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by David Spiro, MD | Doctor Podcast Network
HuMed goes beyond diagnoses and procedures to explore the profound human experiences of medical professionals. Join Dr. Spiro as he engages in deep, candid conversations with fellow doctors, nurses, and other healthcare providers. They share the often-unseen realities of their work in the demanding hospital environment – the challenging cases, the emotional toll, and the ethical dilemmas they navigate daily.
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At 14, Josh Belfer was working for a radio star: Philadelphia talk-radio host Michael Smerconish. Today he is a pediatric emergency medicine attending at Children's Hospital of Philadelphia (CHOP) and Assistant Professor of Clinical Pediatrics at Penn, and he joins Dr. David Spiro on HuMed to tell how that mentorship shaped the physician he is today.It started on a 45-minute bus ride to school in 2004, when his dad suggested he switch his Discman to AM talk radio. One visit to the studio led to news tips, then research for a book chapter, then a one-line email, "This is fantastic. Great work.", and years as an intern and researcher, including an elevator interview with Jose Canseco. Josh explains how the pace of live radio taught him to turn on a dime in the ER, and why he feels what his patients' families feel more now that he is a father himself. He and David also talk about surviving overnights, noticing when a colleague isn't OK, hot and cold debriefs after hard cases, and the mentors he watched lead through COVID during his chief residency year. It's a warm conversation about mentorship, resilience, and the human side of pediatric emergency medicine.In this episode:– A Discman, AM radio, and a 14-year-old's first studio visit– The one-line email that launched years as a researcher– An elevator interview with Jose Canseco– How live radio trains you to turn on a dime– "I feel what my patients feel more now that I'm a father"– "If it was your child, what would you do?"– Overnights, sleep, and a two-physician household– Who notices when a colleague isn't OK?– Hot and cold debriefs, and letting residents step away– Mentorship, grit, and working like you could get cutChapters00:00 "The parents are hearing that noise"00:16 Meet Dr. Josh Belfer01:39 The story he chose to tell02:39 2004: a freshman on a 45-minute bus ride04:12 A Discman, his dad, and Philly talk radio05:58 Election night and an invitation to the studio06:49 First morning in a shoebox studio08:47 Research for a book chapter at 1409:41 "This is fantastic. Great work."10:52 Reporting from the field12:11 An elevator interview with Jose Canseco14:56 Radio's pace, and the road to the ER15:15 Breaking news at 6:45 a.m.16:44 No script in the pediatric ER18:09 Focus, hard work, and staying humble20:21 Fatherhood and a career at CHOP22:38 "I feel what my patients feel"23:35 "Is this something to be worried about?"24:45 Overnights, sleep, and emotional reserve26:30 How he gets through overnights29:13 Who notices when a colleague isn't OK?30:47 "Weren't you just here yesterday?"31:34 Starting over as a new attending35:02 When residents see something hard35:54 Hot and cold debriefs, explained37:20 Letting a resident step away39:18 The check-in, days later40:24 The power of "Are you okay?"41:16 Grit, resilience, and working like you could get cut43:56 Mentors, then and now45:05 Chief resident when COVID hit Long Island46:31 Rapid fire: Sixers or Knicks?47:35 HipPEMcrates and the PEM Podcast49:20 Closing reflectionsJosh earned his BA at the University of Pennsylvania and his MD at Rutgers Robert Wood Johnson Medical School, completed pediatric residency and a chief residency year at Cohen Children's Medical Center, and trained in pediatric emergency medicine at Columbia University. He created HipPEMcrates, a pediatric emergency medicine education blog (hippemcrates.com), and works behind the scenes on the PEM Podcast with his father, Dr. Robert Belfer.HuMed unveils the human side of medicine, hosted by Dr. David Spiro, MD.New episodes on Apple Podcasts, Spotify, and YouTube — please follow and leave a rating, it helps other listeners find the show.
