Bedside Rounds
86 episodes - English - Latest episode: 8 months ago - ★★★★★ - 410 ratingsBedside Rounds is a storytelling podcast about medical history and medicine’s intersections with society and culture. Host Adam Rodman seeks to tell a few of these weird, wonderful, and intensely human stories that have made modern medicine.
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Episodes
74 - R2D2
September 03, 2023 00:00 - 33 minutes - 31.2 MBWhat does it mean when a computer can make better medical decisions than a human? The progress in large language models, and in particular the popularity of ChatGPT, has brought these questions to the forefront in 2023, but we’ve been discussing this for over 50 years. In this episode, Dr. Shani Herzig and I are going all the way back to the early 1970s with the invention of AAPHELP, the first real clinical decision support system, and the first time doctors had to contemplate working with –...
73 - Seadragon
June 26, 2023 00:00 - 27 minutes - 27.8 MBWhat happens when a patient far from surgical care – say, at the bottom of the Pacific ocean on a submarine, or at a research base in Antarctica in the middle of the winter – develops a surgical abdomen? This dilemma was the impetus to build the first truly effective clinical decision support system – and to grapple with what it means when a computer can make better medical decisions than a doctor. In this episode, part one of three, we discuss the dramatic stories of appendectomies at Novol...
72 - Problems
March 20, 2023 03:00 - 52 minutes - 62.2 MBAmerican doctors spend the majority of their time during the day on the computer, either writing or reading notes about their patients; only a small fraction is spent with the human beings in their care. Technology itself – especially the electronic medical record – has often been blamed for this. But in this episode – a recorded grand rounds that I gave at the San Francisco VA in 2022 – I argue that this alienation has its roots in the way we’ve decided to organize clinical data, and the as...
71 - A Doctor's Work, part 2
January 16, 2023 01:00 - 37 minutes - 34.6 MBIn the past episode, cultural and medical historians Lakshmi Krishnan and Mike Neuss discussed the history of the actual work of the doctor – Holmesian detective, data entry clerk, or something else altogether. In this episode, we conclude our discussion by talking about what type of metaphors are best suited for clinical work. Plus a brand new #AdamAnswers about the reason that American doctors are so obsessed with using, well, the # symbol in our notes.
70 - A Doctor's Work
December 19, 2022 01:00 - 49 minutes - 57.6 MBWhat do doctors actually do? Are they Sherlockian detectives, hunting down obscure clues to solve intractable cases? Are they virtuosic experts, training for half a lifetime to bring the latest science to bear to cure disease? Or are they clerks, whose main job is to collect and enter data into the electronic health record? In this episode, Adam is joined by medical and cultural historians Lakshmi Krishnan and Mike Neuss to discuss the stories we tell about our own work – and how this often ...
69 - The Database
October 31, 2022 00:00 - 48 minutes - 59.4 MBHow do doctors actually think? And if we can answer that, can we train a computer to do a better job? In the post-WW2 period, a group of iconoclastic physicians set about to redefine the nature and structure of clinical reasoning and tried to build a diagnostic machine. Though they would ultimately fail, their failure set the stage for the birth of the electronic health records, formalized the review of systems, and set up a metacognitive conflict that remains unresolved to this day. This ep...
68 - The History
July 25, 2022 00:00 - 39 minutes - 48.1 MBInternal medicine physicians like to pride ourselves on our clinical reasoning – the ability to talk to any patient, pluck out seemingly random bits of information, and make a mystery diagnosis. But how does this actually work? In this episode, called The History, I’ll be joined by Gurpreet Dhaliwal as we explore the beginnings of our understanding on how clinical reasoning works – starting in the middle of the 19th century with polar tensions between two ways of approaching our patients tha...
The Facemaker with Dr. Lindsey Fitzharris (#histmedconsultservice)
June 07, 2022 00:00 - 51 minutes - 40.5 MBModern plastic surgery was born out of the horrors of trench warfare in World War I. In this episode, Adam interviews historian Lindsey Fitzharris about her new book The Facemaker, about the life of surgeon Harold Gillies and his quest to rebuild his patients' faces.
