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This Medical Life

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Welcome to the This Medical Life podcast. Our mission is to share stories about the triumphs and tragedies of diseases and illnesses from ancient times up until what we know today. It is about those scientific and medical minds who came before us and how, every single day, we stand on the shoulders of giants. This is a podcast about the stories of medicine. Hosted by Dr. Travis Brown and Steve Davis, our target audience is General Practitioners, medical students, and other health professionals. We hope to educate, inspire and celebrate those who choose to care for others in their profession. From experience, we know that our audience extends beyond these fields and would like to welcome anyone to listen. The stories of those who came before us are nothing short of remarkable and we hope you enjoy them as much as we do. Production by Steve Davis

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S7 · E113
Yesterday · 1 hr 13 min
Episode 113: Early Onset Colorectal Cancer (EOCRC)
Early onset colorectal cancer is bowel cancer diagnosed before the age of 50. It makes up about 10 to 15% of colorectal cancers, and incidence is rising by about 2% a year according to colorectal surgeon Dr Scott Mackenzie. In Episode 113, a patient, a colorectal surgeon and a GI pathologist look at what the condition means for clinicians. Age is no guide. Many of these patients have few symptoms and present at stage three or four. Helen Worthington describes her diagnosis of stage four bowel cancer at 39 and what she would like doctors to know. Dr Mackenzie explains why persistent bowel symptoms and rectal bleeding need investigation at any age, and why family history is the most practical risk marker. Dr Tristan Rutland covers how these tumours differ under the microscope, including the poorly differentiated, mucinous and signet ring types seen more often in younger patients. Younger patients are easy to reassure. The guests suggest a low threshold for colonoscopy referral when a younger patient has a persistent change in bowel habit or rectal bleeding, and genetic assessment after any early onset diagnosis. The episode introduces you to the symptoms, risk markers and pathology findings relevant to this group, so you can feel more prepared for the younger patient with bowel symptoms. This is the story of early onset colorectal cancer. Our Special Guests: Helen Worthington is an Adelaide-based primary educator, wife and mum with almost 20 years in schools as a classroom teacher and in leadership roles. In 2025, at 39, she was diagnosed with stage four bowel cancer. She is on extended leave from teaching and having chemotherapy. Dr Scott Mackenzie studied medicine in Aberdeen, completed basic surgical training in Glasgow, then subspecialty training in general and colorectal surgery in Edinburgh. He was the international colorectal fellow at Concord Hospital in Sydney, and is now a senior lecturer in surgery and a surgeon in the Colorectal Surgery Department at Liverpool Hospital. Scott is a returning guest. Dr Tristan Rutland is an anatomical pathologist and associate professor at the University of Western Australia, with a subspecialty and research interest in GI pathology and asbestos-related diseases. He received the Conrad Muller RCPA Outstanding Teaching Award in 2020 and the Resident Advocate Award from the College of American Pathologists in 2022. Tristan is a regular guest. Listen: This Medical Life podcast is available on all podcasting services, Apple Podcasts, YouTube, and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E112
October 19 · 32 min
Episode 112: Pleomorphic Adenoma | Mixed Tumours
Pleomorphic adenoma is the most common parotid gland tumour. It is benign, usually presents as a painless, slow-growing lump near the jaw, and was first described by surgeon Theodor Billroth in 1859. In Episode 112, ENT surgeon Dr Rowan Valentine explains how it is assessed and managed. Meet the mixed tumour. In 1859, German-born Austrian surgeon Theodor Billroth gave the first medical description of a slow-growing, painless, encapsulated tumour that occurs mainly in the parotid gland, beside the jaw. Under the microscope it showed a mix of tissue types, so he called it a “mixed tumour”. Today we know it as a pleomorphic adenoma. Billroth also performed the first laryngectomy and the first successful partial gastrectomy for gastric cancer, and he was a friend of the composer Johannes Brahms. Dr Travis Brown tells his story at the start of the episode. Jaw lumps raise worry. Dr Valentine walks through what he asks, what he examines, and what he recommends when a patient presents with a parotid lump. History: how long the lump has been there, whether it hurts, whether it changes in size, and whether the patient has noticed any weakness of the face. Examination: mobility of the lump, the overlying skin, tenderness, sensation near the ear, and the function of each branch of the facial nerve. Red flags: pain, skin involvement, a history of skin cancer excisions on the head and neck, and facial nerve paralysis. Biopsy limits: in Dr Valentine’s words, fine needle aspirates and core biopsies have about 90% accuracy in separating benign from cancerous lumps. Surgery: what the operation involves, how the facial nerve is protected, and the risks Dr Valentine quotes to patients. Follow-up: why recurrence can follow if the capsule of the tumour is breached, and how that shapes surveillance. Long-standing lumps are easy to set aside. Dr Valentine explains why a lump that has been present for years still deserves a plan, and his closing advice for doctors is that a parotid lump is cancerous until proven otherwise. The episode introduces you to the questions, examination findings and red flags an ENT surgeon looks for, so you can feel more prepared for the patient who says, “I’ve had this for years.” This is the story of pleomorphic adenomas. Our Special Guest: Dr Rowan Valentine is an adult and paediatric ear, nose and throat (ENT) surgeon. He trained in Adelaide, completed a PhD during his surgical training, and spent a year at the University of Florida on an anatomy fellowship. He supervises surgical trainees and medical students, and he is a regular guest on This Medical Life. Listen: This Medical Life podcast is available on all podcasting services, Apple Podcasts, YouTube, and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E111