What if your cholesterol looks normal, your 10-year risk score is just 2.3%, and you're still a ticking time bomb? Josh Wageman, PhD, DPT, a clinical lipid specialist, physician assistant and author of The Home Security System and the Lipid Neighborhood, joins Dr. David Spiro on HuMed to tell the story of a fit, running friend whose Lp(a) and coronary artery calcium score revealed heart disease his routine labs had missed.His friend's family history was riddled with heart attacks, yet his blood pressure, blood sugar and LDL were all normal. One conversation on a 5:30 a.m. run led to two extra tests: an Lp(a) of 128 mg/dL and a calcium score of 2,814. He needed a five-vessel bypass, and a year later he finished a half Ironman. Dr. Wageman explains why he calls Lp(a) "the felon of the lipid neighborhood," what a low-dose coronary calcium (CAC) scan shows and what it costs, and how statins, ezetimibe and PCSK9 inhibitors work, told through his mailman metaphor. It's a warm, often funny conversation about prevention, friendship, and using what you know to help the people you love.In this episode:– Normal cholesterol, a 2.3% risk score, and a calcium score of 2,814– "Got plaque? Get a CAC": what a coronary calcium scan shows– Why Lp(a) is "the felon of the lipid neighborhood"– A five-vessel bypass, then a half Ironman a year later– The four pillars of your heart's home security system– Why Lp(a) is worth checking at least once in a lifetime– Menopause, statins and rising Lp(a)– Statins, ezetimibe and PCSK9 inhibitors, explained with mailmen– "Prioritize protein and eat real food"Chapters00:00 "He was a ticking time bomb"00:18 Meet Josh Wageman, clinical lipid specialist01:38 Why stories stick better than textbooks02:13 "Beyond the 10-year risk calculator"02:41 A runner friend with a worrying family history03:40 "Got plaque? Get a CAC"04:01 Normal labs and a 2.3% risk score05:05 "He picked the wrong parents": an Lp(a) of 12805:35 A coronary calcium score of 2,81406:20 A ticking time bomb and a five-vessel bypass07:08 A half Ironman one year after surgery07:57 What a calcium scan is, and what it costs09:28 From reactive to preventive medicine10:01 Does a calcium score show narrowing?11:07 "You're fine till you're not"11:58 The four pillars of your home security system12:58 Lp(a): the felons of the lipid neighborhood14:18 The genetic piece: one in five people16:06 Checking Lp(a) at least once in a lifetime17:10 Menopause, statins and rising Lp(a)18:02 The patient whose Lp(a) jumped on a statin19:02 Statins, plaque and the art of medicine21:30 Beyond "HDL good, LDL bad": the mailman metaphor22:34 Statins, ezetimibe and PCSK9, in plain English24:18 Why metaphors and stories matter25:30 Ultra-processed food and the fat-free era26:28 "Prioritize protein and eat real food"28:05 What "real food" means, and what about eggs?30:18 Glucose "dollar bills" and your fat "savings account"32:36 Where to find his book33:23 Closing reflectionsJosh's book, The Home Security System and the Lipid Neighborhood, is on Amazon, with links at lifelovelipids.com.This episode is education and storytelling, not individual medical advice. Talk with your own clinician about testing and treatment.HuMed unveils the human side of medicine, hosted by Dr. David Spiro, MD.New episodes on Apple Podcasts, Spotify, and YouTube — please follow and leave a rating, it helps other listeners find the show.
What happens when a rural doctor opens a scan report in the middle of his ER shift, and it's his own? Dr. Peter Crane — a board-certified family physician in full-time rural practice in Idaho and host of the podcast Doctors Making a Difference — joins Dr. David Spiro on HuMed to talk about the night he read "26 centimeter, likely sarcoma" with patients still waiting, and the long road from radiation and major surgery back to full-time practice.Dr. Crane took over the practice of the doctor who delivered him, in the town where he grew up, caring for patients "from the cradle to the grave." He describes finding the mass himself at 4 a.m., finishing his shift after reading the report, and feeling almost ashamed to be sick. He talks about the surgeon, his own medical school preceptor, who made him promise six weeks off, the two residency friends who took over his entire practice, and the moment of clarity that convinced him he would choose medicine all over again. It's a candid, hopeful conversation about compartmentalization, burnout, life without anonymity in a small town, and being the kind of doctor you'd want for your own family.In this episode:– Reading his own "likely sarcoma" report mid-shift– Compartmentalization: survival skill or harm?– The surgeon who made him promise six weeks off– Two friends who took over his whole practice– What really matters, and why he'd still choose medicine– No anonymity: doctoring in a small town– How a rural family doctor stays current in everything– Fixing burnout with sleep, staffing, and better schedules– "I don't trust doctors, but I trust you": trust and misinformationChapters00:00 "26 centimeter, likely sarcoma"00:17 Meet Dr. Peter Crane01:54 Taking over for the doctor who delivered him02:50 Jet-lagged at 4 a.m.: a mass in his own abdomen04:09 When your practice partner is your doctor06:41 What a doctor feels when it's his own mass08:20 Reading his own CT report mid-ER shift09:42 Is compartmentalization healthy?11:56 Warning signs he missed, and feeling ashamed to be sick13:07 Biopsy, waiting, and a rare diagnosis14:41 His surgeon: his own medical school preceptor15:43 What really matters in life16:42 "If I got to do it again, I'd be a doctor"18:36 How being a patient changed the way he practices19:17 Nerve damage and the long road back20:49 Doctor and patient in the same small hospital21:55 A rash check on aisle 13: life without anonymity23:29 Why every doctor should practice rural for a while26:16 How a rural family doctor stays current in everything28:02 Six weeks off, and the friends who covered his practice30:36 "I just do everything every day"31:31 When helicopters can't fly: tele-critical care33:45 Burnout before the tumor, and what fixed it36:58 Misinformation and vaccine hesitancy38:19 "I don't trust doctors, but I trust you"39:19 Why we need more doctors making content40:36 Closing reflectionsHuMed unveils the human side of medicine, hosted by Dr. David Spiro, MD.New episodes on Apple Podcasts, Spotify, and YouTube — please follow and leave a rating, it helps other listeners find the show.
