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Dating, Doctoring & the AI Era
92 Plays1 month ago
In this episode, our hosts Dr. Isabella Ntigbu MD, Dr. Aldwin Soumare DO, and Dr. Dumebi Okocha MD discuss dating in your 30s in medicine, the relevance of AI as a potential threat to physician careers, as well as some current events from around the nation. Tune in for their opinions, hot takes, and a couple laughs along the way.
Please join the SNMA for AMEC 2026 in Pittsburgh, PA held from April 1st - April 5th.
Register for AMEC 2026 here !
To share your thoughts on our discussions or if you have any questions to ask our hosts, email podcast@snma.org for a chance to be featured on the show
Disclaimer: The opinions and views expressed on our podcast do not reflect the official stance of the Student National Medical Association.
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Transcript
AMEC 2026 Conference Overview
00:00:00
Speaker
The views expressed on this podcast represent only those of the hosts and do not represent the views of the Student National Medical Association. AMEC 2026 will be held in Pittsburgh, Pennsylvania at the David L. Lawrence Convention Center. from April 1st to April 5th, 2026. This year, the conference is entitled Bridging Generations with Hope, Illuminating the Voices and Visions of the Future of Medicine.
00:00:26
Speaker
AMEC 2026 will bring together over 3,000 pre-medical students, physicians, alumni, and healthcare care professionals from across the country for a vibrant and empowering experience.
00:00:38
Speaker
Join us this year in Pittsburgh as we build bridges to inspire hope, strengthen bonds, and empower the bold visionaries who will transform healthcare care for generations to come.
Introduction to The Lounge Podcast
00:00:49
Speaker
To register, make sure you click that link in the description box below. Now you know what time it Yeah, let's start the show, baby.
00:01:14
Speaker
Welcome to SMA Presents The Lounge. Whether you are a student in the lounge, doctor's lounge, or lounging around at home, get ready to join SMA for meaningful conversation on topics affecting minorities in medicine and groups that often sit at the margins of healthcare. Happy New Year's, everybody.
Reflecting on Celebrations and New Year's Resolutions
00:01:30
Speaker
Um, 2025 was definitely a memorable year and people have already started the process of reminiscing on the past. Um, like the Instagram challenge, the 2016 throwbacks. And as we get kickoff 2026, what are some holiday traditions and memories from the past few weeks that you've been thinking about?
00:01:48
Speaker
My name is Dr. Sumari and my name is Aldwin. Uh, hi everybody. Uh, Happy New Year to everybody ah that's listening Happy New Year to everybody on the pod. Love y'all, as always.
00:02:01
Speaker
But um yeah, it was it was a good holidays. My favorite memory was going to a gala in New York City in Manhattan to celebrate. um Black excellence. We celebrate a lot of black health organizations. We gave away toys too as well. And the proceeds went to underserved communities, children underserved communities too. It was lit, man. We was dancing all night.
00:02:22
Speaker
I was missing all the dance halls, soca, reggae, because you know in Sacramento, don't got yeah know none of that You what I mean? So it was like I was back where I needed to be refreshed and and re-entertained and being around black excellence.
00:02:36
Speaker
And I would say 2026, like my vibes this year is to continue. um I'm doing dry January and I've lost like eight, seven pounds on the last few weeks.
00:02:48
Speaker
So I think like realizing like, you know, cutting back on the licks, man, I got chill on the weekends and I've been feeling really good. My skin looks, you know, I see my skin looking real good, right? Yeah. dick yeah so yeah i want to continue doing that like decreasing my alcohol intake and then staying um physically active so i've been in the gym every day pretty much and i feel good my mood is good um my life is good and i'm just missing one essential component which we'll talk about on the pod later on that one viral okay
00:03:23
Speaker
I like that little that little thing at the end, you know? It's like almost like the foreshadowing of what's to come. um Happy New Year's, everybody. This is Dr. Isabella. um Yeah, I think what are some of my favorite holiday memories from these past couple weeks? Well, I clearly travel every year for my birthday. My birthday falls on New Year's Eve, so I am never in the country on my birthday these years. So I was in Costa Rica. I had a great time. It was relaxing. it was very... It tranquil. The um natural landscape was very beautiful. I got to do horseback riding. I got to be at the beach. I got to um see the fireworks at one of like the downtown squares in San Jose. so it was really great. And honestly, like i needed it was like a two-week break for me. And then afterwards, I got see family, friends like back home.
00:04:14
Speaker
Dope. So I feel like I needed that because you know residency you know is tiring. um And I felt like that was a good way for me to kind of reset and refresh and and just reprioritize what I'm hoping this year will look like. Hopefully, 2026 will be much better than 2025.
Social Media Detox and Personal Fulfillment Goals
00:04:32
Speaker
I've loved the 2016 throwbacks I've been seeing because 2016, I feel arguably, was probably one of the best years I've ever had in my life. So so kind of seeing everybody like go back to that year like i think that was the year I graduated high school. I started college at Howard. like Life was great. So I'm hoping 2026 will be like a throwback of that. um And in terms of New Year's resolutions, um honestly, my New Year's resolution is actually to doubt like to use social media less. I feel like this world right now is like really chaotic. And you know on social media, that's like all I see. And it just kind of brings you back to like
00:05:10
Speaker
all the negativity and, you know, granted, I'm not going to talk it and discuss about it on this platform, but I think we kind of all understand what I mean by that. And i just want to, I want to be off that stuff. Love. I want to be more present in real life. Um, so that's really going to be my goal, especially like, as I'm continuing to like get further and further in residency, I feel like it'll help me stay more focused and like continue to be present and showing up and like learning and growing as a physician. So yeah, I would, I would say that's kind of mine.
00:05:39
Speaker
Yeah, all great. I would say for me, I'm doing maybe, by the way, it would be guy in resident. um I would say for me, um New Year's strategy resolution would be to like, maybe like, gain more hobbies. So i was kind of thinking about like, what do I do outside of work outside of, you know, watch TV, read about work and scroll.
00:06:00
Speaker
So I guess this year would be more of finding something else I like to do um And then I'm also getting married this year, so I guess my hobby will be planning a wedding. But after that, I guess I have to find another personality. So doing something like that would be great. And then just like you said, Isabella, just be more intentional with your time and not doom scrolling all the time. I think I've definitely, even looking at my phone now, I just want to move my thumb. There's nothing I'm looking for. Right. That's crazy. That's why I need something else do my time. Yeah.
00:06:36
Speaker
Becoming a gym shark or, you know, swimming. i don't know, man, like trying something different. I just think that because I've moved, you know, so much in my life, like this is like my seventh move. um I think it's hard to like,
00:06:49
Speaker
find roots in an area that you reside in and, like, you know, like, find, like, commonality in that group, if that makes sense. So just being like, okay, i'm in Cincinnati. Let me find something that the Cincinnatians do and, like, kind like, be a part of the culture here um and just make this place more of like, a home for me, so.
00:07:06
Speaker
Right. In Cincinnati? How's that going? I mean, i like Cincinnati. I think... You know, it's a really big, not really big city, but there's like a a lot to do. there's also the Kentucky side, which is pretty cool. So I don't mind it, but it's definitely not my forever. It's definitely like a pit stop but um for the greater um the greater purpose, for sure. so Great. Love it. Well, on that note, um it's time for us to kick off Run
Measles Outbreak and Vaccination Challenges
00:07:37
Speaker
the List. So for our preclinical students, running the patient list on the wards allows the team to address pressing matters of the day. In this segment of the show, we'll be discussing some recent events in medicine and beyond affecting our communities and the populations we serve. So um this is...
00:07:52
Speaker
We're in wintertime. It's currently flu season and all the seasons for different kinds of bacteria to be roaming around. um Something that we know to be a preventable disease with vaccines um has now been found in Oregon. We've had our first measles case of 2026. There was actually three cases reported on January 16th of this year, according to abc News News.
00:08:18
Speaker
In Oregon and Portland, they reported that they were investigating two cases of measles and want people to know about locations where they might have been exposed to this highly infectious virus. um It seems like it was Lebanon Community Hospital in the ED as well as Albany General Hospital in the ED that they discovered these cases. um They developed the typical symptoms, rash, fever, cough, runny nose.