67 - Fever on the Frontier
March 21, 2022 00:00 - 48 minutes - 45.9 MBIn the early 19th century, a strange new illness, seemingly unknown to medicine, ravaged settler communities in the American Middle West. As fierce debates about this new disease, now called milk sickness, raged – was it from toxic swamp gasses? arsenic in the soil? infectious microorganisms? from the poor constitutions of the settlers – an irregular medicine woman named Dr. Anna and an indigenous Shawnee healer discovered the cause of the disease and successfully prevented it in their commu...
66 - Burnout
January 08, 2022 01:00 - 53 minutes - 49.7 MBBurnout seems to stalk healthcare workers; between a third and a half of doctors and nurses had symptoms of burnout BEFORE the COVID-19 pandemic. Major medical associations have recognized burnout as a serious problem and the condition is being added to ICD-11 as an “occupational phenomenon.” How did we get ourselves into this situation? How has burnout gotten so bad? In this episode, the first #HistMedConsultService, I’m joined by historians of healthcare and emotions Agnes Arnold-Forster a...
65 - The Last Breath
November 05, 2021 00:00 - 40 minutes - 39.8 MBHow can we medically tell whether or not someone is alive or dead? The answer is much more complicated than you'd think. In this episode, which is a live podcast I gave with Tony Breu at the Massachusetts Chapter of the American College of Physicians annual meeting on October 16, 2021, we track the evolution and controversies of the death exam, from a trans-Atlantic scandal surrounding a possible vivisection, a 19th century “X-prize” to determine a technology that could diagnose death, the i...
64 - A Vicious Circle
October 04, 2021 00:00 - 40 minutes - 37.9 MBDuring World War II, the US Army launched a seemingly routine experiment to find the ideal way to screen soldiers for tuberculosis. Jacob Yerushalmy, the statistician in charge of this project, would succeed at this task -- and end up fundamentally changing our conception of medical diagnosis in the process. This episode features Dr. Shani Herzig, as well as a new segment featuring Dr. Umme H. Faisal on Yellapragada Subbarow and his discovery of ATP. Bedside Rounds store: https://www.teepu...
63 - Signals
August 23, 2021 00:00 - 40 minutes - 41.3 MBWhat does it mean when different physicians disagree about a diagnosis? I am joined by Dr. Shani Herzig as we explore this issue in the second part of my series on the development of diagnosis. We’re going to discuss the advent of signal detection theory in the middle of the 20th century as new diagnostics such as laboratory testing and x-rays started to challenge the classical view of diagnosis. Along the way, we’re going to talk about focal infection theory and why it seems that everyone i...
62 - The Sisters Blackwell
May 10, 2021 00:00 - 41 minutes - 43.1 MBElizabeth Blackwell -- the first woman to earn a medical degree in the United States -- and her sister Emily Blackwell are some of the most important physicians of the 19th century, firmly establishing the role of women as physicians, starting an infirmary and hospital for poor women and children, and founding a women’s medical college that was decades ahead of its time. In this episode, Dr. Nora Taranto joins me to explore the legacy of the Blackwells along with Janice Nimura, who recently ...
61 - Etymologies
March 29, 2021 00:00 - 39 minutes - 41.8 MBWords matter. At its best, etymology gives us insight not only into the origins of words, but why they remain so important today, especially in medicine, where we’ve been accruing jargon for millennia. In this episode, we’re delving into four specific words -- doctor, cerebrovascular accident, rounds, and zebras. And along the way, we’re going to discuss pre-historical pastoralists on the Eurasian steppes, medieval universities, Octagonal air-ventilated chambers in 19th century Baltimore, a...
60 - Santa's Salmonella
December 24, 2020 01:00 - 38 minutes - 41.9 MBFor a special holiday treat, we’re going to explore two tales of salmonella disease detectives -- the first about Mary Mallon (“Typhoid Mary”) and the birth of the genre; and the second about a mysterious salmonella outbreak at Massachusetts General Hospital solved with the assistance of a very jolly patient. Along the way, we’ll talk about clinical epidemiology, the long-lasting influence of Berton Roueché, and the joys of being an internist! You can sign up for the Digital Education ...