He looked fit, ate well, exercised, and had a calcium score of zero six months earlier. Then, at 34, Dr. Stephen Hussey had a widowmaker heart attack.Diagnosed with type 1 diabetes at age nine, Dr. Hussey, a doctor of chiropractic with a master's in functional medicine and author of Understanding the Heart, spent his adult life trying to do everything right. In this episode, pediatric ER physician Dr. David Spiro talks with him about the heart attack he suffered alone during COVID, the frustration of feeling unheard in the hospital and being labeled noncompliant, his decision to depart from the standard medication plan, and the stress he believes set the stage for it all. David also presses him on the hard question: how can he know what actually drove his recovery? The episode ends with what nearly dying at 34 changed about his life and purpose.CHAPTERS0:00 "I had a widowmaker heart attack at 34"0:16 Meet Dr. Stephen Hussey1:39 Asthma, allergies and type 1 diabetes at age nine2:53 "I felt like a pincushion" and the nurse with the magic kit4:19 Giving bad news to children and families7:25 From patient to health practitioner9:17 What "avoiding toxins" means to him10:33 Sauna, sweat and microplastics14:13 A heart attack despite a zero calcium score17:53 What a widowmaker heart attack felt like21:28 Alone in the hospital during COVID23:30 Labeled "noncompliant"25:23 Why he declined the standard medications27:00 A new blockage in his leg29:04 Light, sauna and circadian rhythm33:58 Semmelweis and challenging medical dogma35:17 How does he know what worked?37:43 Stress and the nervous system41:38 The 36 hours before the heart attack43:28 Heart attacks without blocked arteries45:44 "Stay in your lane": answering his critics47:55 Heart disease, obesity and insulin resistance51:43 What nearly dying at 34 changed54:44 ClosingWatch the full video on YouTube: HuMed with David Spiro, MDFollow HuMed on Instagram: @humedpodHuMed unveils the human side of medicine through real stories from clinicians. Guests share their personal experiences and views, which are their own. This episode is for storytelling and education, not medical advice. Talk with your own doctor before changing any treatment.
After years in emergency medicine, Dr. Vassily Eliopoulos (Dr. Vass) coded a man in a rural Wyoming ER who was his age, had no other risk factors, and looked exactly like him. That night pushed him from the ER toward longevity medicine and cardiovascular prevention.In this episode of HuMed, pediatric ER physician Dr. David Spiro talks with Dr. Vass about why doctors neglect their own health, the "golden handcuffs" that kept him stuck, how therapy and CBT-I helped him heal from years of night shifts, and why he believes disease care and true health care are two different systems. He also walks through his longevity pyramid, built on community, purpose and sleep, not supplements and saunas.CHAPTERS0:00 He coded a man who looked exactly like him0:28 Meet Dr. Vass: ER doctor turned longevity physician2:05 The code in Rock Springs, Wyoming4:48 Why doctors neglect their own health8:13 The lost art of healing11:03 "We're training technicians, not physicians"15:07 Trapped in a broken system18:18 The golden handcuffs20:44 Healing from decades of night shifts28:30 Disease care vs. true health care35:37 Why no one told Dr. James Wittig he was sick39:04 Advice to his younger self: don't let fear decide42:32 Dr. Vass's longevity pyramid44:55 What dying patients talk about47:51 Purpose: the old dog and the rabbit51:21 A quarterly "board meeting" with his kids53:16 Fasting, thermal springs and community57:54 Closing thoughtsWatch the full video on YouTube: HuMed with David Spiro, MDFollow HuMed on Instagram: @humedpodhumedpod.comHuMed unveils the human side of medicine through real stories from physicians. This episode is for education and storytelling, not individual medical advice.