00:08:38
Speaker
They, of course, were not you know giving the ah personal information in terms of gender, age, or county of residence for these patients. um However, um they wanted people to know that if you were at these locations during these dates um between January 6th and January 7th, that they should contact their healthcare provider immediately and let them know that they have a potential exposure to somebody who had measles. um And then at that point, they can determine whether or not they're immune to it based on their vaccination records or not. um According to Howard Chu, MD, a PhD medical director of clinical diseases at
00:09:11
Speaker
Oregon Health Authority, he so he states measles here is here in Oregon and rates are increasing nationally, which is why we encourage everyone to make sure they're protected by talking with their providers about being up to date on vaccinations. um There's a couple of public health departments you can reach 24 hours a day if you have any you know suspected cases. um And yeah, I think another thing to really highlight once again is this vaccination situation in terms of you know declining coverage by people who are deciding not to take these vaccines. We know that vaccines have kind of been under attack um in turn from more of a ah federal level in terms of who is kind of managing that. And we even now have talked about in a prior episode about Hep B now potentially being optional, or I think now it is optional. So there's kind of a lot of changes happening from a vaccine front. So I would like to ask you all, you know, how can people kind of continue to keep, of course, this spread of measles down and um what can they, what can be done to make sure that they actually go to get checked out? Because there are some ah overlap in symptoms when it comes to like measles and maybe something like as simple as the common cold, like how, what can we do to make sure people are aware of, Hey, you might have something that is like a more serious disease and to get checked out.
00:10:30
Speaker
um So this is why I always kind of say that OBGYN is definitely primary care because one of the routine things that we look for like in our new OB labs is if you're rubella immune and as you know, the mumps, measles, rubella vaccine, um you can get postpartum.
00:10:48
Speaker
ah Definitely not when you're pregnant if you are rubella not immune. So it's very interesting how like even in pregnancy you get the most care you'll ever get in your life and you even know if you're immune so you can get re-vaccinated so things like this don't really happen. um So it's definitely very dangerous that they're declining like m MRI or sorry, m MRI, and MMR coverage. um Because it's one of those things that we routinely check for um in like the OB world. um So definitely very dangerous. And I didn't know measles was still, I mean, i knew it was a thing, right? But because of like how vaccinated, I mean, when I, went back in 2000, I was vaccinated. You what mean? Like this just wasn't like a thing. So I, I'm scared, honestly. I think it's weird. Yeah.
00:11:33
Speaker
Yeah, I'm not surprised just because of seeing what's happening on the agenda on the federal level. We know um what has been done and there's a certain level of thought that is manifesting across the country regarding vaccines and safety for our children. And that's being corroborated by what's happening in federally. So unfortunately, you know, this is something that I encountered last year when I was in family medicine, many patient um many children's families were denying vaccines outright they come into the clinic, but that puts other children um in a state of exposure too, as well. And that's something that's not talked about either, but I feel,
00:12:18
Speaker
um That we you got to continue to be in these spaces, you know, continue education, continue to be ah in the school systems and having conversations with parents, even if they're not interested, because I feel like ah some pediatricians give up when they're like, oh this parent is like, we know what type of time they're on, but still even having that initial conversation, one to two minutes, like, hey,
00:12:39
Speaker
I suggest that you get this vaccine. If you're not interested today, that's okay. But it is my duty to protect our children and to protect you as well and the welfare of of of people in the community here.
00:12:52
Speaker
And i i just listened to a podcast and even ah RSV is now ah one of the vaccines that a pregnant woman can receive and has been associated with decreased hospitalizations for babies with pneumonia and RSV overall. So there's plenty of studies. And I would even say print out the articles and give it right to patients. You know what saying? It may be beyond the scope, but it's like, what do I have to lose to lie to you? Why would I lie to you about what vaccines do?
00:13:19
Speaker
You know what I'm saying? so um that's my thought in regards to that. And, you know, we got to just continue to push the pedal um with this agenda toward our constituents of patients and children and and continue to advocate on a federal level too.
00:13:37
Speaker
Yeah, I think that's super important. And especially within the ED, I mean, just look at the fact that both of these cases, right, were discovered in emergency departments, which is good to show you that we are the first line. Be careful. Unfortunately, me, I'm the one, right? God forbid someone comes in. I'm the first person that that patient is seeing. And ultimately, I'm face to face with a lot of presentations that I may not even know the severity of it, which is why we got to stay masked up, gloved up, you know, all those things. Um, but I, every day I pray. So that's kind of what keeps me going.
00:14:12
Speaker
God is my protection in that place. right um Yeah, so yeah, I think um it's good that we're talking about um the reason why vaccinations are so important. And even despite what we would be hearing on a larger front from other people who aren't actually healthcare, care we understand the consequences when people do not take vaccination um ah compliance seriously. So yeah, I think it's good that we discussed this.
Black Men in Medicine: Family and Dating Challenges
00:14:42
Speaker
Yeah. Well, with that being said, it was great to hear about the vaccines. But I think another topic we, you know, are definitely going to have some fun with and talk about is a recent post that I did talking about on Instagram, talking about being unmarried, being a black man in medicine.
00:15:03
Speaker
2026, I'm 35, no kids, not married, and some days that reality sits heavy. As a black man, I feel there's an unspoken pressure. We got build, to provide, to create legacy too. like Otherwise, we're not valid.
00:15:16
Speaker
honestly don't want to be a 45-year-old raising a one-year-old child. I want to be at an age gap. that could run and play with my children. You got Al Pacino and a number of guys raising their children in the 80s and it's no way, dog, that's gonna be me. I also wanna be a baby father. i wanna to be present.
00:15:30
Speaker
I wanna build meaningful family intentionally. My father had me at 32 and I'm three years removed from that. So right now I think about time, I think about increased social association with autism and older fathers. I chose medicine, and I need to say this out loud, career focus affects men too.
00:15:47
Speaker
I really feel like moving so many times and lifestyle pursuing my dreams has prevented me from creating real stability. Long hours, always being ready, almost ready for the next phase of my life. See, recently someone came into my life saying she wanted a man, talked about building, talked about a family who was aligned or so I thought.
00:16:06
Speaker
But over time, i realized she didn't want partnership. She wanted attention. And when the i asked the real questions, the truth showed up. She said she was interested, but the distance was too far.
00:16:18
Speaker
Whatever that means, that won't hurt because I showed up, I invested, I poured in flowers, consistency, respect, and men deserve care too. We feel rejection deeply. I'm not bitter, but I'm clearer. And I just hope this next chapter brings alignment, not wasted time. And I hope you guys hearing this, all the men hearing this, don't give up, don't lose hope.
00:16:40
Speaker
But for my men, 30 and older, what y'all think? Like, how's y'all feeling about family and moving forward in your future? Because for me, it's looking real spooky. I'm not going lie. And I'm a little scared, but still optimistic.
00:16:54
Speaker
And i mean, this stemmed from conversations with women and just people in general across a time phase of the last several months and particular experiences that I've had.
00:17:06
Speaker
um And seeing like a lot of my homies, ah you know, being in positions where they're relationships, they thrive in. and feeling a sense of emptiness and isolation. Because it's like, yeah, you got your professional goals and your accomplishments, but at the end day, what does that mean? you know When you leave your legacy, people not necessarily always going to think first, to oh, this guy was a psychiatrist. ah It's like, yo, what did you do? like How did you make people feel? What did you create?
00:17:33
Speaker
And part of that creation to me as a man is creating a family, having bonds, everlasting bond, with somebody, particularly a wife. And um when this IG post went down, it was like interesting because I was speaking it speaking to it from the perspective of black men.
00:17:52
Speaker
And oftentimes people think, oh, yeah, you're a black man in medicine. You got all the options. But that's not true. You know i'm saying? In my experiences, I'm talking for me, I don't got all the options that I desire, you know what saying, or that i'm I'm interested in.
00:18:05
Speaker
I keep it like that. Because lot of people, oh, yeah, nobody's hitting me up. Like nobody. Now it's the options that I'm not like interested in. That's like trying to rock with me. You know, mean, just like women got standards, you know, men got standards as well.
00:18:17
Speaker
You know, I want a want a woman that's accomplished. That's, you know, it'd be nice if she's also in the profession, too, that's, you know, able to connect, support, encourage me.
00:18:28
Speaker
you know, that's down to earth, humble and all that good stuff, God fearing. And I feel like, um, to be honest, some people may feel type of way, but this post was for black men. I'm talking about black men and experiences that we got.
00:18:41
Speaker
Like, we don't talk about that. We are not, uh, reinforced or we are not encouraged to talk about these experiences of isolation. And even I just saw a real ah Jason Derulo talking about this. Like he's 37 and it's like, damn, like,
00:18:55
Speaker
i I should have been married mad times, but it didn't even work out. You know, I'm out here like grinding, doing my thing and I don't feel like I got identity. And that's how I feel right now. Like, I feel like I don't got an identity. I'm going through a midlife identity crisis type of situation.
