Top news this week: Systemic corticosteroids linked with worse COVID-19 outcomes

In this episode, Serpil Erzurum, MD, draws on her vast experience at health care systems across the country to discuss the importance of compassion as a mentor and trainee when paving the path for others, breaking the cycle of self-doubt and learning from disappointment and failure in our careers. Intro :01 The interview :18 Who is Dr. Erzurum as a person? Passions, interests and childhood 1:13 What have been your favorite parts of working in health care across the country? 5:22 How do you juggle and find balance between the many different roles in health care? 9:53 The importance of enjoying life above all 11:50 Erzurum on surrounding yourself with people that respect your life choices 15:00 Paving the path for others; being a good mentor and leader 16:35 Erzurum on trusting and communicating with your mentors 20:00 Working through ‘imposter syndrome’; dealing with failure and self-doubt 21:45 Times when Dr. Erzurum faced disappointment and failure. 25:32 What do you do for fun? 28:15 Have you inspired your daughters? 30:12 Why don’t we expose specialists and trainees to specialties outside their own institutions? 31:44 What skillsets should trainees work to improve during Fellowship? 36:02 Final thoughts 39:15 Outro 41:18 Serpil Erzurum, MD, is the chief research and academic officer at the Cleveland Clinic. She is also the chair of Lerner Research Institute. We’d love to hear from you! Send your comments/questions to Dr. Bhardwaj at [email protected]. Follow us on Twitter @HealioPulm @abhi_bhardwaj99. Disclosures: Bhardwaj and Erzurum report no relevant financial disclosures.

We all will be at the receiving end of critical illness for ourselves or our loved ones. It is almost guaranteed. A family’s needs are the blind spot of the overstretched and dysfunctional health care system that needs to be addressed. Here, Kristin Flanary, also known as Lady Glaucomflecken, shares her experience, hoping to highlight the challenges of the families who are at the revived end of critical illness for their loved one. Take-home lessons for health care professionals: While clinical excellence and focus on the patient is an absolute given, what sets a great HCP apart is clear and frequent communication, empathy and kindness. Let’s do better. Intro :00 The interview :39 Tell me a bit about yourself. Where did you grow up? What was life like before and now? 3:40 Having to do CPR on your loved one 13:01 Can you share with me what exactly happened when your husband went into cardiac arrest? And what can we do better? 20:47 The experience of being in the hospital 28:42 How did you manage being kicked out of the hospital? How long was he in the ICU and in the hospital for? 47:25 The struggle starts for patients and families when they come home because now they don't have the same support system. Can you share some of those struggles? 55:10 We are almost 21 months out from the cardiac arrest at this point. How are you both doing now? 1:02:14 Spreading the message about sudden cardiac arrest and learning to do bystander CPR. 1:05:32 Can you share a happy moment or memory since the cardiac arrest event? 1:11:15 Flanary’s message to listeners 1:16:15 Thank you, Kristin Flanary 1:18:32 Kristin Flanary, MA, is administrator and communications manager at Belin-Blank Center for Gifted Education & Talent Development at the University of Iowa. To read Flanary’s article in Journal of Cardiac Failure, click here: https://www.onlinejcf.com/action/showPdf?pii=S1071-9164%2821%2900403-6. We’d love to hear from you! Send your comments/questions to Dr. Bhardwaj at [email protected]. Follow us on Twitter @HealioPulm @abhi_bhardwaj99. You can follow Kristin Flanary on Twitter @LGlaucomflecken. Disclosures: Bhardwaj and Flanary report no relevant financial disclosures. 

Kristin B. Highland, MS, MD, does it all and makes it look easy. In this episode, we discuss how to follow your dreams, balance your life and define success on your own terms. Intro :01 About Highland :16 The interview :33 At Cleveland Clinic, we don't care about your birth coordinates. We care about who you are and what you bring to the table. :54 Imposter syndrome 3:15 Tell me a bit about your background, your personal life, your professional life. Where did your journey start? 7:48 The nonlinear journey to success 30:48 The end of fellowship is not the end of your expertise 37:11 Balancing work and family as a single mother 39:38 Best advice to be a good mentee 45:43 What other skill sets should fellows acquire during training beyond clinical excellence? 46:51 Thank you, Dr. Highland 51:41 Kristin B. Highland, MS, MD, is fellowship trained in both pulmonary/critical care and rheumatology and is the respiratory institute research officer and associate program director for research and scholarship at the Cleveland Clinic. We’d love to hear from you! Send your comments/questions to Dr. Bhardwaj at [email protected]. Follow us on Twitter @HealioPulm @abhi_bhardwaj99.

