Pamela Wible MD

JUNE 20, 2025

Psychiatrists define burnout as a job-related dysphoria in an individual without major psychopathy—meaning you’re normal; your job is killing you. Moral injury is a normal human response to an abnormal traumatic event—a deep soul wound shattering one’s identity and morality. Primary prevention intervenes before injury (seatbelts).

Medical Student 246

Medical Student Diagnosis Physicals Medical 246

PEMBlog

OCTOBER 2, 2024

uh, ill defined epigastric or chest pain, and it’s often worse by eating or lying down after meals. This measures both acid and non acid reflux events. This is obviously ordered by a gastroenterologist, but But the probe itself measures reflux, and then the patient can press a button for an event monitor.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

GeriPal

OCTOBER 5, 2023

Summary Transcript Summary Communicating about a serious illness is hard. Last week’s podcast we talked about the challenge around miscommunication in serious illness. Why it’s such a natural way to explain the condition of someone with an acute critical illness that’s threatening their life. Eric: Why is it?

Illness 136

Illness IT Patient-Centered Families 136

GeriPal

MARCH 9, 2023

Two of our guests today, Stacy Fischer and Brian Anderson, are involved in large multicenter trials of psychedelics for patients with advanced cancer (Fischer) or life-limiting illness (Anderson). Psilocybin, the most commonly used psychedelic, increases heart rate and blood pressure, which may potentially lead to cardiovascular events.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

FEBRUARY 20, 2025

The SAMHSA defines trauma as an event, series events or set of circumstances experienced by an individual as physically or emotionally harmful or life threatening, with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional or spiritual. I guess that’s an event.

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

MAY 25, 2023

Sarah: But as you bring your inner circle into your care, you know, how does that that that feels like an important group to be assessing in terms of psychological outcomes and kind of what their experience with the process is like as they’re navigating illness and serious illness. Alex: LJ, are you going to add to that?

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. Areej: So when I was in college, I had a close friend who had a serious illness and actually died as a result of cancer. I entered medical school and I did a course that was offered that’s called living with a life threatening illness.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

JUNE 30, 2022

Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. Eric: And what do we know about the outcomes of individuals getting these procedures, especially those with cognitive issues and dementia. Welcome to the GeriPal podcast, Samir. Samir: Thanks, Alex and Eric.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Participants were critically ill and intubated. P AI R stands for Palliative and Advanced Illness Research Center. What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. So we’re going to be today talking about serious illness palliative care in the homelessness population. And this is really traumatic event for his street family and the street community that he knew.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

OCTOBER 26, 2023

Ann: Well, I think teamwork is key in this space and I am a big baseball fan, big Red Sox fan, which is not a good thing to be right now, but I really think it’s indicative of how we should all be working together on this team to help our seriously ill patients. Ann: No, he was very excited. So we used a lot of rehab to death.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. GeriPal podcast with Linda Fried on frailty. Lauren: Yeah.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

MARCH 13, 2025

Alex Smith Links Link to the McGill National Grand Rounds Series on Palliative Care , Michael Kearney as initial presenter, and registration for future events. When we first started, they were concerned about the fact that nurses were going to be only working with people that were very ill and people that were grieving. by Kearney.

IT 104

IT Patient-Centered Families Family 104

GeriPal

SEPTEMBER 12, 2024

Ishwaria 05:29 And that’s really how this field of professional well being, healthcare professional well being, clinician well being, has evolved, is that there is an important place in our overall professional well being for personal resilience and our individual coping strategies, recovery methods from day to day. And Covid was just.

IT 110

IT Healthcare Healthcare Professional Patient-Centered 110

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. And I think that there is room for shortening the duration if your patient is non-immunocompromised and not severely ill. difficile infections.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JULY 11, 2024

We get a bit of, in the veteran population, kind of a mix of a lot of mental health issues thrown into these comorbid illnesses, including cirrhosis, but it’s usually the decompensated cirrhotics or the folks with liver cancer and cirrhosis, or one of both. Can you come and be in our clinic once a week? Brittany 15:07 Right.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

NOVEMBER 7, 2024

We also briefly mention Susan Wong’s terrific studies that found a disconnect between older adults with renal failure’s expressed values, focused on comfort, and their advance care planning and end-of-life care received, which focused on life extension; and another study that found quality of life was sustained until late in the illness course.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

FEBRUARY 17, 2022

When we have a medication with up front harms and downstream benefits, it’s critical that we consider the time to benefit, or how long it will take an individual to benefit from a test or treatment. For individuals with a life expectancy less than the time to benefit, the up front harms outweigh the downstream benefits. .