00:19:10
Speaker
and I think that this conversation beckons like, what is is missing in people's lives? Because there were a lot of men that were saying the same thing and some were like, yo, I don't really care about like finding a wife.
00:19:22
Speaker
You know, if it happens, it happens. But like, for me, I'm like, I'm trying to move with intentionality. there I'm not trying to be old. Like I said, Nicole. I'm not trying be 45, 50, like having children and none of that.
00:19:32
Speaker
Like, you know what mean? Like I'm trying to be where I'm at right now and start building, which is very important to me. So with that being said, want to hear your thoughts with me.
00:19:44
Speaker
Yeah, you know, so one, as I give my thoughts, I just want to commend you, Dr. Aldi, for being um open and vulnerable, both on your personal social media platform, but then on this podcast and being willing to discuss something like like you've already said that a lot of Black men actually don't typically talk about out loud. And I think that, you know, a lot of times Black women were very vocal. I'm very vocal about the pitfalls. It's years ago, you know.
00:20:13
Speaker
ah of dating um as a black woman in medicine, but then, you know, I'm not gonna hold you. Sometimes I have this bias that, well, black men can't possibly like be going through what I'm going through. Cause it's like, you have the ability to choose, right? Like men get to choose and men get to pursue yeah versus women are more on the receiving end of like, you know,
00:20:32
Speaker
wanting to be chosen or wanting to be pursued so a lot of times i just feel like the onus is like more on the man and like it's more so when he wants to move um so i just assume like what complaints could you have about it you're like hitting so many milestones you have like your career in order you're a black man you're handsome, like all of these things that maybe most women would, you know, not complain about or have any hesitancies about versus women don't necessarily get to have that same, like I would say um ability to um coordinate or, or lead that aspect of their life. So hearing you kind of talk about like,
00:21:05
Speaker
some of these other barriers that I've also faced, like moving around, not really getting to be like in one place, like not necessarily having the time maybe to invest in that aspect of your life because you are pursuing a career. I think those things are valid. And I think like, you know, you kind of opening up that conversation can allow, say someone like me to also think about it on the other side of the coin. Like, okay, why is it this like successful black man not even interested in like dating seriously or he's not moving like with any type of integrity or he's not moving with like any, um, maybe wanting this to actually pursue something with intention, but there could be other things happening behind the scenes that I'm not necessarily aware of. So I think it's a important conversation to have. And it allows to even as black people in medicine, it start to kind of heal some of those like miscommunications we have about like why dating doesn't work between black people in medicine sometimes, you know? So yeah, I'm grateful for you kind of opening up that conversation. so that's kind of my thoughts. Thank you, Izzy. thought you was going to try to get at me. hey You know what mean? I'm quite shocked. was ready for it.
00:22:14
Speaker
um Yeah. Do maybe as someone who's like about to be married, I don't know if you have like any thoughts. I'm very interested in. Yeah. know I think I. Okay. So when I was looking at the scripts before all this, I went through my phone and I looked at like,
00:22:31
Speaker
the black American male mentors that I've had in medicine. um So like non IMG, like born and raised in America through the process here and how many of them were married to black women? I got 12 on my contacts. and 10 of them are married to white women.
00:22:49
Speaker
Hey, Jesus. Don't start. Don't start. Don't start. I didn't even talk about anything with white women. Honey date black woman, but gonna let you go. No, I don't really care who anyone dates. You know, white, black, cream. I don't really care. not cream but What I do know is that when I was in the process of finding a mate, right, I knew it wasn't going to be in the confines of the school of medicine.
00:23:17
Speaker
Black men there or not because the black men that were there. Sorry. Love y'all all my SMA homies Yeah, but I knew you who you guys were dating and it wasn't people like me. So I went to the engineering side of things the next week people know That's where I kind of looked for people who want to be with people like me So I think like it's kind of hard I, it's hard to not to, what's the word?
00:23:49
Speaker
Your perspective is like very different that I haven't heard. Right. Because what I saw in my medical school is that they had the leverage and they could honestly pursue. There's so many black women there. There are so many women in general in medical school that they were like the, the prize in a way, because there were like 60% of my med school were women and there were only a certain amount of men. So they were the ones being pursued. And then they chose who they wanted at the end. So In my opinion, as like a black woman in medicine, I just knew just from where I was, it just wasn't going to happen. I always wasn't going to marry another doctor from my med school. You know what I mean? So I just looked elsewhere. And I think that's what, at least what black women have to do. You have to look like, in my opinion, you kind of have to look out, out, out because the hospital is very small. And it's from the statistics that I saw in my contacts.
00:24:45
Speaker
That's just kind of what it gives a lot of times. Sorry, but that's just kind of like my opinion on it. I would say my experience, all my homies that's in med school or residents or doctors, they're married to black women. So um when I, when I, even recently I saw there was a stat like over 88% black men.
00:25:07
Speaker
who make six figures are married, so black women. So seeing that, you know, it is what it is. Do we know how legitimately the statistic... I mean, I believe it because I see it. Like, I see what's up. Like, I got mad homies that's in medicine. You know I'm really tapped in. So I know there are exceptions to the rule when people are going to make decisions.
00:25:32
Speaker
But ah source, we we don't got no source, bro. Wait, so hold on. This is so... that that I actually... i so Okay, how do i kind of frame my thoughts here?
00:25:46
Speaker
I still align with everything that I said prior, right? And like, just because I said what I said doesn't mean that I can't also see like all the sides of the situation, right? Like I do think that ultimately there is some truth want to be saying in terms like, if we even look at like, celeb like athletes, right? And how a lot of them get with like, now and i mean how many athletes are there that are six figure earners compared to the overall population of black men are six figure or earners? No, that's fair. They make up like a slice of the population. And honestly, in medicine- Very very small slice.
00:26:16
Speaker
Yeah. and And honestly, in medicine, I can only really go off of like what I've seen more so in terms of my exposure to black men in medicine. Like I would say at my school, it was probably more like half and half where some were with like non-black women and then the others were with like black women. So I definitely, it wasn't just like everybody was with a black woman. um So I do, you know, I'm not trying to say that like those things, are not true in terms of black men probably wanting to pursue black women but i do think there's a little bit maybe of a mismatch or imbalance when we talk about who values like being a partner who's black is it more women or black men and i do feel like i've heard more black women being more strict than like i can only be with the black man i haven't really heard that too much with black men doing that same thing with like, oh, mike my option can really only be with a black woman. And that's just my experience though, right? but I'm not saying that, you know, there's not black men who are like very like gunk ho saying, oh, be with black woman. Cause I'm sure there's men out there who are like that, you know? So I think it's like, once again, it's more so like these conversations and kind of like these differences and experiences are really just based on what we're exposed to, what we kind of see. And like, there's so much nuance to it. I think in general,
00:27:23
Speaker
we can all agree that it's hard to pursue romantic relationships as a black person in medicine, period. but i don't There it is. Thank you. Thank you. We need a part two, though. we won Yeah, we that one we definitely need a part two. And I think like this is just a conversation that I'm glad that we've started, especially you, Aldrin, once again, like kind of opening up that platform for black men to talk about it Because once again, i feel like a lot of times we don't hear their side of things. We just kind of like say, this is like a horrible experience. like Black men but in medicine are...
00:27:51
Speaker
like, you know, horrible options that they don't value us. And it's just us talking to the abyss. I want to change that. we don't hear her response. Sorry, black queens. I value y'all all the way. I love y'all. And only y'all. Yeah. So i I personally thought this was a great conversation. And we definitely, for sure, for sure, need to come up with but a part two. And hopefully, if you catch us at AMEC, who knows? We might find a way to even have a larger discussion about this at one of our you know, events. So I think this is something that our listeners always value is us kind of talking about these kinds of conversations. So yeah, it was a great conversation.
00:28:28
Speaker
In other things, you're talking about people in medicine, but how about there's no one in medicine like Elon Musk thinks is going to happen? He's mad. He's crazy, bro.