In this episode, E. Wes Ely, MD, MPH, discusses the value of human connection with patients, reflects on the values of hope and mercy in patient care, and reads key excerpts from his book, Every Deep-Drawn Breath. Intro :01 About Ely :21 About Every Deep-Drawn Breath :49 The interview 1:20 Impact of Ely’s work 1:37 Tell me a bit about your background. Where did this all start? 5:32 Do you think if you spend enough time and cater deeply enough, you can create that human connection? 9:24 The other side of the bed 15:00 The story of Jimmy Johnson 29:49 Bringing back normalcy in the ICU for patient healing 35:11 How do you bring hope during this dark period? 40:20 Spirituality in patient care 44:57 Significance of Every Deep-Drawn Breath 51:03 Thank you, Dr. Ely 53:50 Wes Ely, MD, MPH, is professor of medicine and critical care at Vanderbilt University Medical Center and associate director of aging research at VA Tennessee Valley Geriatric Research and Education Clinical Center. We’d love to hear from you! Send your comments/questions to Dr. Bhardwaj at [email protected]. Follow us on Twitter @HealioPulm @abhi_bhardwaj99. You can reach Dr. Ely on Twitter @WesElyMD. Disclosures: Bhardwaj reports no relevant financial disclosures. Ely is author of Every Deep-Drawn Breath.

In this episode, Bhardwaj’s mentor, Benjamin S. Abella, MD, MPhil, FACEP, FAHA, discusses the importance of a strong mentor-mentee relationship, his path into internal and emergency medicine training and much more.   Intro :00 Welcome to another episode of Vital Capacity :19 About Abella :28 The interview 1:40 Tell me a bit about yourself in your own words 1:54 The importance of blending the personal and professional aspects of academic mentorship 5:00 How do you find balance? Define a day for me 8:41 You’re one of the few people in the country who are trained in both internal medicine and emergency medicine … Can you share with me how that started? 11:50 If someone wants to have a physician-scientist career, what advice would you give them and do you have any experiences and examples you can share? 18:21 After you were trained in emergency medicine residency and the resuscitation fellowship, you are now leading all these efforts at Penn. When did that transition happen? 21:14 Can you share some of the ways you navigate talking to other physicians and convey the message of timing of cardiac care after cardiac arrest? 29:11 Can you tell us the story about the soldier and the use of cardiac cooling? 34:53 Thanks so much, Ben 39:33 Benjamin S. Abella, MD, MPhil, FACEP, FAHA, is the professor and vice chair of research at University of Pennsylvania’s Department of Emergency Medicine. He directs the Center for Resuscitation Science and the Penn Acute Research Collaboration at the University. We’d love to hear from you! Send your comments/questions to Dr. Bhardwaj at [email protected]. Follow us on Twitter @HealioPulm @abhi_bhardwaj99. You can reach Abella on Twitter @benjaminabella. Disclosures: Abella reports receiving honoraria from Becton Dickinson, Stryker and Zoll; research fees from Becton Dickinson, NIH and PCORI; and ownership in MD Ally and VOC Health. Bhardwaj reports no relevant financial disclosures.

This week, FDA advisory committee unanimously recommends Moderna booster shot; the USPSTF advises against aspirin for primary CVD prevention for adults 60 years or older; FDA permits marketing of new e-cigarette products; and more. Read the full coverage here: FDA advisory committee unanimously recommends Moderna booster shot USPSTF advises against aspirin for primary CVD prevention for adults 60 years or older FDA permits marketing of new e-cigarette products, marking first authorization of its kind More than half of COVID-19 survivors experience symptoms 6 months after recovery FDA issues new guidance on sodium, calls it ‘pivotal’ moment in US health References: FDA Press Release USPSTF Statement Press Release Groff D, et al. JAMA Network Open. 2021;doi:10.1001/jamanetworkopen.2021.28568. FDA Conference Call

