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Loss of DEI Hurts Everyone: Farah Stockman, Ali Thomas, Ken Covinsky

GeriPal - A Geriatrics and Palliative Care Podcast

Release Date: 04/17/2025

Implementing Palliative Care in Nursing Homes show art Implementing Palliative Care in Nursing Homes

GeriPal - A Geriatrics and Palliative Care Podcast

The need for better palliative care in nursing homes is significant. Consider this: the majority of the 1.4 million adults residing in U.S. nursing homes grapple with serious illnesses, and roughly half experience dementia. Many also suffer from distressing symptoms like pain. In addition, about 25% of all deaths in the United States occur within these facilities. Despite these substantial needs, specialized palliative care beyond hospice is rare in nursing homes. Furthermore, only about half of nursing home residents nearing the end of life receive hospice care. So, how can we improve...

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Lucid Episodes: Andrea Gilmore-Bykovskyi & Andrew Peterson show art Lucid Episodes: Andrea Gilmore-Bykovskyi & Andrew Peterson

GeriPal - A Geriatrics and Palliative Care Podcast

Have any of you watched the movie “”?  At the end, one of the characters, who has dementia, experiences an episode of lucidity.  When I watched it, between tears (I’m a complete softie) I remember thinking, “Oh no! This will give people false hope!  That their loved one is ‘in there.’ If only they could find the right key to unlock the lock and let them out.” Today we talk about lucid episodes and what they might mean to the person with dementia, their family and loved ones, to philosophers, to clinicians, to neuroscientists. Our guests are Andrea...

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Music as Medicine: Jenny Chen, Tyler Jorgensen, & Theresa Allison show art Music as Medicine: Jenny Chen, Tyler Jorgensen, & Theresa Allison

GeriPal - A Geriatrics and Palliative Care Podcast

As you know, dear listeners, I love music. We start each podcast with a song in part to shift the frame, taking people out of their academic selves and into a more informal conversation. Well, today’s guests love music at least as much if not more than me, and they each make a strong case for music as medicine. Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Look for Jenny to potentially appear on the show (no lie). Tyler Jorgensen not only plays music for his patients, starting out with just pulling up a tune on his iPhone, he and others...

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Nudges for Prognosis and Comfort Care in the ICU: Kate Courtright, Scott Halpern, & Jaspal Singh show art Nudges for Prognosis and Comfort Care in the ICU: Kate Courtright, Scott Halpern, & Jaspal Singh

GeriPal - A Geriatrics and Palliative Care Podcast

Our main focus today was on to consider a more palliative approach to care.  Our guests are all trained in critical care: Kate Courtright, Scott Halpern, and Jaspal Singh.  Kate and Scott have additional training in palliative medicine.  To start. we review: What is a nudge? Also called behavioral interventions, heuristics, and cognitive biases. Prior podcasts on the , and a different trial conducted by Kate and Scott in which the . What is sludge?  I’d never heard the term, perhaps outside of Eric’s pejorative reference to my coffee after adding copious...

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Psilocybin in Serious Illness: A Podcast with James Downar, Ali John Zarrabi and Margaret Ross show art Psilocybin in Serious Illness: A Podcast with James Downar, Ali John Zarrabi and Margaret Ross

GeriPal - A Geriatrics and Palliative Care Podcast

We’ve covered psychedelics on the podcast before—first in 2019 with , and then again in 2023 with Stacy Fischer, Brian Anderson, and Theora Cimino, focusing on the . In today’s episode, we’re taking a closer look at the current state of the science around one specific psychedelic: psilocybin. We'll discuss three recent clinical trials involving patients with serious illness, joined by our guests , , and .  We begin with a refresher on psilocybin—what it is, how it might work, what conditions it may help treat (including demoralization), and how it’s typically administered....

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HIV, Aging, and Palliative Care: Peter Selwyn and Meredith Greene show art HIV, Aging, and Palliative Care: Peter Selwyn and Meredith Greene

GeriPal - A Geriatrics and Palliative Care Podcast

Peter Selwyn, one of today’s guests, has been caring for people living with HIV for over 40 years.  In that time, care of people with HIV has changed dramatically.  Initially, there was no treatment, then treatments with marginal efficacy, complex schedules, and a tremendous burden of side effects and drug-drug interactions.  The average age at death was in the 30s. Now, more people in the US die with HIV rather than from HIV.  Treatment regimens are simplified, and the anti-viral drugs are well tolerated.  People are living with HIV into advanced ages.  The...