October 5 · 52 min
Episode 111: 2026 Early Prostate Cancer Detection | PSA And mpMRI
New guidelines are here. The Prostate Cancer Foundation of Australia and the Australian Government Department of Health, Disability and Ageing have released the 2026 Guidelines for the Early Detection of Prostate Cancer. One in seven Australian men will be diagnosed with prostate cancer. The aim is to find early prostate cancer in the men most at risk, while sparing low-risk men tests they do not need. The story starts in forensic science. In the 1960s, crime labs needed a better way to detect semen than finding sperm, which break down within minutes to an hour. Dr Travis Brown explains how the Japanese forensic scientist Mitsuhara identified a protein he called gamma-seminoprotein. Teams at Cornell and the University of California found the same protein under other names. Today we call it PSA. By the 1970s, researchers saw it was raised in advanced prostate cancer, and its long, debated path as a screening test began. The last guidelines came out in 2016. Since then, two things have shifted the balance of risk and benefit: access to multiparametric MRI, and the move from transrectal to transperineal biopsy. In this episode, Ken walks through the key changes: Free-to-total PSA ratio is no longer needed. MRI is better at sorting risk. About 80% of men with a confirmed PSA above 3 already have a free-to-total ratio below 25%. Ages 45 to 49 (higher risk): refer when PSA is above 1 ng/mL. This group includes men with a brother with prostate cancer, a father diagnosed at 65 or younger, or a BRCA mutation. Ages 50 to 69: the threshold stays at 3 ng/mL, or 2 ng/mL for higher-risk men. Ages 70 and over: for men likely to live more than seven years, the threshold is 5.5 ng/mL. Men below 5.5 can reasonably stop testing. Repeat the test in one to three months. About 30% of men with a PSA above 3 will test well below 3 on repeat, often due to BPH-related variation. GPs should now start the conversation. The 2016 guidelines had GPs respond when a man raised it. The new guidelines, endorsed by the RACGP, ask GPs to raise PSA testing with men aged 50 to 69. Not for prostate cancer screening. In the evidence, rectal exams by non-specialists added as many false positives as false negatives. Ken notes that urologists still gain useful information from it, and a rectal exam remains relevant when you are looking for rectal cancer. Men with a first-degree relative with prostate cancer, men with BRCA mutations, and men of African ancestry. The guidelines also name Aboriginal and Torres Strait Islander men as a priority population because of poorer access to care. Ken adds that men in regional Victoria have worse prostate cancer outcomes than men in the city. This is the story of the 2026 Early Detection of Prostate Cancer. Useful Link: 2026 Guidelines for the Early Detection of Prostate Cancer in Australia Our Special Guest: Professor Ken Sikaris is a chemical pathologist and head of clinical integration at Dorevitch Pathology. He is a NATA laboratory assessor, a founding fellow of the RCPA Faculty of Science and a principal examiner in pathology informatics. Ken was one of the first people to measure PSA in Australia, bringing in some of the first test kits around 1989. He helped write the new guidelines. Listen: This Medical Life podcast is available on all podcasting services, Apple Podcasts, YouTube, and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E110
September 21 · 1 hr 7 min
Episode 110: Narcolepsy | Fighting The Sleep Demon
In 1880, a French physician described a patient having up to 200 sleep attacks a day, some triggered by nothing more than a good hand of cards or the sight of his own wine barrels. That case, and an earlier 1877 description from German psychiatrist Carl Westphal, gave the condition its name and its first clinical picture. Dr Travis Brown reads from both original case reports before turning to two guests for where narcolepsy stands today. Di Spillaine, an Australian narcolepsy advocate and lived experience educator, describes going almost 40 years undiagnosed, mistaking her symptoms (childhood hallucinations, cataplexy triggered by laughter, sleep paralysis) for ordinary tiredness until a multiple sleep latency test finally confirmed narcolepsy. Professor Robert Adams, a respiratory and sleep physician at Flinders Medical Centre and medical director of the Adelaide Institute for Sleep Health, explains the underlying orexin deficiency behind narcolepsy type 1, how it differs from everyday tiredness and other sleep disorders, and the diagnostic pathway, including the Epworth Sleepiness Scale and multiple sleep latency testing. What to listen for: the questions Professor Adams suggests a GP ask beyond “are you tired”, and why narcolepsy sits, in his words, at the end of the queue of likely causes but should still be considered in young patients with long-standing, profound sleepiness. This is the story of narcolepsy. Useful Link: Epworth sleepiness scale: https://www.cdc.gov/niosh/work-hour-training-for-nurses/02/epworth.pdf Our Special Guests: Di Spillaine is an Australian narcolepsy advocate, lived experience educator and creator of the podcast Waking Up Tired: Narcolepsy Symptoms Explained Professor Robert Adams is a respiratory and sleep physician at Flinders Medical Centre and medical director of the Adelaide Institute for Sleep Health at Flinders University Listen: This Medical Life podcast is available on all podcasting services, Apple Podcasts, YouTube, and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E109