This week, use of systemic corticosteroids is linked with worse covid-19 outcomes; an investigational antiviral drug reduces risk for hospitalization and death by about 50% in patients with COVID-19; Pfizer-BioNTech submit vaccine data for children aged 5 to 11 to FDA; and more. Read the full coverage here: Use of systemic corticosteroids linked with worse COVID-19 outcomes Antiviral reduces risk for hospitalization, death by about 50% in patients with COVID-19 Pfizer-BioNTech submit vaccine data for children aged 5 to 11 to FDA Unlike flu, cold viruses persisted during pandemic, study finds AstraZeneca COVID-19 vaccine 74% effective, protects against asymptomatic disease References: Yochai A, et al. Asthma treatment: clinical and translational science. Presented at: European Respiratory Society International Congress; Sept. 5-8, 2021 (virtual meeting). Press Release Press Release Rankin, DA, et al. Abstract 154. Presented at: IDWeek; Sept. 29-Oct. 3, 2021 (virtual meeting). Sobieszczyk M, et al. Abstract LB6. Presented at: IDWeek; Sept. 29-Oct. 3, 2021 (virtual meeting).

Eduardo Mireles-Cabodevila, MD, is an internationally renowned "Guru of Mechanical Ventilation and Neuromuscular Disease." He is also a fearless leader in the ICU. In this episode, he shares his journey into medicine and how he developed the “10 commandments” of fellowship research. Intro :00 Mireles, thank you for joining me today :19 The interview 1:07 In your own words, tell me about your journey … How did this start? 1:13 How many years is med school in Mexico? 4:45 And you did internal medicine residency after that? 5:43 So, you did you 2 years of training there and then moved to the U.S.? 6:36 I have heard that you had tried to call the secretary back in the day at the Cleveland Clinic and you were not getting to the person … and then eventually you became the boss of the same secretary. 9:43 You just briefly touched on the value that your wife played in your life. Can you tell me a little bit more about your family? 11:23 Were the initial few years hard in the U.S.? 12:40 What other challenges did you navigate? 15:03 How did you become so fearless? 18:26 How did you get into these different roles? 23:29 Tell me a little bit about how, after almost a decade of this leadership position that you have, how do you prevent burnout? 32:13 Where are some of the favorite places you have traveled? 37:43 Do you read a lot apart from the books that you need to double up your expertise beyond what everyone does? 39:53 You’re known as the “ventilator guru,” and that’s how you’re educating the world, not just the Cleveland Clinic. How did you get better at it? 41:45 I remember being told a story that you were working on a research project, and you didn’t find anything meaningful there and you turned that disappointment into the 10 commandments. Can you share with me what that was? 46:25 What’s your most important advice to the listener? 49:38 Thank you so much for your time, Dr. Mireles 50:23 Eduardo Mireles-Cabodevila, MD, is the director of the Medical Intensive Care Unit and medical director of the Simulation and Advanced Skills Center at the Cleveland Clinic. We’d love to hear from you! Send your comments/questions to Dr. Bhardwaj at [email protected]. Follow us on Twitter @HealioPulm @abhi_bhardwaj99. Disclosures: Bhardwaj and Mireles-Cabodevila report no relevant financial disclosures.

In this episode, Atul C. Mehta, MB, BS, discusses his path to become a physician, his early struggles once he arrived in the United States and some of the changes he’s witnessed in how bronchoscopies are performed. Intro :00 About Mehta :23 The interview 1:25 In your own words … how did you get into medicine? 2:14 Can you share a little bit about your initial struggle coming to the United States? 7:10 Is your altruistic nature as a physician and mentor a result of coming from a humble background when you started your medical career? 13:14 You still work 15, 16 hours a day for almost 50 years … How do you have the energy to do that? 17:10 What have you seen that has changed from when you saw your first flexible bronchoscopy to now? 20:07 How do you find time for family with all you do and how do you do justice with that? 24:53 How do you prevent burnout in this demanding career? 28:21 You have worked in different countries … how did those things happen? 33:15 How old were your kids during your time working in India and Abu Dhabi? 37:01 I know you have family in Bollywood … are you a big fan of Bollywood? 39:42 Do you have a moment to share any failures that you felt were really important to learn from? 40:30 Do you have very fond memories from your childhood, or any med school quotes that you think of? 43:37 Is there anything else you’d like to share? 45:40 Thanks for listening! 45:49 Atul C. Mehta, MB, BS, is professor of medicine, Lerner College of Medicine; endowed chair in lung transplantation, Cleveland Clinic and founder and president of the American Association of Bronchoscopy. We’d love to hear from you! Send your comments/questions to Dr. Bhardwaj at [email protected]. Follow us on Twitter @HealioPulm @abhi_bhardwaj99. Disclosures: Bhardwaj and Mehta report no relevant financial disclosures.