Bedside Rounds

Bedside Rounds is a storytelling podcast about medical history and medicine’s intersections with society and culture. Host Adam Rodman seeks to tell a few of these weird, wonderful, and intensely human stories that have made modern medicine.

74 - R2D2 09/03/2023

74 - R2D2 What does it mean when a computer can make better medical decisions than a human? The progress in large language models, and in particular the popularity of ChatGPT, has brought these questions to the forefront in 2023, but we’ve been discussing this for over 50 years. In this episode, Dr. Shani Herzig and I are going all the way back to the early 1970s with the invention of AAPHELP, the first real clinical decision support system, and the first time doctors had to contemplate working with – or competing against – computer systems. /episode/index/show/bedsiderounds/id/27816447

73 - Seadragon 06/26/2023

73 - Seadragon What happens when a patient far from surgical care – say, at the bottom of the Pacific ocean on a submarine, or at a research base in Antarctica in the middle of the winter – develops a surgical abdomen? This dilemma was the impetus to build the first truly effective clinical decision support system – and to grapple with what it means when a computer can make better medical decisions than a doctor. In this episode, part one of three, we discuss the dramatic stories of appendectomies at Novolazarevskaya and aboard the submarine Seadragon. Also, there’s a brand new #AdamAnswers about the origin of the word “scut.” /episode/index/show/bedsiderounds/id/27234297

72 - Problems 03/20/2023

72 - Problems American doctors spend the majority of their time during the day on the computer, either writing or reading notes about their patients; only a small fraction is spent with the human beings in their care. Technology itself – especially the electronic medical record – has often been blamed for this. But in this episode – a recorded grand rounds that I gave at the San Francisco VA in 2022 – I argue that this alienation has its roots in the way we’ve decided to organize clinical data, and the assumptions that we’ve made about the nature of medical care. In particular, I’m going to discuss one of the most influential medical thinkers of the second half of the 20th century, Larry Weed, his invention of the problem-oriented medical record and the SOAP note, and how his insight – that medical documentation fundamentally influences how we think about our patients – changed the way we think about our patients. /episode/index/show/bedsiderounds/id/26129526

71 - A Doctor's Work, part 2 01/16/2023

71 - A Doctor's Work, part 2 In the past episode, cultural and medical historians Lakshmi Krishnan and Mike Neuss discussed the history of the actual work of the doctor – Holmesian detective, data entry clerk, or something else altogether. In this episode, we conclude our discussion by talking about what type of metaphors are best suited for clinical work. Plus a brand new #AdamAnswers about the reason that American doctors are so obsessed with using, well, the # symbol in our notes. /episode/index/show/bedsiderounds/id/25581999

70 - A Doctor's Work 12/19/2022

70 - A Doctor's Work What do doctors actually do? Are they Sherlockian detectives, hunting down obscure clues to solve intractable cases? Are they virtuosic experts, training for half a lifetime to bring the latest science to bear to cure disease? Or are they clerks, whose main job is to collect and enter data into the electronic health record? In this episode, Adam is joined by medical and cultural historians Lakshmi Krishnan and Mike Neuss to discuss the stories we tell about our own work – and how this often conflicts with the realities of clinical practice. /episode/index/show/bedsiderounds/id/25359834

69 - The Database 10/31/2022

69 - The Database How do doctors actually think? And if we can answer that, can we train a computer to do a better job? In the post-WW2 period, a group of iconoclastic physicians set about to redefine the nature and structure of clinical reasoning and tried to build a diagnostic machine. Though they would ultimately fail, their failure set the stage for the birth of the electronic health records, formalized the review of systems, and set up a metacognitive conflict that remains unresolved to this day. This episode, entitled “The Database,” is the second part of this on the history of diagnosis with Gurpreet Dhaliwal. /episode/index/show/bedsiderounds/id/24841875

68 - The History 07/25/2022

68 - The History Internal medicine physicians like to pride ourselves on our clinical reasoning – the ability to talk to any patient, pluck out seemingly random bits of information, and make a mystery diagnosis. But how does this actually work? In this episode, called The History, I’ll be joined by Gurpreet Dhaliwal as we explore the beginnings of our understanding on how clinical reasoning works – starting in the middle of the 19th century with polar tensions between two ways of approaching our patients that are still felt today. Along the way, we’ll talk about the American Civil War, Car Talk, Sherlock Holmes, and whether the practice of medicine can ever be considered a science. Sign up for Digital Education 2022 here: Sources: Fitzgerald F, Curiosity. Montgomery K, How Doctors Thinks (amazon link: ) Da Costa J, Medical Diagnosis, 1864. /episode/index/show/bedsiderounds/id/23817305