59 - Cry of the Suffering Organs
November 30, 2020 01:00 - 43 minutes - 46 MBDiagnosis is arguably the most important job of a physician. But what does it actually mean to make a diagnosis? In this episode, we’ll explore this question by tracking the development of the “classical” model of diagnosis and pathological anatomy and discussing three cases over three hundred years. Along the way, we’ll ponder the concept of the lesion, iatromechanistic theories of the human machine, the birth of the International Classification of Diseases, and the rise and decline of the ...
The House of Pod: How medical podcasting made me a better doctor and educator … and how it might change the future of medical education for everyone
November 23, 2020 16:49 - 38 minutes - 43.2 MBIn this episode, I talk about my podcasting journey -- how I started Bedside Rounds for inspiration during a low period in residency, how it changed me as a physician, and how it has changed my views about digital education and the future of medical education in general. This is a live recording of a talk I gave at the Michigan ACP annual meeting last month. Also, we are hosting the first annual iMED conference in January (virtual this year, of course) -- the link is cmeregistration.hms.ha...
58 - The Original (Antigenic) Sin
October 26, 2020 00:00 - 55 minutes - 60.6 MBThe COVID-19 pandemic laid bare the racial health disparities in the United States, with markedly increased mortality especially among Blacks and Native Americans. In this episode, Tony Breu and I discuss the conception of race, racism, and the social determinants of health through three historic plagues in the United States -- from yellow fever in New Orleans, to poliomyelitis, and finally the early days of HIV/AIDS -- and what lessons we can draw for COVID-19. Along the way, we’ll discuss ...
57 - The Second Wave
August 31, 2020 00:00 - 45 minutes - 49.8 MBIn August of 1918, a horrific second wave of the Spanish Flu crashed across the world. In this episode, the third of a four-part series exploring hydroxychloroquine and COVID-19, I’ll explore this single moment in time, through the mysterious origins of the Spanish Flu and historiographical controversies, scientific missions to mass burial sites in remote Alaskan villages, the ill-fated journey of the HMS Mantua, debates about how to count victims of a pandemic, and the mystery behind Pfeiff...
56 - La Grippe
July 13, 2020 00:00 - 43 minutes - 47.3 MBThe 1889 Russian Flu was the first influenza pandemic in an increasingly globalized world. In this episode, the second of a two-parter on how hydroxychloroquine became a great hope in COVID-19, we’ll talk about how quinine became the standard of care for influenza. Along the way, we’ll discuss the astrological origins of the flu, the nosological difficulties of identifying past pandemics, conspiracy theories about previous global coronavirus outbreaks, the media panic over the Russian Flu, f...
Introducing the Curious Clinicians!
July 09, 2020 04:00 - 19 minutes - 14.5 MBThis bonus episode introduces episode four of the Curious Clinicians, about Vincent Van Gogh and digitalis. The Curious Clinicians is a new medical podcast produced by Hannah Abrams, Avi Cooper, and Tony Breu; you can download them all at curiousclinicians.com.
55 - The Fever Tree
June 08, 2020 00:00 - 43 minutes - 44.6 MBWhere did cinchona, the first medication to cure malaria, come from? This episode explores the murky history of the bark of the fever tree and its derivative chloroquine with mysterious pre-Columbian Pacific crossings of the plasmodium parasite, Jesuit priests and Inca healers, a Chinese Emperor performing a clinical trial to treat his fever, chemistry leading to the first modern pharmaceuticals, and imperialism on a global scale. This episode is the first of a multi-part series exploring ho...
54 - 1918 (guest episode with Hannah Abrams and Gaby Mayer)
May 18, 2020 00:00 - 39 minutes - 39.8 MBThe 1918 influenza pandemic, or the Spanish Flu, is the obvious parallel to the COVID-19 pandemic -- a worldwide plague attacking a scientific and global society much like our own. In this guest episode by Hannah Abrams and Gaby Mayer, we chase these parallels wherever they take us, talking etiology, presentation, treatments, masking, curve-flattening, and mortality measures.