"I did healing for myself first, so I could become a better healer."Before Dr. Melissa Mondala treated patients with lifestyle medicine, she needed it herself. She lived with IBS and reflux from her teens, and during her training at Loma Linda she was diagnosed with an atypical breast cancer. Changing how she ate, moved, slept and handled stress changed her health, and her husband's, and it reshaped how she practices medicine.On this episode of HuMed, Dr. David Spiro talks with Dr. Mondala, a double-boarded family and lifestyle medicine physician, fellowship-trained in integrative psychiatry and integrative medicine, about the patients who shaped her: a young single mother of three with pancreatic cancer who kept running for her kids, and a fashion designer with an autoimmune disease who got her life back layer by layer.They also discuss:Lifestyle medicine vs. integrative medicine, and where they overlapWhy ferritin matters even when hemoglobin looks normalHer approach to adult behavior change: one habit, SMART goals and habit stackingWhat medical training leaves out about nutrition and sleepAdvice for frustrated, burned-out physicians who feel stuck practicing reactive medicineDr. Mondala earned her MD at Chicago Medical School at Rosalind Franklin University. She is co-founder of the Doctor Lifestyle Clinic, a direct care practice, and author of Embody Lifestyle Medicine: How to Build a Successful Direct Care Startup.HuMed unveils the human side of medicine through honest conversations with physicians. Follow the show so you never miss an episode.Chapters00:00 Cold open00:22 Introducing Dr. Melissa Mondala02:25 Her own health story: IBS, reflux and food as poison04:21 Loma Linda and the Blue Zones05:30 A breast cancer diagnosis during training07:00 The pillars of lifestyle medicine and her husband's autoimmune disease08:49 The young mother with pancreatic cancer13:53 Lifestyle medicine vs. integrative medicine18:50 A patient with autoimmune disease and a difficult cycle27:36 Why ferritin matters31:45 What standard medical training leaves out36:48 Night shifts, sleep and processed food40:09 How to change adult behavior44:12 Accountability, SMART goals and habit stacking47:05 Lifestyle medicine and autism spectrum disorder50:54 Advice for frustrated, burned-out physicians53:31 Closing
Dr. Rick Pescatore was driving to Pittsburgh with a woman he had met on Hinge, describing a kind of patient he sees every ER shift: pain, nausea, vomiting, and tests that all come back normal. She said the person he was describing "sounds exactly like my mom." A few weeks later her mother was dying in an ICU, and nobody could solve her mystery illness. The missing piece turned out to be vitamin B1 (thiamine). The woman from that drive is now his wife, Katie.Dr. Pescatore is a board-certified emergency physician. He went through the U.S. Naval Academy, studied aerospace engineering, and served in the Navy's submarine force before medical school. He trained at Cooper University Hospital, served as Delaware's chief physician during the COVID-19 pandemic, is editor-in-chief of Emergency Medicine News, still works shifts in a community ER, and co-founded Belly MD.In this conversation with Dr. David Spiro, he talks about helping diagnose his future mother-in-law, why so many ER patients are told they are normal when their lives are not, and how that pattern helped burn him out of full-time emergency medicine. They also get into what night shifts cost physicians, his Navy call sign, his time leading Delaware's pandemic response, and why an ER doctor who used to roll his eyes at supplements now sells them.In this episode:– The drive to Pittsburgh: "sounds exactly like my mom"– An ICU stay nobody could explain, and the vitamin B1 answer– "We tell them that they're normal, but their lives aren't"– Disorders of gut-brain interaction and the ER– Why he calls GLP-1 drugs some of the most revolutionary in history– Burning out of emergency medicine, and the night-shift toll at every age– F-18s, submarines, and the call sign "Aquaman"– Chief physician for Delaware during COVID-19– An ER doctor selling supplements: his answer to the eye-rollsChapters Cold Open: "Met a Girl on Hinge" Welcome & Meet Dr. Rick Pescatore The Drive to Pittsburgh: "Sounds Exactly Like My Mom" Decades of Symptoms, Then the ICU Vitamin B1 and Gastrointestinal Beriberi "We Tell Them That They're Normal" Saving Her Mom's Life With a Vitamin Belly Pain: What the ER Can't Fix Disorders of Gut-Brain Interaction Should Emergency Medicine Change? Diet and the American Food System Sulfite Preservatives and Vitamin B1 GLP-1s, Falls, and the Toenail Question The Naval Academy, F-18s, and the Call Sign "Aquaman" "I Burned Out of Emergency Medicine" The 3 a.m. Problem: Night Shifts and Physician Health Dr. Spiro on Night-Shift Anxiety Chief Physician for Delaware During COVID-19 Building Belly MD Supplements: "I Used to Be That Guy" An ER Doctor Selling Supplements? Testing for Vitamin Deficiencies ClosingLearn more about Dr. Pescatore's work: bellymd.comCheck out the Inside HuMed Newsletter: https://www.humedpod.com/inside-humedThis episode is one physician's personal story and is not medical advice. Dr. Pescatore co-founded Belly MD, which sells supplements, as he discusses in the episode.If this episode meant something to you, follow HuMed on Apple Podcasts and send it to one colleague who needs to hear it.