The Facemaker with Dr. Lindsey Fitzharris (#histmedconsultservice) 06/07/2022

The Facemaker with Dr. Lindsey Fitzharris (#histmedconsultservice) Modern plastic surgery was born out of the horrors of trench warfare in World War I. In this episode, Adam interviews historian Lindsey Fitzharris about her new book The Facemaker, about the life of surgeon Harold Gillies and his quest to rebuild his patients' faces. /episode/index/show/bedsiderounds/id/23328197

67 - Fever on the Frontier 03/21/2022

67 - Fever on the Frontier In the early 19th century, a strange new illness, seemingly unknown to medicine, ravaged settler communities in the American Middle West. As fierce debates about this new disease, now called milk sickness, raged – was it from toxic swamp gasses? arsenic in the soil? infectious microorganisms? from the poor constitutions of the settlers – an irregular medicine woman named Dr. Anna and an indigenous Shawnee healer discovered the cause of the disease and successfully prevented it in their community. But their discovery went unheeded for over a half century. This is a live podcast that I gave to the South Dakota chapter of the American College of Physicians – plus a new Stethospeaks with Dr. Umme H. Faisal on the history of Resusci-Annie’s mysteriously serene face! Teepublic store: Sources: DOYLE JT. Milk sickness. N C Med J. 1947 Jul;8(7):404-10. PMID: 20250350. Furbee L, Snively WD Jr. Milk sickness, 1811-1966: a bibliography. J Hist Med Allied Sci. 1968 Jul;23(3):276-85. doi: 10.1093/jhmas/xxiii.3.276. PMID: 4875594. HARTMANN AF Sr, HARTMANN AF Jr, PURKERSON ML, WESLEY ME. Tremetol poisoning--not yet extinct. JAMA. 1963 Aug 31;185:706-9. doi: 10.1001/jama.1963.03060090038014. PMID: 13953145. Niederhofer RE. The milk sickness. Drake on medical interpretation. JAMA. 1985 Oct 18;254(15):2123-5. PMID: 3900448. Pickard ME and Buley RC, The Midwest Pioneer; His Ills, Cures, & Doctors. 1945. Snively WD Jr, Furbee L. Discoverer of the cause of milk sickness (Anna Pierce Hobbs Bixby). JAMA. 1966 Jun 20;196(12):1055-60. PMID: 5327806. Stenn F. Pioneer History of Milk Sickness. Ann Med Hist. 1937 Jan;9(1):23-29. PMID: 33943945; PMCID: PMC7942921. Townsend RB. Milk sickness- a plague on the new west. Scalpel Tongs. 1999 Jan-Feb;43(1):13-5. PMID: 11623628. Walker JW. Milk-sickness. Science. 1886 Dec 10;8(201):540. doi: 10.1126/science.ns-8.201.540. PMID: 17741312. /episode/index/show/bedsiderounds/id/22501844

66 - Burnout 01/08/2022

66 - Burnout Burnout seems to stalk healthcare workers; between a third and a half of doctors and nurses had symptoms of burnout BEFORE the COVID-19 pandemic. Major medical associations have recognized burnout as a serious problem and the condition is being added to ICD-11 as an “occupational phenomenon.” How has burnout gotten so bad? In this episode, the first #HistMedConsultService, I’m joined by historians of healthcare and emotions Agnes Arnold-Forster and Sam Schotland to historicize burnout. /episode/index/show/bedsiderounds/id/21706001

65 - The Last Breath 11/05/2021

65 - The Last Breath How can we medically tell whether or not someone is alive or dead? The answer is much more complicated than you'd think. In this episode, which is a live podcast I gave with Tony Breu at the Massachusetts Chapter of the ACP annual meeting on October 16, 2021, we track the evolution and controversies of the death exam, from a trans-Atlantic scandal surrounding a possible vivisection, a 19th century “X-prize” to determine a technology that could diagnose death, and the mysterious Lazarus phenomenon. /episode/index/show/bedsiderounds/id/21001565

64 - A Vicious Circle 10/04/2021

64 - A Vicious Circle During World War II, the US Army launched a seemingly routine experiment to find the ideal way to screen soldiers for tuberculosis. Jacob Yerushalmy, the statistician in charge of this project, would succeed at this task -- and end up fundamentally changing our conception of medical diagnosis in the process. This episode features Dr. Shani Herzig, as well as a new segment featuring Dr. Umme H. Faisal on Yellapragada Subbarow and his discovery of ATP. /episode/index/show/bedsiderounds/id/20690183