53 - The Antonine Plague (guest episode with Liam Conway-Pearson)
April 27, 2020 00:10 - 31 minutes - 32.7 MBPlagues have fascinated us since antiquity, but the Antonine Plague stands out because one of the most famous physicians in Western history was present to make detailed observations. In this episode, guest host Liam Conway-Pearson explores what we know -- and what we don't know -- about this plague, which ravaged Rome two millennia ago. Plus a brand new #AdamAnswers about using convalescent plasma to treat the Spanish Flu of 1918! Sources: Adrian Muraru, “On Galen of Pergamum: The Gre...
A short message from Adam
March 25, 2020 16:11 - 4 minutes - 3.77 MBAs the COVID-19 pandemic increasingly spreads across the globe, Bedside Rounds is going on hiatus. This short message explains why and gives some historical context. Stay in touch on Twitter in the upcoming months @AdamRodmanMD.
52 - The Rebuff
March 02, 2020 01:00 - 40 minutes - 50 MBOver the past several centuries, the medical field has established a firm graph on the domain of the human body, with one very notable exception -- the teeth. In this episode, we’re going to explore this historic split between medicine and dentistry, and the moment in history where the two fields could have been rejoined but were “rebuffed.” Along the way we’ll talk about barbers and enemas, a fun tool called the dental pelican, 19th century professional drama between doctors and dentists, a...
Winter Shorts #4 - The Backlog
February 04, 2020 01:00 - 30 minutes - 38.6 MBDid Hippocrates call consults for chest pain? Were there specialists in black bile? Where does our poetic terminology for heart and lung sounds come from? Is there a historical parallel for #MedTwitter? I’ve fallen off the bus with #AdamAnswers, so in this month’s episode I’m playing catch up on many of the amazing questions you guys send me with the first Winter Short (#spoileralert -- not actually short) -- the Backlog!
51 - Hero Worship
December 16, 2019 01:00 - 46 minutes - 57.6 MBAt the end of 2019, William Osler’s legacy is stronger than ever; he has been called the “Father of Modern Medicine” and held up as the paragon of the modern physician. In this episode, I’m going to explore the historical Osler -- just who was William Osler in the context of rapidly changing scientific medicine at the dawn of the 20th century, and how did he become so influential? But I’m also going to explore Osler the myth -- what does the 21st century obsession with the man say about us, ...
50 - I Know Nothing
October 28, 2019 00:00 - 43 minutes - 48.5 MBWhat does it mean to know something in medicine? In this episode, we’ll explore this question by developing a historical framework of medical epistemologies in a journey that involves King Nebuchadnezzar, citrus fruit, leeches, water pumps, ICD-10, Socrates, skepticism, and 1970's computer programs designed to replace doctors. This is a version of a Grand Rounds given at BIDMC on October 25, 2019. Sources: Bothwell LE et al, “Assessing the Gold Standard -- Lessons from the Histor...
49 - The Ether Dome
September 30, 2019 00:00 - 43 minutes - 43.8 MBThe world before anesthesia was brutal -- surgeons inflicted torture on largely conscious patients, hoping to finish an operation as quickly as possible. But all of that changed with the introduction of inhaled ether. This episode covers the context behind the discovery of etherization, with myths about screaming medicinal plants, a “missing recipe” of medieval general anesthesia, 19th century recreational drug use, and a controversy carved in granite. Sources: Brown, M. The Palgrave ...
48 - Micrographia (FIXED AUDIO)
August 29, 2019 11:51 - 39 minutes - 43.9 MBBecause of dad brain, the original musical tracks for episode 48 were offset by almost 30 seconds (even more embarrassing, because I actually LISTENED to it before uploading). I've fixed the audio for the original episode, but anyone who downloaded it already is stuck with the bad audio version. Because of limitations in the podcasting medium, the only way I can get a new episode to those who have downloaded but haven't listened yet is to release a new episode to the feed. Eventually (maybe ...
48 - Micrographia
August 28, 2019 00:00 - 39 minutes - 43.9 MBGerms are regarded today with a combination of fear and disgust. But mankind’s first introduction to the microbial world started off on a very different foot. In this episode, as part of a larger series contextualizing germ theory, we’ll talk about the discovery of animalcules and how they forever changed our conception of the natural world -- and what causes disease. Plus, a new #AdamAnswers about the influence of Bayes Theorem on medicine! Sources: Albury WR, Marie-Francois-Xavier B...