Debating AI in Medicine
00:28:38
Speaker
Sorry, Elon, I'm bad. But his hypothesis is that because of ai has been, you know, taking over technology and some aspects of medicine, that all of a sudden we're just sort of replaceable. And he said in the next three years, people won't need to go to medical school because AI will be running things and people will receive
00:28:58
Speaker
you know, president presidential level healthcare due to ai And he said a lot of things that I'm not really going to read because I don't really believe in it. he was on a podcast thing, all this other type of stuff. But I wanted to kind of ask you guys, one, your thoughts about it. And then two, do you think your specific specialty, so we've got psych here, emergency medicine, obstetrics, can we be replaced by AI?
00:29:26
Speaker
That's kind of what I want to talk about. Actually, I just listened to a podcast on this. It psychiatrist talking about like AI so psychosis and all these kind of things for the patients. But in terms of as on the physician side of things, I don't think within the next 10, 20 years, AI could replace us. Because remember, we navigate a very abstract reality, abstract dimension, which is the mind. And to be able to to interpret and understand the mind is there's no calculations. There's no textbook.
00:29:55
Speaker
There's none of that. Right. It's really, so you know, ah spending time with patients and learning human qualities and understanding those human qualities and emotions along the spectrum. So for AI to be able to do that is it's going to be it's going to have to be like very complicated in advance. I kid you not, like I do, I'll be on ChatGPT, like it'd be putting me on you know what I'm saying? When I'm doing content and things that nature and you can have conversations with it. We have apps where people are forming relationships and bonds with AI.
00:30:24
Speaker
But in terms of like from the psychiatry perspective, it I don't think it's going to be very realistic. And we do know that there was, ah AI was able to take the step one or step two exam and it was able to pass. I think it got like 65, 70% of the questions. Okay. on that But again, that doesn't mean that it has the capabilities to diagnose and remember, patients, and I can't speak for every field, but I will say this, patients do not read like a textbook, someone with lupus is going to may look different in one person than it is another person, the same thing. In psychiatry, someone with borderline personality disorder, one person may do engage in a lot of self-harm. Another person may have what we call pseudo psychosis and start to have hallucinations. But that person may have specific hallucinations to themselves and not the other person with BPD. So it's different. You know i'm saying? So with that being said, I don't think that it's going to be able to like navigate those different trajectories and spectrums of people and patients.
00:31:25
Speaker
Yeah, I totally agree. um So emergency medicine, clearly everyone has their opinions about it, and it's a specialty that I think is only made for a certain kind of person. But I will say that a lot of people from the outside looking especially if you're medicine, think that it's formulaic. You can just put in a bunch of different symptoms and somehow pop up with the differential. Yep. differential is half of the battle, right? Because like you said, Aldwin, someone can come in with potentially this, but because of clinical experience and knowledge, you can kind of tease out the difference and say, actually, this doesn't really seem to look exactly like that. This also kind of could look like this. And there's kind of like a fine-tuned balance with medicine where the things that you learn in a textbook don't always look the way that is. It's actually experience and knowledge that you build over time that allows you to be able to tease out the difference. Then there's also the side of the humanistic touch, right? A lot of times some patients, there's nothing wrong with them, but they just want to be next to somebody, look someone in the eyes and have that person sympathize and empathize with what they're going through. No one wants to look into a robot's eyes and be able to think that they're going to say. You're not going to have that humanistic touch. And a lot of what we do in medicine is actually more about empathy as human beings, not just about being able to say, I can give you this medication or I can perform this procedure and save your life. But even just like having that, I care about your situation. I want you to better. I'm here for you.
00:32:48
Speaker
Those things you can't really, a robot you can't teach a robot that and a robot can never give another human being this way that we can as humans to each other. So I think you can't replace that. And even if I think about it from a specific emergency medicine standpoint, if someone's coming in coding, you know, and something bad is happening,
00:33:04
Speaker
Like you want to know that everything was done possibly correct. You don't want to mistake someone to die and they say robot was the one that we put in the hands of this person who's coding. You know what you're gonna say? You're gonna say like, did the robot see this? The robot see that? You know what you're gonna say? The robot is a robot. Yeah. it was like it's good yeah so certain things that they know that they trust more with a human being that would care and think about those things that you don't know if a robot would have cared about that if they're going through a formula that they were programmed to do you don't know if they saw or recognize certain things that you as a you know with your clinical experience and knowledge would have probably seen and recognized so that once again goes into these like kind of nuances that
00:33:45
Speaker
AI robots programming cannot really fill in the void of a human being who's gone through schooling, who's worked with patients and who's actually kind of seen what it is to kind of care for a vast amount of patients with certain very clinical presentations. I think you can't really, you can't really replace that. So even in 1020, I still don't even see it in 1020, even 50 years, I'm skeptical, to be honest with you. So that's really my thoughts about it.
00:34:06
Speaker
Exactly. And like, even in the OB-GYN world, one, like no one's ever going to be like, you know, Alexa, deliver the baby. Like you if no one wants a robot to deliver the baby. Like they want a midwife or an OB-GYN or someone like that.
00:34:19
Speaker
And then in like the GYN world, but there's so many like complex presentations of like one thing we always get in the yeah ER, like a PUL concept, like pregnancy of a unknown location. And sometimes that can be very complicated. A radiologist can look at like the clinical data, like the trends in the quant or whatever, and say and empty intrauterine cavity, but given quant, most likely ectopic pregnancy, you know, and then from there, like recommend methotrexate, right?
00:34:46
Speaker
AI would be like, oh, like empty uterus, spontaneous abortion, right? Because they don't have like the clinical context. They didn't do the pelvic exam. They didn't match the patient's abdomen. They didn't check the prior or should see there was a confirmed IUP. You know, like with very like nuances to things that lab work,
00:35:06
Speaker
you know, can't tell you, right? Like we had this like complex PUL the other day. She had like a quant of 134, but she had a large like adnexal mass, it was 5.5 centimeters. We took her back to the OR.
00:35:18
Speaker
It wasn't ectopic. She actually had like a tubo ovarian abscess, but she also has a PUL, but that wasn't the pregnancy, but she didn't have a white count. She didn't have a fever. She had none of the classic symptoms of PID, but knowing AI, they see a quant, nothing in the uterus, okay, ectopic. but it takes an actual clinician to like get the whole entire picture. Oh, sorry. A PUL is a pregnancy of unknown location. So not in the uterus and not outside the uterus. You can't find it.
00:35:44
Speaker
That's what it means. Um, so I think things like that, you can only really learn through the practice of medicine. You know what I mean? And, um, I just think ai AI is good. I think AI is good for helping doctors help patients, but I don't see ai replacing us as the middleman. Like AI is supposed to help physicians with their notes and evidence-based guidelines and like quick resources and stuff like that. But I don't think it's ever going to take us away and my opinion. Remember, this is the same guy that stated that we're going to be on Mars with the civilization and settlement in 2030. Right.
00:36:22
Speaker
which is not feasible, takes six to nine months to get to Mars. We're not even talking about radiation exposure, infertility, psychological warfare, and all these kind of things. So I'm saying that to say he puts these things out, and I think a lot of it is due to some underlying narcissism or outlying, overlying narcissism because he says these things, and because his brain is conditioned to do certain things and have yes, yes, yes, yes men all around him,
00:36:50
Speaker
He thinks like every and anything is possible and that's not necessarily the case. So I'll be sure. No, a hundred percent. I think that overall, once again, like this AI has been on a very quick trajectory these past couple of years. And so I think there's a lot of like fear and just assumptions about what it's going to do and what it could potentially replace. And, you know, we really had to understand ah and not, know,
00:37:19
Speaker
dial back or kind of dumb down our education and our clinical acumen that we're receiving um through our training, through the fact that we went through medical school, like the fact that we show up every day for our patients and we wanna learn and get better, that cannot be replaced by robots and AI. And I think we like, one like you said, to maybe we have to like,
00:37:38
Speaker
know what place AI has in terms of how it can help us be better, you know, ah clinicians, but it doesn't necessarily, shouldn't something that we're looking at as to how it can replace what we're already doing. Cause it's like, that doesn't make any sense. Like patients are not going to feel as safe with a robot compared to another human being who understands their plight and would want and care about, you know, them getting better. I don't think you can replace that. And so that makes me feel more assured that, you know,
00:38:04
Speaker
i don't I'm not fearful for anything regarding like the future of medicine with AI or my job, like to be frank with you. And I don't think anyone should listen to somebody who's not in medicine trying to tell people how we should approach um this aspect of AI when it comes to our jobs. So that's my sense of it.