63 - Signals 08/23/2021

63 - Signals What does it mean when different physicians disagree about a diagnosis? I am joined by Dr. Shani Herzig as we explore this issue in the second part of my series on the development of diagnosis. We’re going to discuss the advent of signal detection theory in the middle of the 20th century as new diagnostics such as laboratory testing and x-rays started to challenge classical views of diagnosis. /episode/index/show/bedsiderounds/id/20217512

62 - The Sisters Blackwell 05/10/2021

62 - The Sisters Blackwell Elizabeth Blackwell -- the first woman to earn a medical degree in the United States -- and her sister Emily Blackwell are some of the most important physicians of the 19th century, firmly establishing the role of women as physicians, starting an infirmary and hospital for poor women and children, and founding a women’s medical college that was decades ahead of its time. In this episode, Dr. Nora Taranto joins me to explore the legacy of the Blackwells along with Janice Nimura, /episode/index/show/bedsiderounds/id/18939290

61 - Etymologies 03/29/2021

61 - Etymologies Words matter. Etymology gives us insight not only into the origins of words, but why they remain so important today, especially in medicine. In this episode, we’re delving into four specific words -- doctor, cerebrovascular accident, rounds, and zebras. And along the way, we’re going to discuss pre-historical pastoralists on the Eurasian steppes, medieval universities, Octagonal air-ventilated chambers in 19th century Baltimore, and of course, early 21st century sitcoms. /episode/index/show/bedsiderounds/id/18479606

60 - Santa's Salmonella 12/24/2020

60 - Santa's Salmonella For a special holiday treat, we’re going to explore two tales of salmonella disease detectives -- the first about Mary Mallon (“Typhoid Mary”) and the birth of the genre; and the second about a mysterious salmonella outbreak at Massachusetts General Hospital solved with the assistance of a very jolly patient. Along the way, we’ll talk about clinical epidemiology, the long-lasting influence of Berton Roueché, and the joys of being an internist! /episode/index/show/bedsiderounds/id/17229014

59 - Cry of the Suffering Organs 11/30/2020

59 - Cry of the Suffering Organs Diagnosis is arguably the most important job of a physician. But what does it actually mean to make a diagnosis? In this episode, we’ll explore this question by tracking the development of the “classical” model of diagnosis and pathological anatomy and discussing three cases over three hundred years. Along the way, we’ll ponder the concept of the lesion, iatromechanistic theories of the human machine, the birth of the International Classification of Diseases, and the rise and decline of the autopsy. /episode/index/show/bedsiderounds/id/16991198

The House of Pod: How medical podcasting made me a better doctor and educator … and how it might change the future of medical education for everyone 11/23/2020

The House of Pod: How medical podcasting made me a better doctor and educator … and how it might change the future of medical education for everyone In this episode, I talk about my podcasting journey -- how I started Bedside Rounds for inspiration during a low period in residency, how it changed me as a physician, and how it has changed my views about digital education and the future of medical education in general. /episode/index/show/bedsiderounds/id/16921904

58 - The Original (Antigenic) Sin 10/26/2020

58 - The Original (Antigenic) Sin The COVID-19 pandemic laid bare the racial health disparities in the United States, with markedly increased mortality especially among Blacks and Native Americans. In this episode, Tony Breu and I discuss the conception of race, racism, and the social determinants of health through three historic plagues in the United States -- from yellow fever in New Orleans, to poliomyelitis, and finally the early days of HIV/AIDS -- and what lessons we can draw for COVID-19. /episode/index/show/bedsiderounds/id/16469516

57 - The Second Wave 08/31/2020

57 - The Second Wave In August of 1918, a horrific second wave of the Spanish Flu crashed across the world. In this episode, the third of a four-part series exploring hydroxychloroquine and COVID-19, I’ll explore this single moment in time, through the mysterious origins of the Spanish Flu and historiographical controversies, scientific missions to mass burial sites in remote Alaskan villages, the ill-fated journey of the HMS Mantua, debates about how to count victims of a pandemic, and the mystery behind Pfeiffer’s bacillu /episode/index/show/bedsiderounds/id/15802157

56 - La Grippe 07/13/2020

56 - La Grippe The 1889 Russian Flu was the first influenza pandemic in an increasingly globalized world. In this episode, the second of a two-parter on how hydroxychloroquine became a great hope in COVID-19, we’ll talk about how quinine became the standard of care for influenza. Along the way, we’ll discuss the astrological origins of the flu, conspiracy theories about previous global coronavirus outbreaks, the media panic over the Russian Flu, and first year law school cases about Carbolic Smoke Balls. /episode/index/show/bedsiderounds/id/15110039

