A lump discovered while shaving during a ski trip turned Dr. Julie Gould's world upside down. As an obstetrician who prided herself on healthy living—never microwaving plastics, exercising regularly, getting routine checkups—she never expected to face follicular lymphoma. "I'm the one who's going to live forever," she thought, making her cancer diagnosis all the more shocking.

Dr. Gould takes us through her journey from initial discovery through diagnosis, treatment decisions, and the profound ways cancer changed her outlook on life. With remarkable candor, she shares the surreal experience of creating a "funeral playlist" the night of her diagnosis, then learning to use humor—"Mom has cancer...your turn to do the dishes"—to normalize the illness with her teenage children.

The episode offers rare insight into how a physician navigates the healthcare system as a patient. Dr. Gould describes advocating for her own testing, seeking second opinions, researching treatment options, and finding the right oncologist who matched her communication style. Her experience defied expectations in surprising ways—the dreaded Rituxan treatments she feared would debilitate her "felt like water," while the seemingly counterintuitive "watch and wait" approach for a stage three cancer initially felt baffling.

Perhaps most valuable are Dr. Gould's reflections on how cancer transformed her practice. She now brings deeper empathy to patients awaiting test results, understanding their anxiety in ways textbooks could never teach. Though she initially planned to drastically reduce her workload, she discovered her identity remained deeply connected to her role as a physician—finding that meaningful work provided crucial psychological support during treatment.

Ready to gain perspective from someone who's experienced cancer from both sides of the stethoscope? Listen now and discover why having grace for others—and yourself—might be the most important lesson from facing mortality.

Dr. Darren Haskell sits down with host Jason Edwards to share his unique perspective as both a practicing internist and Chief Medical Officer at St. Luke's Hospital. Their conversation cuts to the heart of healthcare's most pressing challenges while offering a glimpse into promising solutions on the horizon.

Dr. Haskell represents a vanishing breed of physicians who still follow their patients from the office to the hospital bedside. "It's just the way I was trained," he explains, noting how patients appreciate seeing a familiar face during vulnerable moments. This continuity of care, once standard practice, has largely disappeared as medicine has become more specialized and fragmented.

The demands on primary care physicians have reached staggering levels. One eye-opening study revealed that delivering guideline-directed preventive care would require 29 hours per day for a physician with a standard patient panel – an impossibility on our 24-hour planet. This reality has transformed primary care into "a team sport," requiring nurses, medical assistants, and advanced practice providers working in concert.

Technology offers both challenges and solutions. While electronic health records initially pulled physicians' attention away from patients, Dr. Haskell is now piloting AI-powered voice recognition software that transcribes patient conversations, allowing doctors to maintain eye contact instead of typing notes. "It gets that visit back to being much more what I remember from my training – that human-human connection," he shares.

The conversation takes a sobering turn when discussing physician shortages. The St. Louis region currently faces a deficit of 324 primary care physicians, projected to grow significantly as baby boomers require more complex care. Dr. Haskell predicts "market disruptors" will redefine how primary care is delivered, likely through team-based approaches and technology integration.

Despite these challenges, medicine remains profoundly rewarding. "There are very few professions where you get that feeling, that feedback from people that you've helped," Dr. Haskell reflects. For those considering medical careers, he advises understanding the commitment but emphasizes the incomparable satisfaction that comes from making a difference in patients' lives.

Ready to hear more insights from healthcare leaders? Subscribe to Doc Discussions for conversations that explore medicine's most pressing challenges and inspiring innovations.

Hormones control everything from your mood to your metabolism, and when they're out of balance, quality of life can suffer dramatically. In this eye-opening conversation with Dr. Julie Gould, OB-GYN, we explore the world of hormone replacement therapy and its potential to transform women's health.

Dr. Gould brings clarity to a field often clouded by misconceptions, particularly around cancer risks. She explains how the medical community has dramatically revised its understanding since the Women's Health Initiative study, with the North American Menopausal Society now stating they do not believe hormones cause cancer. For many women, this new understanding opens doors to treatment options that can address debilitating symptoms while potentially offering long-term health benefits.

Beyond just treating hot flashes (which aren't even the most common complaint), hormone therapy addresses a constellation of issues including sleep disturbances, vaginal dryness, diminished libido, joint pain, and cognitive concerns. Dr. Gould walks through the various administration methods—from patches that bypass liver metabolism to gels, pills, rings, and more—helping listeners understand which options might work best for their unique situations.

Perhaps most surprising is Dr. Gould's discussion of testosterone in women. Most people don't realize women naturally have 10 times more testosterone than estrogen in their bodies, and when those levels decline, it can lead to fatigue, brain fog, and loss of vitality. Despite this, there are no FDA-approved testosterone products specifically for women in the US, though they exist in other countries.

This conversation represents a shift toward proactive health optimization rather than just treating diseases after they develop. Whether you're currently experiencing menopausal symptoms or simply want to understand what options might be available in the future, Dr. Gould provides the knowledge needed to make informed decisions about hormonal health at every stage of life.

Ready to learn more? Call Dr. Gould's office at 314-205-6788 to schedule a consultation and discover if hormone replacement therapy might be right for you.