Chimamanda Adichie's Tragic Loss and Medical Negligence
00:38:22
Speaker
And I think that in general,
00:38:24
Speaker
you know These kinds of things can be applied to all situations, particularly when it comes to um medical situations that didn't go the way that you know we would hope for. And we know that um when it came to a recent situation that happened with a very popular literary um expert, Chimamanda Adichie, unfortunately, she was on the other side of that medical um outcome that she probably definitely never imagined for herself. um So unfortunately, recently, Chumanda Adichie, a very popular popular Nigerian Igbo author, um did suffer the loss of her son due to a situation that was alleged overdose of propofol and, you know, mismonitoring that occurred. um So this happened on January 6th of this year.
00:39:10
Speaker
um According to and ny ah New York Times, the celebrated Nigerian author, Chimamanda Ngozi Adichie, is accusing a private hospital in Lagos of negligence that led to the death of her 21-month-old son after the family traveled there from the US for the holidays. The boy, named Nkannu, he was also a twin, who was suffering from an unspecified infection, died on January 6th, a day before he was he was flown to Johns Hopkins Hospital in Baltimore for additional treatment. He was one of twin boys of the author and her husband, Dr. Ivara Esegue. The couple also had a nine-year-old daughter.
00:39:44
Speaker
Miss Adiche outlined what she said were the circumstances that led to her son's death, which she blamed an overdose of inseditive by an anesthesiologist at the private Uricare hospital in a group WhatsApp chat with family and close friends. The chat was leaked to the public and it was shared on social media. A family representative um by the name of Omawumi, confirmed the details of the chat. um And, you know, Mrs. D.J., of course, quoted, you know, suddenly our beautiful little boy was gone forever. It is like living your worst nightmare. i will never survive the loss of my child. um You know, she then specifies that her son had fallen ill after suffering what from what the family thought was a cold. and then it soon transitioned to a very serious infection. He was first treated at Atlantis Pediatric Hospital, which is a private facility in Lagos. He was awaiting a medical evaluation on January 7th to John Hopkins of Baltimore, but the doctors then requested a lumbar puncture test and MRI before he could travel. And so they then referred him to this Uricare hospital for the procedures.
00:40:41
Speaker
um The father carried him to the hospital. The health care workers said that he needed be sedated for the MRI because clearly he's a 21 month old child. So, you know, you want to make sure that ah the patient's going to stay still. um She then wrote that she saw, quote, rushing people rushing into the theater and immediately knew something had happened. A doctor that emerged and told her that her son, Nkanu, had been given too much propofol by the anesthesiologist and had become unresponsive, but quick was quickly resuscitated. And then he was on a ventilator. He was intubated. He was placed in the ICU. Then she heard he had seizures, cardiac arrest, so on and so forth. So now...
00:41:14
Speaker
um they are accusing this anesthesiologist of being criminally negligent, saying he had switched off the child's oxygen and he had, quote, had just casually carried Nkandu on his shoulder to the theater so nobody knows exactly when he became unresponsive, end quote. um She, you know, has suffered a lot of loss, Ms. Adichie. She talked about her mother passing away and her father passing away um and kind of now she's suffering this loss of her child. due to that this alleged situation of um and you know ah such ah mismanagement of anesthesiology. um so you know
00:41:50
Speaker
that's a lot that's been said. i just want to you know kind of clarify for our listeners here. like These are statements that were said by Ms. Chimamanda Adichie, we clearly were not there in the situation. we do not We didn't hear necessarily a public statement from the hospital as to what actually happened um in terms of what caused the son's death. However, from what has been said by Adichie, it sounds like the son was given a high dose of propofol, was not, you know,
00:42:21
Speaker
oxygenated adequately when he was given this protocol and then he was also transported inadequately by being put on a shoulder instead of being put on a structure and he did not have you know once again continuous pulse ox kind of monitoring his oxygen level so they did not know when he became unresponsive that's what it sounds like she knows or was told about the son's death now granted there is a part that talks about a physician telling her that the anesthesiologist is the one who caused it. That is a little bit interesting to me because a lot of times, at least what we're taught in medicine, we don't really like kind of out um our fellow colleagues that want something like a medical failure.
00:42:57
Speaker
It's like kind of just at that moment. So um that that is something that you know was said, but once again, we do not know the full scope of what actually happened. However, I'm curious to know what you guys' thoughts are in terms of like what do you think maybe went wrong in this situation? how do you What do you actually think needs to happen in terms of justice or consequences for the loss of Ms. Adichie's son in this situation?
00:43:24
Speaker
Yeah. Is it routine to give someone propofol for an MRI? Like I- it is what i've never I've never heard of propofol for MRI. don't know for pediatric adults. Yeah. Yeah. I mean, i will say as someone who constantly sees conscious or sedation done, you know, all the time in the ED, For a 21 month old, propofol is a a bit extreme. Not going to lie to you. um Like you said, Ativan, you can give a little bit of fentanyl. You can give intranasal, Verset. like There's different things you can give. um Propofol is kind of extreme for an MRI and he's 21 month old. So that's very young as well. nasty um
00:44:09
Speaker
I think more so what the issue was, if it really did happen, was him not being put on continuous... yeah don't talk to him he wasn't on cmu which is kind of crazy so yeah so but yeah i don't know what you guys like how would you guys approach the situation as someone in this position if it was you you know who lost your child due to this situation crashing out right first and foremost my condolences to this family is such an unfortunate circumstance. um And in medicine, we you know, we've all dealt with error in some capacity, whether it's witnessing colleagues or engaging in it ourselves. But there is a sense of negligence at some point. Like even when you hear you guys talk about like propofol, you know, and sedating a child, you know, we know children's brains are very sensitive and easily could be easily deteriorated by ah medications, especially sedative medications. And so I'm not sure what the thought process was with this anesthesiologist. Definitely investigation should be performed. Nonetheless, I hope that they're able also do autopsy just to you know ensure like maybe the child had some type of pre precipitating event.
00:45:24
Speaker
before they you know died. um But um in terms of what has transpired, i think that um I'm surprised I didn't even hear about this. There's not enough notoriety and attention surrounding this.
00:45:37
Speaker
We know when situations like this happen abroad, no one says anything. I even remember there was like a lady, a video was shared that was unfortunately pregnant and then died in the cab in Lagos. Like she was, her husband was sitting with don't know if you guys remember that. And they were denying her um yeah access to the hospital.
00:45:56
Speaker
But anyway, nonetheless, I just think about these these situations and you know how lack of infrastructure, lack of communication, and even it seems like these people well endowed financially, it still affects people who have the resources as well.
00:46:10
Speaker
So yeah, my condolences is quite unfortunate. I can't even imagine what they're going through. Yeah. Yeah. I definitely you know want to give a quick moment of silence for the loss of Misa DJ's son
00:46:35
Speaker
Yeah, rest in peace to Nkano Adichie. This is really tragic and i hope it kind of just sheds the spotlight as to a lot of kind of the ah infrastructure issues that can exist in developing countries like Nigeria um when it comes to healthcare and, you know, hopefully this can also just be a wake-up call to a lot of other hospitals that are existing in that system and like ways that they can kind of help prevent this from occurring to another family. So yeah, definitely rest in peace to Inkanu Adichie.
UnitedHealthcare and Nursing Home Controversies
00:47:07
Speaker
yeah Speaking on systems problems and issues, UnitedHealthcare was caught paying nursing homes to avoid hospital transfers because hospital care was deemed too expensive. And this is things you can't you can't make up, right? The lack of moral compass ah at a lot of these places and institutions... because of capitalistic warfare, because they want to keep that money instead of saving lives. UnitedHealthcare, as we know, is the nation's largest healthcare conglomerate.
00:47:38
Speaker
And actually, UnitedHealthcare, out of all the top insurance companies, they deny um ah payments for patients at the highest clip. I think it's like 33% or something like that.
00:47:52
Speaker
So ah with that being said, they secretly paid nursing homes thousands in bonuses to help slash hospital transfers for ailing patients. This was part of a tactic to save money, particularly for the company, millions of dollars.
00:48:08
Speaker
Allegedly, these secret bonuses are were paid out as part of United Health program that stations the company's own medical teams and nursing homes and pushes them. to cut care expenses. And in several cases, nursing home residents who needed immediate care failed to receive it And unfortunately, at least one person that we're aware of succumbed to a permanent brain damage following a delay in his transfer, um according to a nursing home log. And one of their practitioners even said, no one is truly investigating when a patient suffers harm.