Introducing the Curious Clinicians! 07/09/2020

Introducing the Curious Clinicians! This bonus episode introduces episode four of the Curious Clinicians, about Vincent Van Gogh and digitalis. The Curious Clinicians is a new medical podcast produced by Hannah Abrams, Avi Cooper, and Tony Breu; you can download them all at curiousclinicians.com. /episode/index/show/bedsiderounds/id/15115607

55 - The Fever Tree 06/08/2020

55 - The Fever Tree Where did cinchona, the first medication to cure malaria, come from? This episode explores the murky history of the bark of the fever tree and its derivative chloroquine with mysterious pre-Columbian Pacific crossings of the plasmodium parasite, Jesuit priests and Inca healers, a Chinese Emperor performing a clinical trial to treat his fever, chemistry leading to the first modern pharmaceuticals, and imperialism on a global scale. /episode/index/show/bedsiderounds/id/14613605

54 - 1918 (guest episode with Hannah Abrams and Gaby Mayer) 05/18/2020

54 - 1918 (guest episode with Hannah Abrams and Gaby Mayer) The 1918 influenza pandemic, or the Spanish Flu, is the obvious parallel to the COVID-19 pandemic -- a worldwide plague attacking a scientific and global society much like our own. In this guest episode by Hannah Abrams and Gaby Mayer, we chase these parallels wherever they take us, talking etiology, presentation, treatments, masking, curve-flattening, and mortality measures. /episode/index/show/bedsiderounds/id/14455973

53 - The Antonine Plague (guest episode with Liam Conway-Pearson) 04/27/2020

53 - The Antonine Plague (guest episode with Liam Conway-Pearson) Plagues have fascinated us since antiquity, but the Antonine Plague stands out because one of the most famous physicians in Western history was present to make detailed observations. In this episode, guest host Liam Conway-Pearson explores what we know -- and what we don't know -- about this plague, which ravaged Rome two millennia ago. Plus a brand new #AdamAnswers about using convalescent plasma to treat the Spanish Flu of 1918! /episode/index/show/bedsiderounds/id/14155295

A short message from Adam 03/25/2020

A short message from Adam As the COVID-19 pandemic increasingly spreads across the globe, Bedside Rounds is going on hiatus. This short message explains why and gives some historical context. Stay in touch on Twitter in the upcoming months @AdamRodmanMD. /episode/index/show/bedsiderounds/id/13696682

52 - The Rebuff 03/02/2020

52 - The Rebuff Over the past several centuries, the medical field has established a firm graph on the domain of the human body, with one very notable exception -- the teeth. In this episode, we'll explore this historic split between medicine and dentistry, and the moment in history where the two fields could have been rejoined but were “rebuffed.” /episode/index/show/bedsiderounds/id/13363265

Winter Shorts #4 - The Backlog 02/04/2020

Winter Shorts #4 - The Backlog Did Hippocrates call consults for chest pain? Were there specialists in black bile? Where does our poetic terminology for heart and lung sounds come from? Is there a historical parallel for #MedTwitter? I’ve fallen off the bus with #AdamAnswers, so in this month’s episode I’m playing catch up on many of the amazing questions you guys send me with the first Winter Short (#spoileralert -- not actually short) -- the Backlog! /episode/index/show/bedsiderounds/id/13002470

51 - Hero Worship 12/16/2019

51 - Hero Worship At the end of 2019, William Osler’s legacy is stronger than ever; he has been called the “Father of Modern Medicine” and held up as the paragon of the modern physician. In this episode, I’m going to explore the historical Osler -- just who was William Osler in the context of rapidly changing scientific medicine at the dawn of the 20th century, and how did he become so influential? But I’m also going to explore Osler the myth -- what does the 21st century obsession with the man say about us? /episode/index/show/bedsiderounds/id/12408605

50 - I Know Nothing 10/28/2019

50 - I Know Nothing What does it mean to know something in medicine? In this episode, we’ll explore this question by developing a historical framework of medical epistemologies in a journey that involves King Nebuchadnezzar, citrus fruit, leeches, water pumps, ICD-10, Socrates, skepticism, and 1970's computer programs designed to replace doctors. This is a version of a Grand Rounds given at BIDMC on October 25, 2019. /episode/index/show/bedsiderounds/id/11792744

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