Clinic 67

Clinic IT Patients Medical 67

GeriPal

JUNE 22, 2023

Through a series of events, I started working as a consultant to the Department of Corrections in around 2006, and I was assigned to the California Medical Facility. But now we have older people dying of older people illnesses. He struggled with mental illness, substance use disorder. Welcome to the GeriPal podcast, Michele.

Families 132

Families Family IT Community 132

GeriPal

JUNE 26, 2025

Those disruptive events or shocks often portend a major decline in function from which people with dementia never fully recover. Today we talk about disruptive events, or health and wealth shocks. So thought it related to our theme of disruptive events about different ways in which you may experience an early demise.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. So there’s this, what is suffering to the individual, and is there some threshold that we could say, “This is real suffering,” or “This is the suffering we talk about in geriatrics or palliative care”? Pain Manag Nurs. doi: 10.1016/j.pmn.2023.11.004.

IT 137

IT Families Family Physicals 137

GeriPal

OCTOBER 27, 2022

James: Yeah, so I guess just to start… I mean, prognosis in general is kind of a term for predicted course of disease, and I think people commonly use it to refer to an individual’s life expectancy or how long the person has to live. I think this is a really difficult topic to talk about with patients.

IT 95

IT Clinic Screening Patients 95

GeriPal

OCTOBER 3, 2024

I wonder if you could say a little bit more about the meta Institute in particular and what it is that clinicians today can do to learn, to be more present and learn about the need to be thoughtful and compassionate in the care that they provide people with serious illness. I cracked myself in my head of these individuals.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

AUGUST 8, 2024

And I think, oh, there was something she did besides getting cancer and dying, which requires such a focus, you know, cancer and terminal illness of any kind. Whereas in cultures that practice cremation properly, it’s a public event full of ceremony and ritual and expectation. And I wonder your thoughts about that. I won’t.

IT 124

IT Families Family Relationship 124

GeriPal

SEPTEMBER 19, 2024

Alex 12:36 And most of our listeners are like clinician, practicing clinicians caring for older adults, people with serious illness. Eric 21:46 So this study showed that in people with chronic critical illness, having palliative care lead one and a half sessions in an ICU around prognosis and goals. Is this superior to that?

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

MARCH 16, 2023

And then I feel like when I’m in clinic I’m helping individuals, and you only have so much time to help so many people. Louise: Well again, if you take that approach, you also get rid of ableism and ageism against children and prejudice against people who are ill. But I was focused on his very ill wife. Eric: Yeah.

IT 105

IT Healthcare Professional Healthcare Transportation 105

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. So the palliative performance scale, or PPS, is essentially a tool to help clinicians with prognostication for seriously ill or palliative care populations.

Families 106

Families Family Patient-Centered Patients 106

GeriPal

DECEMBER 1, 2023

And the two were sort of intermeshed even to the point in the eighties, the thought was all dementia is Alzheimer’s or it’s some medical illness or combination of other stuff that’s not about it. That’s in my view as analogous as to any other illness. You need the plaques to have that illness.

IT 115

IT Clinic Illness Hypertension 115

Medical Xpress

JUNE 23, 2025

Wood, director of Northeastern Universitys Extreme Medicine Certificate Program, says its important for people to recognize the signs of heat illness and how quickly heat exhaustion can progress to heat stroke, when immersion in cold water is necessary to save lives. Heat stroke is the most serious heat illness, Wood says.

Illness 59

Illness Engineering Nurse Practitioner Medical 59

GeriPal

JULY 16, 2024

I think what ageism, when you get right down to it, is, is not really seeing the individual in front of you and the individual in the setting of what they’re trying to accomplish and what matters to them, that it’s always appropriate. Eric 04:17 How do you think about that? Interestingly enough, Ama also has a similar rule.

Diagnosis 141

Diagnosis Diagnose IT Physicals 141