Practicing
Oct 14, 2021
Samir Shaheen-Hussain: Decolonizing Medicine
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Sam talks to Pediatric Emergency physician Samir Shaheen-Hussain about medical colonialism, physician-enabled violence against Indigenous children, and his journey as an activist.
Samir is the author of “Fighting for a Hand to Hold: Confronting Medical Colonialism Against Indigenous Children in Canada” (McGill-Queen’s University Press, 2020).
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Show Notes:
CLARIFICATION: Samir mentions working in Oji-Cree communities during his experience in Sioux Lookout as a medical trainee. The Sioux Lookout First Nations Health Authority serves 33 First Nations, some of which are Oji-Cree. Pikangikum, which Samir mentions, is an Ojibwe First Nation.
Samir's book website
Lancet review of Samir's book
New Scientist interview with Samir
Le Monde interview with Samir
NY Times article on unmarked residential school graves
Terminology:
CEGEP = mandatory pre-university junior college in Quebec
Nunavik = homeland of the Inuit in present-day Quebec
Eeyou = what the Cree in present-day Quebec call themselves
Background:
Map of First Nations in Quebec
Summary Report of the Quebec Viens Commission (to which Samir testified)
Truth & Reconciliation Commission of Canada
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Recorded July 26, 2021
Music: Mr Smith
Art: Jeff Landman
www.practicingpod.com
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More episodes from Practicing
Feb 17, 2023
Alasdair Munro: Communicating Risk
In the clinical work I do in urgent care pediatrics, most of the kids I see come in with an injury or an infection – a fever, cough, runny nose, GI symptoms. That means that – as is the case for many pediatricians – so much of what I do revolves around diagnosing infections and counseling families about them. It’s often routine work, but it has its challenges. The most difficult thing, I think, is seeing parents who are desperate for relief, exhausted from a few sleepless nights with a sick, crying child, and having to tell them that their child isn’t in danger, that nothing more needs to be done, and that this too, shall pass on its own. That disconnect between the distress – which I too have felt as a parent – and the routine nature of these illnesses, is tricky to navigate.
In the last few months, and in particular this past Fall, it seems all of society and much of the news cycle in Canada and the US turned its attention to childhood infections. With an extraordinary wave of RSV and then influenza, pediatric emergency rooms and hospitals were overwhelmed with sick patients. Coming in the midst of the Covid pandemic, this wave of viral infections had health systems reeling. In Canada, shortages of medications like common antibiotics and pediatric formulations of ibuprofen and acetaminophen compounded the sense of chaos and of a breakdown in health services.
All that has now passed, but I wanted to revisit those events and talk a little about what happened. My next guest is someone I’ve come to trust on this subject for his abilities as a communicator.
Alasdair Munro is a senior clinical research fellow in pediatric infectious diseases at the UK National Institute for Health and Care Research (NIHR) in Southampton, England and a medical doctor. He’s currently a senior trainee in pediatrics working in pediatric emergency medicine. During the pandemic he led the live evidence review of COVID-19 in children with the Royal College of Paediatrics and Child Health while running a number of different COVID-19 vaccine clinical trials. He also sat on The Lancet commission on COVID-19 (safe work, travel and schools) as well as the NIHR working group for the study of transmission of COVID-19 in schools.
Alasdair’s gained a large Twitter following, and his substack newsletter, the Munro Report, is widely shared. Whenever I read Alasdair, I feel he captures the way I and most pediatricians I know think, about covid, other infections, and pediatrics more broadly. We cover all of that in our conversation, and I hope you enjoy it as much as I did.
Although I never provide medical advice on this show, since this episode is about my area of clinical expertise, I wanted to make it extra clear that nothing in the following discussion should be construed as direct medical advice to you or a child you know. For those questions, you should see a health care provider yourself.
And now, here’s my conversation with Alasdair Munro.
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Links:
Alasdair's newsletter
Alasdair's Twitter: @apsmunro
Don't Forget the Bubbles (pediatric evidence review site)
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Recorded February 9th, 2022
Music: Mr. Smith
Art: Jeff Landman
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Jan 6, 2023
Carl Erik Fisher: Understanding Addiction
“I’m twenty-nine years old, writing in my journal in a sloppy felt-tip pen (no ballpoints are allowed), trying to understand how I went from being a newly minted physician in a psychiatry residency program at Columbia University to a psychiatric patient at Bellevue, the city’s notorious public hospital.”