00:48:44
Speaker
These incidents are hidden, downplayed, and minimized. And for many, ah because they're medically frail and no one lives, they're just... You know, they just like whatever. And my mom works in a nursing home and we see this and I've seen this even on my geriatric rotation that People just neglect, you know, people who are sick, elderly, who can't advocate for themselves. And because of that, it's like, oh, well, it is what it is. Keep it pushing. No one's going to say nothing.
00:49:14
Speaker
You know, they don't see it. They're not going to say nothing. But in reality, these are human beings. These are people that have lived lives. These are people who deserve compassion, who deserve empathy. As we talked about earlier, and the fact that United Healthcare care has done this, is it's just crazy. it's just preposterous to me. But with that being said, um what is another way to call insurance companies like United Healthcare care out on a national level as it pertains to their unjust ways of and unpaying for essential services for human beings? Just be human, bro. What's wrong with y'all? Yeah.
00:49:49
Speaker
I, you know, it's, I'm actually shocked that despite the rigmarole that that in insurance company basically the mess, basically the mess that they faced when their CEO was murdered in broad daylight. Um,
00:50:11
Speaker
that they still have kind of been sloppy with how they're moving when it comes to um working with patients. And now in this case, you know, nursing homes, it's crazy. Cause of course, you know, in the ED, d like I said, I mean, we're just a, we're a one-stop shop, right? We manage everybody. We have our early mornings with nursing home. And it's so funny because when I was watching the new, the recent episode of the pit and how they have like,
00:50:34
Speaker
They expect on Monday morning to get a whole slew of like elderly patients from nursing homes because that's when they do their medication checks and then that's when they find patients unresponsive or patients, you know, with stroke like symptoms or whatever they may be.
00:50:45
Speaker
um Because that's literally when like they do like they actually see if there's something wrong with a nursing home patient. It's like when they do their bed checks or med checks. And a lot of times we are the ones managing these patients. So and we know how a lot of times these patients are senile, they're they're going through dementia, they can't care for themselves. And we have to get collateral information as to like why they're here, what's wrong with them, all those kinds of things. And so these places are taking care of a lot of elderly folk who are dealing with so many different like medical conditions. And The fact that they're trying to avoid hospital transfer, and that might be the only place where they actually get real care performed is just disgusting, to be honest with you. um We have to invest in our in our aging population, right? They invest in us, and we have to invest in them. That's how the cycle of life works. So the fact that UnitedHealthcare is doing this is very disappointing. um Yeah, I don't... At this point...
00:51:40
Speaker
I don't know what else needs to happen to them for them to wake up. Cause like I said, a tragedy happened not too long ago and they're still moving very recklessly. I don't get I
00:51:54
Speaker
hope these lawsuits come through and take them down. get them go Take all their money for what it's worth, to be honest. Yeah, 100%. hundred percent So ah thank you guys for ah the talk on UnitedHealthcare.
ICE Bill and its Impact on Communities
00:52:08
Speaker
As we see, there's a lot of crises going on from UnitedHealthcare and now even ice um the House of Representatives recently passed a new bill allowing ICE agents to strip search unaccompanied children.
00:52:24
Speaker
I'm not sure if y'all saw that footage of that child or there was a picture of a child who was being detained by ICE, which is just so heartbreaking. You look at the child's eyes and it's like, what is going on? you know But this bill, ah the Kayla Hamilton Act, ah which was narrowly passed, dozen of members who previously voted for extreme bills expanded in mandatory detention,
00:52:46
Speaker
rejected this dangerous bill, signaling a growing shift against the Trump administration. um And the kind or kind ah kids in needs of the defense, President Wendy Young issued the following statement. This bill is rooted in punitive measures, not child protection. It uses a tragic act of violence against Kayla Hamilton to endanger unaccompanied children who are victims of violence themselves.
00:53:14
Speaker
Okay. It would impose restrictive sponsor requirements that would not make children safer and would use information about sponsors for immigration and ah enforcement purposes.
00:53:25
Speaker
It would also allow intrusive physical examinations, possible strip searches. I just feel like we are in a state of anarchy, honestly. It's anarchy. It's domestic terrorism and it's anarchy. Um, To, in your own country, whether you came here, quote unquote, legally or illegally or whatever, the charge that ICE has on this country is simply based off of racism. They see somebody that looks the part, plays the part, they stalk that person, they kidnap this person. They're harassing them. and harass them and you don't know anything about them. All you know is that they look a certain way and now you're doing that towards children. And in the world of healthcare, care it kind of makes me scared as a healthcare provider. I've kind of started thinking like, what would I do, you know, for my patients, especially like in residency, a lot of times we work in like these big, large safety net hospitals and
00:54:20
Speaker
what are we going to do, you know, when, you know, our patients are, you know, the victims of things like this and like this thing about like what policies that our hospitals have in place for this. But then also as we're seeing is you know, healthcare workers are also who are trying to help um just people on the street being targeted by ICE are also being targeted as well and being faced with all this violence too. So it's just a very terrible situation to be in. And, you know, i would like to say, I hope things get better and things like that, but it seems like things are taking a worse, taking turns for the worse. And I'm just wondering,
00:54:58
Speaker
Why is nothing being done from like a congressional standpoint or a judicial standpoint? Like, why are these things allowed to happen? So it's all very disheartening, honestly.
00:55:11
Speaker
Yeah, I definitely want to say add on to, you know, when we decided to bring this topic into our conversation, like there's so much that's even happened since then, like rest in peace to Alex Preddy, an ICU nurse who, you know, passed away after trying to defend a woman who was actually being um harassed and I think about to be taken by ICE. So he was not even supposed to be the victim that allegedly was at the other end of the bullet. um But, you know, we've come to a point now where this has become very chaotic and honestly just plain dangerous. um people don't feel safe.
00:55:43
Speaker
um your To your point, maybe I don't know what is happening up there as to like management of that. I don't have any hope in that changing anytime soon, as long as all things remain the same in terms of the people who are managing this stuff. And, you know, once again, keeping it cute for the podcast. um But yeah, I think that, um yeah, I don't,
00:56:07
Speaker
All I can say is that my heart goes out to these victims that are facing kind of the brutal um nature of ICE and how they're going about conducting themselves. I think it's just been, you know, the very, very, um yeah, a very disappointing experience that we are and having to live through, unfortunately. um this is happening you know in our country with all the resources and all the the access that we have.
00:56:39
Speaker
um And we're actually potentially in a better position than a lot of other places that don't even have as much resources and and access to help prevent
Anthony Joshua's Car Crash: EMS in Nigeria
00:56:46
Speaker
these things. Like say the situation that happened in Nigeria with a famous boxer, Anthony Joshua, who got into a basically a very severe car accident that claimed the lives of two individuals and didn't even have access to basic EMS personnel. So, um you know, to talk about that situation a little bit more, um this happened, ah but i believe, actually a few weeks prior to the situation happening with um Chiamanda's son passing away. um
00:57:14
Speaker
it seemed like the exact date, I wanna get the exact date as to when this occurred, which is not written here. so just give me a second to find that. um So car crash details.
00:57:32
Speaker
um So it seemed like this happened January 2nd of this year. so yeah, it was like, yeah, I remember it being like a little bit after the new year. um And basically what occurred was that he was in a car with two of his friends. Um,
00:57:54
Speaker
The names were Latif Ayodele, who was his personal trainer, and then his strength coach, Sina Gami. um They both were you know visiting Lagos. They were here for New Year's celebrations in their hometown. They were visiting Oakland State. um And then a situation happened where they were in this Lexus SUV that was being you know driven by a personal driver and their SUV crashed into a parked truck on the side of the busy expressway. um The driver was charged and arraigned for court um for dangerous driving and invalid license, among other charges. um In terms of what actually happened, there's been debates over was it speeding that caused the crash? um Was it just due to the bad roads? Of course, because, you Nigerian roads are horrendous, particularly in the state of I've been to Oakland State and that is, yeah. um And then they also, said there was a situation potentially where the Jeep lost a tire and then the driver lost control, which then caused him to swerve into the stationary truck that was parked close to the road. Otherwise, um his two friends unfortunately died right at the scene. um Joshua survived that horrible accident and he was
00:59:00
Speaker
brought out, not by any ambulance truck or any MS personnel, but by people on the road who witnessed it and just you know carried him out. And you could see if you saw in some videos, he was visibly in pain, like you know cringing and all these things. Who knows if he had any any active site of bleeding at the scene. like It was just very not a safe situation of bringing out a victim from a car accident um that was that severe where you lost two lives immediately on the scene. um so This now brought brings the question as to where are ems Like where is the emergency medical services that should be available for situations like this? We know that this is Nigeria where Nigeria has a lot of work to do in many domains and healthcare is one of them as we've discussed previously on Chimamanda's case. um And this is one of those situations where it's another thing that they just do not have in place. And it's very... um
00:59:58
Speaker
very concerning that that's not something that has been addressed at this point in time. And so I'm curious to know from you guys' perspective, like what do you think could have gone differently to have made the situation you know, go a little bit in a better direction, whether it has to do with, like, the cause of the accident and, you know, how they the driver lost control, whether to do with, like, what happened after the fact and, like, how they could have mitigated um making sure to carry the survivors out of this out of the vehicle. Like, what are kind of you guys' thoughts about that situation? i just think it's an unfortunate situation, number one. And just hearing, like, how lack of access, like, really influences...