A Monday morning, 6:45. Dr. Kim Blankshain is changing her infant son when she hears a crash in the next room. Her husband is sitting on the edge of the bed, bleeding from a gash in his forehead. She expects a few stitches. Hours later an ER physician says the CT scan came back and he is being sent downtown to see neurosurgery right away. "What is happening?"Dr. Blankshain is a neuro-ophthalmologist in the Chicago suburbs, a specialist in vision problems that begin in the brain and nervous system. She was in fellowship, trained to read MRIs and CTs, when the scan on the screen was her husband's: an epidermoid cyst pressing on his brainstem, and brain surgery set for the next morning. She joins Dr. David Spiro to talk about being the doctor in the waiting room, and how it changed the way she delivers bad news to her own patients.In this episode:- Why knowing the medicine made it harder, and the moment the neurosurgeon asked, "What do you do for a living?"- The waiting-room buzzer three hours into a four-to-six-hour surgery: "That can't be good"- Receiving bad news as a physician: "I wasn't really hearing what he was saying"- How she gives hard news now: slow down, say it more than once, and sit in the silence- Going back to work the day after her husband came home, with her time off for the year already used on six weeks of maternity leave- Parental leave in medical training, and why she calls the culture "cruel"- Working-mom guilt and the "have it all" lie: "Something has to give on any given day"- Marriage after a baby: feeling like roommates, a year of couples therapy, and TV-free Thursdays- What she tells pre-med students: "It's still just a job"Dr. Spiro also shares how he gives bad news to families in the pediatric ER.Chapters00:00:00 "What is happening?"00:00:20 Meet Dr. Kim Blankshain00:01:50 What a neuro-ophthalmologist does00:02:22 A crash in the next room00:04:10 The ER and the CT scan00:06:08 Rush University: the MRI and the neurosurgeon00:07:27 "What do you do for a living?"00:08:14 Brain surgery, tomorrow00:08:53 The waiting room: "That can't be good"00:09:43 Six weeks of recovery00:10:13 How it changed the way she sees patients00:11:45 On the other side of bad news00:13:04 Slow down, repeat it, sit in silence00:14:17 Dr. Spiro: bad news in the pediatric ER00:15:25 "You are so lucky that you came to me"00:16:36 Back to work the next day00:19:41 Parental leave in medical training00:22:43 Balance with a five-year-old00:23:58 The "have it all" lie00:24:39 On call on the Fourth of July00:26:37 "It's still just a job"00:27:50 Marriage after a baby00:29:23 Couples therapy and TV-free Thursdays00:32:33 Why she believes in therapy for physicians00:33:44 "Nobody says that to a mechanic"00:34:08 Why she reached out to HuMed00:35:31 ClosingCheck out the Inside HuMed Newsletter: https://www.humedpod.com/inside-humedThis episode is one physician's personal story and is not medical advice.If this episode meant something to you, follow HuMed on Apple Podcasts and send it to one colleague who needs to hear it.
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HuMed goes beyond diagnoses and procedures to explore the profound human experiences of medical professionals. Join Dr. Spiro as he engages in deep, candid conversations with fellow doctors, nurses, and other healthcare providers. They share the often-unseen realities of their work in the demanding hospital environment – the challenging cases, the emotional toll, and the ethical dilemmas they navigate daily.
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