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.

Have you ever wondered who's behind those medical lab results that guide your treatment? Meet Dr. Jeff Melnick, St. Luke's Chief of Pathology and laboratory Medical Director, who pulls back the curtain on the fascinating world of "the doctor's doctor" in this eye-opening conversation.

Dr. Melnick reveals that pathology extends far beyond the familiar forensic work popularized by crime shows. With approximately 20 subspecialties spanning anatomic pathology (tissue examination) and clinical pathology (laboratory medicine), these physicians influence nearly every aspect of modern healthcare. While forensic pathology might capture public imagination, it represents the smallest slice of this diverse field.

The technological evolution of pathology presents a fascinating paradox. Core techniques like fixing tissue in formalin and staining with H&E remain largely unchanged after a century, forming the foundation of tissue diagnosis. Yet simultaneously, the field has been revolutionized by molecular pathology and genetic testing, enabling personalized medicine approaches that target specific mutations in individual patients' tumors. This precision has transformed cancer treatment, allowing oncologists to select therapies based on a tumor's genetic profile rather than just its tissue origin.

As laboratory Medical Director, Dr. Melnick serves as an essential bridge between laboratory staff and clinical providers. He describes his role as an "ombudsman" who translates between different professional languages, ensures quality testing protocols, and helps clinicians interpret complex results. Every hospital laboratory requires this medical leadership by law, though patients rarely realize a pathologist's involvement in their routine blood work.

The conversation touches on artificial intelligence's gradual impact on pathology, the scientific breakthroughs (like heat-resistant enzymes from Yellowstone hot springs) that enable modern testing techniques, and even the infamous Theranos scandal that promised revolutionary blood testing from a single drop. Through it all, Dr. Melnick emphasizes that the ultimate purpose remains doing what's best for patients: delivering high-quality diagnostic information at exactly the right time.

Join us for this illuminating glimpse into medicine's hidden experts who guide clinical decisions from behind the microscope. Subscribe to Doc Discussions for more conversations that reveal the fascinating intersections of science, medicine, and patient care.

A fascinating journey into the world of pulmonary medicine awaits as Dr. Neil Ettinger shares his expertise on the complexities of lung health and disease. With decades of experience as a pulmonologist and researcher, Dr. Ettinger offers valuable insights that could quite literally help you breathe easier.

We dive deep into interstitial lung disease, a condition affecting many older adults where the lungs develop progressive scarring that compromises their ability to function. Dr. Ettinger explains the difference between known causes like autoimmune disorders and occupational exposures versus idiopathic cases where the trigger remains mysterious. His optimism shines through as he discusses recent breakthroughs in treatment options, including two approved medications and a promising new drug that recently succeeded in clinical trials.

The conversation takes a crucial turn toward lung cancer screening, revealing the shocking statistic that only about 6% of eligible Americans participate in these potentially life-saving screenings. Dr. Ettinger outlines who qualifies for the annual low-dose CT scans and why catching lung cancer early makes such a dramatic difference in treatment options and outcomes. For those concerned about lung nodules found on scans, his explanation of benign nodules common in the Midwest provides reassurance about what might be normal findings versus cause for concern.

The future of pulmonary medicine looks increasingly promising as we explore emerging technologies and treatment approaches. From targeted cancer therapies that cause fewer side effects to robotic bronchoscopy systems that navigate the complex airways for precise diagnosis, medicine continues to advance. Dr. Ettinger even touches on how artificial intelligence may soon transform how we detect and diagnose lung conditions, potentially saving countless lives through earlier intervention.

Whether you're concerned about your own lung health, caring for someone with respiratory issues, or simply curious about this vital organ system, this episode offers valuable perspective from the frontlines of pulmonary care. Listen now to gain insights that could help you make better-informed decisions about monitoring and maintaining your respiratory health.

Dr. Mary Mason takes us on her remarkable journey from practicing physician to Chief Medical Officer of Centene Corporation in this illuminating conversation about the intersection of medicine and business leadership.

What happens when a physician's analytical mindset meets the corporate boardroom? Dr. Mason discovered her interest in healthcare administration during medical school, choosing to pursue an MBA while maintaining her clinical practice. This dual approach defined her career trajectory as she moved from managing complex cases for 86,000 patients to overseeing Centene's explosive growth from 800,000 to 24 million patients.