Summer Shorts #3 - Insulin Drama
July 26, 2019 00:00 - 22 minutes - 18.5 MBBedside Rounds is on a summer vacation! In the meantime, I'm joined by journalist Dan Weissmann of the podcast An Arm and a Leg to talk about the tawdry history of the discovery of insulin.
47 - The Criteria
June 24, 2019 00:00 - 44 minutes - 46.4 MBCan we ever know what causes a chronic disease? In this episode, I’m joined again by Dr. Shoshana Herzig to finish a three-part miniseries on Bradford Hill and Doll’s attempts to prove that smoking caused lung cancer. We’ll talk about the first prospective cohort trial in history, 1960s “Fake News” from tobacco companies, public spats with the most famous statistician of the 20th century, and the development of the Bradford Hill Criteria, a guideline, however imperfect, that gives doctors a ...
46 - Cause and Effect
May 20, 2019 00:00 - 38 minutes - 40.8 MBDoes smoking cause lung cancer? How could you ever know? The second in a three-part series on causality, I’m joined by Dr. Shoshana Herzig to discuss how Austin Bradford Hill and Richard Doll set out to try and answer this question -- and along the way revolutionized the way we think about what causes disease. In this episode, we’ll talk about the first double-blinded randomized controlled trial, the long shadow of tuberculosis, and why epidemiology is beautiful. Plus, a brand new #AdamAnswe...
45 - The French Disease at 500
April 22, 2019 00:00 - 1 hour - 65.1 MBIn 1495, a mysterious and deadly plague struck the city of Naples. Over the next 500 years, the medical attempts to understand and treat this new disease -- syphilis -- would mold and shape medicine in surprising ways. In this episode, Tony Breu and I will perform an historical and physiological biography of syphilis, covering the development of germ theory, epic poetry, mercury saunas, intentionally infecting patients with malaria, magic bullets, and lots and lots of experiments on poor rab...
44 - The Great Smog
March 25, 2019 00:00 - 42 minutes - 43.3 MBWhat was behind the mysterious increase in lung cancer deaths at the turn of the 20th century? The first of a three-parter investigating the cigarette-smoking link and causality, this episode looks at that early debate, which largely focused on environmental pollution. Along the way, we’re going to talk about toxic vapors -- and not Miasma theory, but the actual literal Great Smog of London in 1952 that killed over 10,000 people -- as well as the birth of the case-control study, Nazi attempt...
43 - The Cursed
February 18, 2019 01:00 - 43 minutes - 48.5 MBWhat killed Charles II of Spain, the inbred monarch whose autopsy famously showed a heart the size of a peppercorn, a head full of water, and a bloodless body? This episode addresses that medical mystery by not only delving deep into Charles’ unfortunate past, but by exploring some of the fundamental assumptions physicians have made about the nature of disease. Along the way we’ll walk about inbreeding coefficients, postmodern philosophy, and two thousand years of anatomy and autopsy. Plus a...
42 - The Lady with the Lamp
January 14, 2019 01:00 - 39 minutes - 45.6 MBFlorence Nightingale stands as one of the most important reformers of 19th century medicine -- a woman whose belief in the power of reason and statistical thinking would critically shape the both the fields of epidemiology and nursing. This episode discusses the fascinating story of Nightingale’s legacy -- how modern nursing was born out of the horrors of war, medical theories about poisonous air, the outsize influence of the average man, the first graph in history, and how a woman who died ...
41 - Animal Magnetism
December 17, 2018 01:00 - 40 minutes - 49.7 MBMesmerism has had an outsize influence on medicine, despite the rapid rise and fall of its inventor Dr. Franz Mesmer and hostility from the medical establishment. This curious story covers the healing powers of magnets, secret societies in pre-Revolutionary France, fundamental questions about what makes someone alive, and one of the most fascinating medical investigations in history led by a dream team of Benjamin Franklin, Lavoisier, and Guillotine on behalf of King Louis XVI. Plus, a #Adam...
