Hepatic Stuff! 

Bonus Song on Rhythm Strip, ACLS, Medical Song; Be a hero