Throughout our discussion, Dr. Mason articulates the fundamental differences between medical and business decision-making cultures. Where medicine has clear hierarchies and protocols, business environments often feature ambiguous authority structures and group decision processes that can bewilder clinicians. Yet physicians bring invaluable perspectives to corporate settings - a calm, solution-focused approach captured in her memorable phrase: "Look, nobody died, okay? We can fix this."

The conversation pivots to healthcare's pressing challenges, including the corporate employment of physicians (now 75%), creating scenarios where business executives without clinical backgrounds make decisions affecting patient care. Additional concerns include hospital financial struggles, the technological complexity of modern healthcare, and the worrying trend of physician burnout leading to early retirement.

Dr. Mason's insights crystallize in her book "Think Like a Doctor, Lead Like a CEO," which encourages physicians to recognize their transferable leadership skills while helping business executives understand the value of clinical thinking in corporate environments. Her journey demonstrates how medical training provides an exceptional foundation for leadership roles where clear thinking and decisive action matter most.

Want to discover how clinical thinking can transform business leadership? Dr. Mason's book "Think Like a Doctor, Lead Like a CEO" is available now on Amazon and Barnes & Noble's website.

Peek behind the surgical drape in this eye-opening conversation with Jared Barton, a Certified Registered Nurse Anesthetist (CRNA) with an extraordinary career. Did you know that 80% of all anesthetics are administered not by doctors, but by nurse anesthetists? Barton reveals this surprising statistic while taking us through the intense world of operating room anesthesia, where life-and-death decisions happen behind a paper screen that separates the anesthesia provider from the surgical team.

Barton shares his remarkable journey through the "militant" training program at the University of Alabama at Birmingham, where a single mistake meant immediate expulsion, and his subsequent work in high-stakes environments including level one trauma centers. With striking candor, he discusses the reality of watching patients' vital signs "second by second by second," and the intuition that develops after years of practice – that sixth sense when something doesn't look quite right.

Perhaps most impressive is Barton's perfect track record: he's never lost a patient throughout his entire career. While he modestly attributes this to luck rather than skill, his descriptions of managing critical situations – pushing blood products with both hands during massive hemorrhages, anticipating problems before they become critical – speak to the expertise that comes only with thousands of hours of vigilant practice.

The conversation also explores the evolving landscape of healthcare delivery, with ambulatory surgery centers creating even more demand for CRNAs, making this a highly secure career path that's unlikely to be replaced by automation or artificial intelligence. For anyone curious about what really happens when you're under anesthesia, or considering a career in healthcare, this conversation offers rare and valuable insights from someone who has spent decades keeping patients alive during their most vulnerable moments.

From the swimming pool to the operating room, Dr. Ryan Reidy's journey exemplifies how elite athletic discipline transforms into surgical excellence. As a former Division I swimmer at Eastern Illinois University who now serves as a cardiothoracic surgeon at St. Luke's Hospital, Dr. Reidy reveals why surgical program directors actively seek athletes for their residency programs.

The parallels between competitive athletics and surgical mastery become evident as Dr. Reidy describes his training at the renowned Texas Heart Institute within the massive Texas Medical Center complex. This medical metropolis, housing approximately 40 hospitals including world-class institutions like MD Anderson Cancer Center, provided unparalleled surgical volume and experience. "Reps really matter," Dr. Reidy emphasizes, explaining why busy surgeons typically deliver superior outcomes through both experience and validated trust from referring physicians.

Dr. Reidy offers fascinating insights into modern cardiothoracic surgical approaches, particularly his preference for minimally invasive thoracic techniques that speed recovery without compromising cancer outcomes. He shares his philosophy on esophageal cancer surgery, balancing technical considerations with patient safety through meticulous visualization. Beyond the operating room, he discusses how mountain biking and disconnecting from constant communication help maintain the mental clarity needed for surgical precision. Whether you're curious about surgical careers, interested in medical technology advancements, or simply appreciate stories of human excellence, this conversation delivers compelling perspectives from the cutting edge of cardiothoracic surgery.