40 - Phage
November 12, 2018 01:00 - 52 minutes - 74.1 MBBacteriophages -- viruses that target and kill bacteria -- were one of the most promising medical treatments of the early 20th century, and were used to treat all sorts of infections, from cholera to staph, and everything in between. But by the 1950s, they had all but died out in the West. This episode tells the story of the humble phage, from its discovery in the waters of the Ganges, love trysts ending in a KGB execution, and to a resurgence of this once forgotten therapy in the 21st centu...
39 - The White Plague
October 08, 2018 00:00 - 41 minutes - 47.8 MBTuberculosis has been humanity’s oldest and greatest killer. Starting at the turn of the nineteenth century, the White Plague was decimating entire generations in the crowded and unclean cities of Europe, North America, and across the globe. But as medical science learned more about the disease, doctors and reformers developed new ways to combat it, most notably specialized tuberculosis hospitals that sought to heal their patients with fresh air, rest, and a nutritious diet. This episode dis...
0 - Introduction
September 10, 2018 00:00 - 14 minutes - 15.9 MBMany podcasts start with an “Episode 0”, basically a mission statement for the podcast. Well, better late than never! This episode explores why I make Bedside Rounds, my philosophy about medical history, and a little bit about who I am and my research methods. Hopefully listeners new and old alike will find it interesting!
38 - Blood on the Tracks (PopMed #2)
September 10, 2018 00:00 - 50 minutes - 45.9 MBThe first population study in history was born out of a dramatic debate involving leeches, “medical vampires,” professional rivalries, murder accusations, and, of course, bloodletting, all in the backdrop of the French Revolution. The second of a multipart series on the development of population medicine, this episode contextualizes Pierre Louis’ “numerical method,” his famous trial on bloodletting, and the birth of a new way for doctors to “know”. Plus a brand new #AdamAnswers about Occam’s...
37 - Let It Bleed (PopMed #1)
August 06, 2018 00:00 - 31 minutes - 36.6 MBFor thousands of years, bloodletting was the standard of care for any number of medical conditions, but at the turn of the nineteenth century, often acrimonious debates about the practice would lead to a new method of medical knowledge. The first of a multi-part series on the birth of population medicine, this episode visits the controversies surrounding the death of George Washington and Benjamin Rush’s bleeding of Philadelphia during the 1793 yellow fever epidemic and asks the big question...
36 - Filth Parties
July 05, 2018 00:00 - 51 minutes - 56 MBThe southern United States was hit by a dramatic epidemic of a mysterious disease called pellagra in the early twentieth century. This episode discusses the cultural and scientific sources of the outbreak -- from the cotton fields of the south, to the cow pastures of rural Germany, to the river basins of Uganda -- and the incredible lengths a young doctor named Joseph Goldberger went through to try and put an end to this plague. Plus, a new #AdamAnswers about the source of the name “internal...
The Adventure of the Speckled Band by Sir Arthur Conan Doyle
June 04, 2018 00:00 - 51 minutes - 57.9 MBSir Arthur Conan Doyle considered The Adventure of the Speckled Band to be his best Holmes story, and Adam does too. Meant to be a companion to Episode 35 (Sherlock), this is the story in its entirety. THIS IS NOT AN EPISODE! It's Adam reading for almost 50 minutes. Consider yourself forewarned!
35 - Sherlock
June 04, 2018 00:00 - 34 minutes - 38.3 MBWhy do doctors love Sherlock Holmes so much? In this episode, we’ll explore this endearing, nerdy obsession with the good detective, from Holmes’ medical origins and influences, the parallels with medical reasoning, and how the Holmes stories still influence medicine to this day. Plus a new #AdamAnswers about the origin of the white coat. All this and more in Episode 35 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine! Sources: Blumhagen DW, “The Doctor’s W...
34 - The Physical
May 04, 2018 00:00 - 33 minutes - 38.8 MBThe physical exam has become a ritual of the modern doctor’s appointment, with pokes, prods, and strange tools. How did this become a normal thing to do? In this episode, I’ll discuss how the physical exam went from the medieval examination of a flask of urine to basically what we have today in just a few decades in early 19th century France, and how the exam is still developing in the 21st century. Plus, a brand new #AdamAnswers about why Americans insist on using the Hermes’ Staff as a sym...