That’s a quote from the first page of Carl Erik Fisher’s The Urge: Our History of Addiction (Penguin Random House, 2022). As he reckons with what has brought him to that point and enters recovery, Carl revisits his own history of alcohol and drug use and comes to pose broader questions. “Why was there a totally separate system for addiction treatment? Why do we treat addiction differently from any other mental disorder? If everyone seems to know that the system is broken, why isn’t anyone changing it?” he writes.
“The Urge” explores these and other questions, offering a history of addiction and medicine and society’s response to it through the ages. Drawing on sociology, anthropology, and theology along with psychology, neuroscience, and of course medicine, Carl’s book is part memoir, part work of popular science. But it’s also something more. That’s why I was so eager to explore it with him.
Carl Erik Fisher is an addiction physician, bioethicist, and person in recovery. He is an assistant professor of clinical psychiatry at Columbia University and maintains a private psychiatry practice focused on complementary and integrative approaches to addiction and recovery. His writing has appeared in The New York Times, The Guardian, Slate, and elsewhere. The Urge was named one of the best books of 2022 by The New Yorker and The Boston Globe. He also is the host of the Flourishing After Addiction podcast, which I highly recommend.
Carl’s work is so compelling to me because it combines his scholarly curiosity with his clinical experience and personal past. It’s one thing to write a history of addiction; it’s quite another to do so while also working with patients who struggle with addiction and who are in recovery while being in recovery yourself. The result is work that I’d describe as integrated, a rich whole that combines the general and the specific, the scientific and the experiential, the analytic and the critical. It’s no exaggeration to say that The Urge helped me see the world around me – both current events and medicine’s particular role in them – as I hadn’t seen it before.
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Links:
Carl's website
Carl's podcast
The Urge website
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Recorded December 13, 2022
Music: Mr Smith
Art: Jeff Landman
Photo of Carl: copyright Beowulf Sheehan
www.practicingpod.com
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Dec 1, 2022
Sabine Hildebrandt: Dissecting the Past
The summer I turned thirteen my family moved to Berlin from Canada. Although we were an essentially secular Jewish family, I had a basic Jewish education and quite a developed awareness of the history of World War II and the Holocaust. Like many young readers, I had been captivated by “The Diary of Anne Frank”. I’d also been to museums and seen plays, movies, and read many stories about the period and the plight of Europe’s Jews under the Nazis.
So although I was well aware of Germany’s brutal history, I wasn’t prepared for its omnipresence in everyday life in Berlin. Subtle, almost banal traces of the Nazi past were everywhere: in discreet memorial plaques on buildings, in the names of subway stops, or even on the ground beneath one’s feet, where the names of deported Nazi victims were engraved on special brass cobblestones in the sidewalks in front of the victims’ former homes.
But for Harvard anatomist Sabine Hildebrandt, growing up in postwar Germany meant being surrounded by a lack of evidence of her country’s dark past. Absent Jewish neighbors, abandoned synagogues, and uncomfortable silences: that was her experience. From the silence a curiosity emerged, a need to know that was the impetus for her ongoing quest to excavate the past, to understand it and to memorialize it. And that’s what she does in her book, “The Anatomy of Murder: Ethical Transgressions and Anatomical Science during the Third Reich”, the first systematic study of anatomy under National Socialism.
Sabine Hildebrandt is an associate professor of pediatrics at Boston Children’s Hospital, and a lecturer on Global Health and Social Medicine at Harvard Medical School. She also teaches anatomy and history of anatomy at Harvard.
I knew I wanted to speak to Sabine when I saw her name mentioned in not one, but two stories in the New York Times related to German anatomy’s Nazi past; one about the notorious Pernkopf anatomical atlas, and the other related to her work as a member of the Historical Commission on the University of Strasbourg, which was taken over by the Nazis during the war and was the site of some harrowing abuses. I’ve linked to both articles below.
Speaking to Sabine was interesting on many levels. The history she has systematically laid out in her work is horrific, but unquestionably fascinating and valuable in its own right. But what is so special about her work, I think, is the way it prompts us to reflect on medicine’s relationship to power, and the discipline’s intrinsic potential not only for good, but also for evil.
On that note, a brief warning. My conversation with Sabine includes the discussion and description of medical violence and outright crimes in a context of tremendous brutality and disregard for human life. So please listen with caution and care.
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Links:
Sabine's bio
New York Times article on Pernkopf Atlas
New York Times article on Strasbourg University
Sam's review of "The Anatomy of Murder"
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Recorded October 12, 2022
Music: Mr Smith
Art: Jeff Landman
www.practicingpod.com
Twitter: @practicingpod
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