01:00:42
Speaker
um areas, do you know developing countries like Nigeria and many countries across Africa. This is a very similar trend and it goes to show ah the question of where are the resources being poured into, you know, when inherently, you know, emergency medical services should be at the top of the list because emergencies happen everywhere and we can't predict. I'm sure and we i'm sure Anthony Joshua and his friends didn't predict that this would happen, you know, especially not after, you know, winning ah you know a tremendous fight and then going to celebrate.
01:01:18
Speaker
you know And I was watching the videos of them. um And they were basically like real close homies. You what mean? it was just like an unfortunate tragedy. And um I do feel like at the same time, like...
01:01:30
Speaker
that I haven't really heard anything in terms of like, at least like my research in terms of like what Nigeria is doing to improve the situation. Cause it should be like ah a red alarm, like a red alert, like, yo, we messing up, you know what And obviously it shouldn't take someone of Anthony Joshua's stature and prominence for this to happen. This should have been in place before even Anthony stepped foot in that country.
01:01:54
Speaker
So it's a wake up, you know, it should be a wake up to the president, to to the state itself, to the people, the governing bodies that something needs to be done and more resources allocated for those, especially in regions that may not necessarily have that access.
01:02:10
Speaker
I think it's always very interesting that, you know, in the United States, um there are a lot of like great um Nigerian physicians, right? But yet our healthcare in Nigeria is poo-poo. It's nuts. Like basic things that you should be able to take care of, basic things that like, you know, like sickle cell crises, malaria, you know, UTI. It's like, you know, like, cause my grandparents still live there and it's like,
01:02:39
Speaker
mountain like mountains just to get basic healthcare. You have to know somebody who knows somebody to get there. My family is like a healthcare family. My dad's a physician. My mom's a nurse practitioner. My aunt's a nurse practitioner. and It's literally like pulling teeth to get basic healthcare for my grandparents and for My cousin's there, you know what I mean? And we're like, well integrated into the system there. So I mean, where Nigeria needs to start is from the top. I think there's a systemic issue. Obviously, there's money there. we don't know where it is, but it's all being pocketed. And it's not helping the people and trickling down below. um It's very frustrating. And, you know, I think, you know,
01:03:19
Speaker
SNMA obviously has like a lot of Nigerian Americans who are becoming physicians. And I think it's important that as you're getting this training here, that we remember our people, you know, back home, whether that's, you know,
01:03:32
Speaker
I mean, however way you're able to help, whether it's like medical mission trips or um just helping even your family back home. It's like super important, making sure that they're good, that they're up to date on their adult health maintenance, that your girls are getting their pap smears over there, that, you know, like if they're having you know any issues that you use our privilege here in the United States to help our people back home. um Because unfortunately, you know, even with the last case that we talked about, rich or poor, you know what i mean? Like, it's all about who you know, how you you can get access and how much money you have to get that. And as you can see here, people with lots of means are still being inflicted on the health care, the poor health care in Nigeria. So um just keep that in mind, you know, as you're grinding here and enjoying our, you know, attending salaries. That seems to a and all Yeah, there's other things that we have to think about. And I just, before we kind of move on, I just want to quickly also highlight, you know, Freedom House and what that um has been.
01:04:40
Speaker
meant in the black community in terms of EMS in its early stages and kind of the founding years. um So it was actually an endeavor that was um done to provide community-based EMS a segregated Pittsburgh, particularly in the Hill district, which was their most populated black community. The majority of the paramedics were actually trained by the program where they represented the community. They were exclusively all African-American males. And in one year, the five ambulances made answered nearly 6,000 calls in the first year, saving more than 200 lives. And previously EMS was just a privatized kind of venture It was only offered for white neighborhoods and undertaken by untrained professionals such as police, funeral homes, fire departments, and private companies. And so this was like really what kind of launched um what we now know to be like current EMS today. And so I just want to give, you know, Freedom House like their ah flowers for kind of being what paved the way for us to now have the ems that we have.
01:05:27
Speaker
benefit from in America and some other countries like the UK and um ah Australia, I'm sure, and like other places. So yeah, definitely wanted to highlight them as well.
Black Maternal Health and Dr. Janelle Greensmith's Death
01:05:41
Speaker
And speaking of, you know, other, unfortunately premature deaths, um I know you guys heard about Ms. Janelle Greensmith. She um is a doctor of of nurse practice. She's also a trained midwife and black maternal health advocate. And unfortunately,
01:05:57
Speaker
She passed away during childbirth with her own with her first child due to um preeclampsia with severe features. Her story is that she came to the hospital on Christmas Eve and then she delivered at 32 weeks. And for those that don't know, with like severe preeclampsia, the max you deliver is that they try to get you to 34 weeks. So the fact that she delivered at 32 weeks means most likely she was decompensating from her severe preeclampsia. Yeah.
01:06:23
Speaker
So she delivered via C-section because it was probably urgent. And then um on December 29th, her incision opened up and then she was having bleeding. And then she was rushed back to the OR.
01:06:36
Speaker
And from the reports, they said the surgery went well and she was recovering fine, like postoperatively. But then things kind of took a turn for the worse. And this is where I'm kind of having, i guess, confusion about what happened that led to things. There's not like much clarity on it. I don't know if she went to DIC or whatever, but all in all, unfortunately she passed away. And as we know with, um,
01:06:58
Speaker
black mortality, morbidity and mortality, maternal morbidity and mortality in America, um it is terrible. And the fact that, as we all know, education does not keep you immune from these complications, unfortunately. And I'm not you know talking about like the hospital could have done anything better. or you know It's not really about that. It's just more about like succumbing to these terrible illnesses that um pregnancy can open you to. um So I think...
01:07:27
Speaker
one, I want to know your thoughts on the whole situation. And then also, i just kind of wanted to do more of like a PSA that whether you work in obstetrics or not, or you and you deal with pregnant patients on a daily basis, we all kind of have our duty to pregnant people. I think a lot of people um kind of put pregnancy on the OBGYNs and maybe like family medicine, you know what i mean? Just because they're not comfortable. um But I will say that you know no matter what your profession, it never hurts to get a blood pressure on someone. It never hurts to ask. The standard um review systems for a pregnant patient, leakage of fluid, feeling your baby move right over quadrant pain, headache, shortness of breath, and looking at their labs. You know what I mean? Because that's how we save
01:08:13
Speaker
people from things like this. You know, I had um an infectious disease fellow messaged me the other day, because my patient had HIV and was following them. And she texted me on Epic and said, she's having a blood pressure 140 over 90. Is it okay if I send her to OB triage? You know what I mean? It's like those type of proactive things like outside of the OB b profession that helps save women from succumbing to preeclampsia. And So just putting that out there that it's, you know, not just OB's job or family medicine's job or the ah ER's job to screen for these types of things. You know, we all went to medical school. We all did our clerkship.
01:08:51
Speaker
And just knowing the red flags and symptoms of these things can really save a lot of people. Yeah, no, 100%. I think what you stated, um do maybe, is like important about how like your education and like how much experience even have in healthcare care still doesn't make someone immune from the same type of health tragedy happening to that person. I mean, she was Dr. Janelle Green-Smith was a proud member of the Black Nurses Association of America. She was in um you know like clearly involved in a lot of work regarding trying to help
01:09:24
Speaker
ah prevent Black maternal morbidity and mortality, and then she still was victim in her own first pregnancy. And it's just kind of like a really sad outcome that occurred. um And I think that it just, once again, wakes us up a little bit to why it's important for us to continue to advocate and to make sure that we're like paying attention, even if you're not in medicine, like you said, just being able to recognize certain things you know, trying to make sure that even if you're not directly in healthcare, that you can recognize and understand the science. And if you're not even directly in OB-GYN and you are in healthcare, care just being able to like appropriately triage when something is emergent versus not, and like kind of bring that person to the right place and and make sure that they are getting the right um intervention, I think like is very important. So Yeah, I totally um agree with that. And rest in peace to Dr. Janelle Green-Smith. you know I'm praying for her and her loved ones for having to kind of um go through this tragedy. um
01:10:18
Speaker
Yeah, in her in her case. so
01:10:24
Speaker
She also has um a GoFundMe account as well. i think it's GoFundMe.com. slash Dr. Janelle Greensnitz family. so if it's in your heart to contribute to her financially as well, that's the link.