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Potentially Unsafe Low-evidence Treatments: Adam Marks, Laura Taylor, & Jill Schneiderhan show art Potentially Unsafe Low-evidence Treatments: Adam Marks, Laura Taylor, & Jill Schneiderhan

GeriPal - A Geriatrics and Palliative Care Podcast

More and more people are, “”  Self-identified experts and influencers on (podcasts!) and social media endorse treatments that are potentially harmful and have little to no evidence of benefit, or have only been studied in animals.  An increasing number of federal have a of endorsing such products. We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently.  Ivermectin to treat cancer.  Stem cell treatments. Chelation therapy.  Daneila Lamas wrote about this issue in the -after we...

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Loss of DEI Hurts Everyone: Farah Stockman, Ali Thomas, Ken Covinsky show art Loss of DEI Hurts Everyone: Farah Stockman, Ali Thomas, Ken Covinsky

GeriPal - A Geriatrics and Palliative Care Podcast

I read Farah Stockman’s article in the NYT on , and thought, “Yes, and ‘everyone’ includes harm to our healthcare workforce, our patients, and their families.” So we’re delighted that Farah Stockman, pulitzer prize winning journalist, author of , and editorial board member at the New York TImes joins us to set the bigger picture for this discussion.  Farah provides clear examples from the Biden administration, in which having the most diverse cabinet in history was critical to building bridges, empathy, and inspiring others to feel included. We are also pleased to welcome Ali...

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RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest show art RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest

GeriPal - A Geriatrics and Palliative Care Podcast

Early in my research career, I was fascinated by the (then) frontier area of palliative care in the emergency department.  I emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? This is not why I went into emergency medicine. I went into emergency medicine to act. I can’t do the primary thing I’ve been trained to do: ABC, ABC, ABCs.  Most emergency providers wanted to for seriously ill patients, but they didn’t have the knowledge, skills, or experience to do...

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GeriPal Takeover! Nancy Lundebjerg and Annie Medina-Walpole show art GeriPal Takeover! Nancy Lundebjerg and Annie Medina-Walpole

GeriPal - A Geriatrics and Palliative Care Podcast

Whelp, goodbye folks!  Eric and I have been DOGE’d. In a somewhat delayed April Fools, Nancy Lundebjerg and Annie Medina-Walpole have taken over podcast host duties this week. Their purpose is to interview me, Eric, and Ken Covinsky about your final AGS literature review plenary session taking place at the Annual Meeting in Chicago this May (for those attending, our session is the plenary the morning of May 10).  We discuss our favorite articles, parody songs, and memories from AGS meetings past, with a little preview of a song for this year’s meeting.   We covered: ...

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I read Farah Stockman’s article in the NYT on why attacks on DEI will cost us all, and thought, “Yes, and ‘everyone’ includes harm to our healthcare workforce, our patients, and their families.”

So we’re delighted that Farah Stockman, pulitzer prize winning journalist, author of American Made: What Happens to People When Work Disappears, and editorial board member at the New York TImes joins us to set the bigger picture for this discussion.  Farah provides clear examples from the Biden administration, in which having the most diverse cabinet in history was critical to building bridges, empathy, and inspiring others to feel included.

We are also pleased to welcome Ali Thomas, a hospitalist, member of the Baha'i Faith, leader of anti-racism efforts in the Pacific Northwest, and founder of the BIPOC Health Careers Ecosystem.  Ali talks about the history of affirmative action, which started as a program for Whites, the importance of diversity in the healthcare workforce, the history of allyship and cross cultural collaboration, and his own efforts to provide opportunity and support for historically oppressed groups in his own community to obtain healthcare careers.

And Ken Covinsky, avid baseball fanatic, joins us and notes that the day we record (April 15) is Jackie Robinson day.  Many may be familiar with the story of Jackie Robinson breaking the color barrier in major league baseball in 1947, but may not be aware of the tremendous adversity Jackie Robinson faced, and persistence he displayed, off the field.

We address many things, including:

  • The movement in Corporate America and institutes of higher education to implement DEI programming in the wake of George Floyd

  • The general agreement in America of the value of diversity, and disagreement, unpopularity, and backlash about DEI as it was implemented

  • How the pursuit of diversity and excellence are not in tension, they are aligned and necessary for each other

  • What we can do to build bridges across differences

There was so much we hoped to talk about and didn’t get to, but I will link to now, including: Ali’s mom’s personal history with and study of school desegregation in South Carolina, Farah’s mom’s pioneering work as a speech language pathologist, and Ken’s perspectives on the importance of studying ageism and racism in research.

What a Wonderful World could be sung in irony at this moment.  I hope we all take it literally, with the hope this podcast ends with. The podcast follows the arc towards hope of this video on Race Amity from the National Center for Race Amity, courtesy of Ali Thomas (his dad is featured).

-Alex Smith