01:10:42
Speaker
Well, along the same lines of... oh of substance use and what you call it? Sorry, let me just backtrack. My brain is slow.
01:10:54
Speaker
On the same lines of speaking on postpartum peripartum care, ah this month is Substance Use Disorder Treatment Awareness Month.
01:11:06
Speaker
And ah one of the top causes of mortality in postpartum women is suicide and substance use, ah particularly overdose in particular.
01:11:20
Speaker
But speaking to also in general substance use overall, I think this is a great month to have a conversation. It's January. We're beginning a new year.
Substance Use Disorder Treatment Awareness
01:11:30
Speaker
new leaf And I just I did my addiction psychiatry rotation a couple months ago and ah really learned a lot about like harm reduction strategies. Actually, there's one I'm at the hospital now. There's one two blocks away from the hospital.
01:11:45
Speaker
That's open six days a week, um six hours a day. And people oftentimes, when we talk about substance use, demonize and criticize people. But addiction and substance use is deeper than the person. It's in the neurochemicals. It's in the nerve cells. It's in the brain. It's embedded in who the person is in many ways and affects how they interpret and walk in their walks of life. I think it's important for us to have this conversation because um addiction and substance use increasingly is becoming an issue. We know that we've been dealt with the blows of an opioid crisis. About close to 200,000 people have died from the opioid crisis between the early two thousand up until or so.
01:12:33
Speaker
And there are always emerging evidence of new drugs on the market. We know Xylazine is being mixed with fentanyl. ah Even now um on the West Coast, there's this thing called Kratom that people use. I remember had a patient who was telling me about it and they called the drink xatchil you know Xanax, which is Alprozolam.
01:12:56
Speaker
They called it that to attract people. you know These small things that are happening to attract people, although It has this thing called Kratom, which is similar to opioids, which people use for pain and also for anxiety as well. And so there's a lot of education. And um I think even for you, Isabella, you've dealt with a lot of people along the realms of substance use. And so interesting when you go to different areas around the country, like here, it's like a lot of meth.
01:13:23
Speaker
The Southeast crack cocaine. Northeast is mainly a lot of like fentanyl and a lot of opioid use. But with that being said, I think ah we also need to remind people that there are resources out there, Alcoholics Anonymous, Narcotics Anonymous.
01:13:39
Speaker
ah There's also resources and support for family members. And remember also 988 is a great hotline. I've texted 988 myself, and I even tell patients and sit with them to text in front of me just so they know that is an access. And I recommend all physicians do that, regardless of what field you're in, because you never know.
01:13:59
Speaker
just from that point of contact, how that could benefit somebody telling them to reach out to 988. There's someone there that can be able to help you. And I think for me, it's also ah important for me. I had ah one of my homies who died and in high school, one of my basketball basketball teammates, unfortunately succumbed to substance abuse when I was 25 years old. And um my high school is actually gonna be commemorating his life ah next month in New York City.
01:14:27
Speaker
but um With that being said, you know, ah I wanted to ask you guys, what are your thoughts surrounding substance use and how um will you implement your knowledge about substance use in the patients that you see and take care of?
01:14:44
Speaker
Yeah, I mean, definitely in the ED, I see like a lot of patients who clearly are, you know, substance use or opioid use disorder, alcohol use disorder, you know, history of alcohol withdrawal, alcoholic seizures. So clearly, like I have a lot of patients that I see who have this extensive history of that. And I think, you know, once again, like it's trying to one, make sure that you're not stigmatizing patients, which can be difficult sometimes. Sometimes those patients can be your more difficult patients, right? That are not really like super, um,
01:15:14
Speaker
I would say responsive to the questions that you ask them or not, like you know, easy to get the physical exam on them. You know, they're usually those patients can easily be stigmatized, but I think it is,
01:15:25
Speaker
my job, our job to like make sure that we're actively working against that. I know that this is a place where they're not going to be judged and that we just want them to get better. And of course, reminding them of their resources, reminding them of like, that they can always get help at any point in time and just like, you know, um keeping them safe. So I think, you know, ah this is a good month for us to remember and think about any whether it's people that we know or patients that we serve who deal with substance use disorders and just like making sure that we're being accountable for how we're taking care of them as well. Yeah. So I would say that's kind of my, my thoughts about it.
01:15:59
Speaker
Yeah. i would say for me in the like OB space, obviously people with um opioid use disorder, substance use disorder, get pregnant. um A lot of times,
01:16:10
Speaker
especially if they're deep into their disorder, a lot of times they don't get prenatal care. So a lot of times when I'm encountering them, it's when it's time to push, you know what I mean? um That's actually been like the most um interaction or like not most interaction i've had with them. But like you usually a lot of times, like if they are like deep into their and addiction and they're pregnant, they're not going to get prenatal care. They come in, they get, And then it's time to push. um But what I find very tricky with and something that I realize now that I probably need to get better at is like treating their pain and addiction, like intrapartum and then also a postpartum. Because if they get C-sections or even just like total postpartum pain or they get an epidural or there's not like their coping mechanisms for pain are different than the average person. And I realize
01:16:56
Speaker
And I'll just call myself, but i think I'm very uncomfortable with patients in pain with opioid use disorder. Because lot of times I don't know how to go about it. And it's very easy to just be like, the lot of push, the lot of push, lot of push. But, you know, and we console addiction and we do all those things. But I think this year, now that we're talking about it, I think I need to do a better job of,
01:17:20
Speaker
learning about addiction in pregnancy and stop being uncomfortable with treating their pain. um Because again, they experience, they're in pain and if they didn't have an opioid use disorder, i know exactly what I would do for them. I wouldn't be scared to give them fent. I wouldn't be scared to give them morphine. I wouldn't be scared to give them stay all. But every time i have a i come across a patient with, um,
01:17:45
Speaker
you know, opioid use disorder or whatever, i hesitate a little bit. And I think that's where our addiction psychiatrists come in. But i think also it's like one of those biases that I think this year I'm going to learn to knock and to not be scared of that patient population. And I'm calling myself out on because to be more accountable for it. So. I love that. I'm happy to hear that, you know, and and we do know opioid use in itself can cause hyperalgesia and cause people to have more pain in itself just because of the mechanism, how it works on the body.
01:18:16
Speaker
But, and, you know, luckily for people opioid, you know, we got buprenorphine and, a lot of other medications, patches. we got sublinguals that we can give. You can induce people. And Isabella, I'm sure you'll do some of that too as well um in the ED. So um I think that your work is tremendous. And the fact that you you're stating that is a beautiful thing because I feel like a lot of people in other fields when they're dealing and treating with pain, if they're not an addiction or in some form of you know pain management, they're like, oh, let me stay away. But again, you are that point of contact. You know I'm And even your case, 3% of women are purported that are pregnant to have opioid use. So it's very important for us to have that knowledge. And I try to, you know for me on my own state, try to stay abreast. I'm actually listening to OBGYN podcast. So I'll be tapped in on y'all. Okay.
01:19:10
Speaker
so ah Thank you guys for sharing that. And ah this has been an incredible show. Thank you for all the listeners that have been... Hey!
01:19:24
Speaker
Now I'm playing. Sorry. Nah, it's all good. Sorry, Alden. You can restart the closeout. you know This was a great episode. Thank you, everybody, for tapping in. Everybody that's listening, ah we had an enjoyable time. Happy New Year's again. i know it's belated New Year's, but that's our show.
01:19:45
Speaker
Good looking. Thank you for joining us for the episode of SNMA Presents The Lounge. Let us know your thoughts about the discussion we had today or ask us a question for a chance to be featured on the show by emailing us at podcast at snma.org.
01:20:02
Speaker
and be sure to follow the SNMA all of our social media platforms to stay up to date on upcoming events. Thank you guys so much for tuning in. We will catch you all next episode.
01:20:13
Speaker
Bye.