September 14 · 1 hr 6 min
Episode 109: Sexual Harassment In Medicine | Dr Louise Stone
Sexual harassment in medicine is almost universally perpetrated by men, and in over half of doctor-on-doctor cases, it happens in the workplace itself, not at a conference or a staff event. That is one of the findings from a decade of research by Dr Louise Stone, who began this work in 2014 after a young intern disclosed a sexual assault to her in consultation. Dr Travis Brown speaks with Dr Louise Stone, a professor of general practice with expertise in doctors’ health, sexual safety and professionalism, about what her research uncovered. Dr Stone identifies two distinct groups of perpetrators: persistent predators who choose careers with access to power, and a smaller group of senior doctors, often isolated by decades of on-call work, who form inappropriate attachments without the same pattern of repeat behaviour. She explains why junior doctors on rotating three-month terms are especially vulnerable, why specialties such as surgery, psychiatry and pathology carry disproportionate risk, and why zero tolerance policies tend to drive the problem underground rather than reduce it. She also sets out what she has found does help: peer intervention from someone at the same level of seniority as the person behaving badly, and giving survivors clarity on what they actually want from a reporting process, whether that is justice, protection of others, or simply healing. What to listen for: The early warning signs Dr Stone flags for junior doctors and medical students, and why a colleague’s discomfort is worth naming rather than dismissing. This is the story about sexual harassment in medicine. Our Special Guest: Dr Louise Stone is a professor of general practice, previous lead medical educator for GP training in Australia, and author of Sexual Harassment Between Doctors: Healing Medical Cultures Around the World, available from her website: https://www.drlouisestone.com Listen: This Medical Life podcast is available on all podcasting services, Apple Podcasts, YouTube, and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E108
August 31 · 1 hr 6 min
Episode 108: Alzheimer’s Disease | Auguste Deter’s Decline
One doctor’s case from 1901 changed how we understand memory loss. Auguste Deter was 51 when her husband Carl brought her to see Dr Alois Alzheimer in Frankfurt, worried by memory lapses that had turned into paranoia and confusion. When Auguste died five years later, Alzheimer examined her brain and found two things under the microscope: amyloid plaques between nerve cells and neurofibrillary tangles within them. His 1906 presentation to a room of psychiatrists drew no questions at all. It was not until 1910, when Emil Kraepelin included the case in his Handbook of Psychiatry, that the term Alzheimer’s disease appeared in print for the first time. Dr Liam Mulcahy, physician trainee and author of Beyond the White Coat, traces that discovery in detail, then Dr Travis Brown turns to two guests for where the disease stands in 2026. Dr Daniel Clarke, consultant neurologist at Sir Charles Gairdner Hospital and director of clinical trials at Alzheimer’s Research Australia, covers how Alzheimer’s actually presents (often nothing like the stereotype), why history remains the most important diagnostic tool, and why non-pharmacological measures such as exercise and vascular risk control come before medication. He also explains why family history is often overrated, and why he does not recommend routine APOE4 gene testing. Dr Gemma Daley, consultant chemical pathologist at Sullivan Nicolaides Pathology, explains what the new p-tau181 and p-tau217 blood tests can and cannot tell a GP, who should and should not be referred for them, and why they are adjunctive tests rather than standalone diagnostic tools. What to listen for: the presenting features that separate Alzheimer’s from ordinary age-related forgetfulness, and what a negative or positive p-tau result actually means for a patient in front of you. This is the story of Alzheimer’s disease. Useful links: Dementia Australia: https://www.dementia.org.au/ Alzheimer’s Research Australia: https://alzheimersresearch.org.au/ Our Special Guests: Dr Liam Mulcahy is a physician trainee with an interest in neurology and author of Beyond the White Coat Dr Daniel Clarke is a consultant neurologist and director of clinical trials at Alzheimer’s Research Australia Dr Gemma Daley is a consultant chemical pathologist at Sullivan Nicolaides Pathology Listen: This Medical Life podcast is available on all podcasting services, Apple Podcasts, YouTube, and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E107
August 17 · 50 min
Episode 107: Bone Sarcomas Part 2 | Ewing And Coley’s Legacy
Two teenage patients, thirty years apart, changed how bone sarcomas are treated. In 1890, seventeen-year-old Bessie Dashiell saw New York surgeon William Coley with a painful hand. Despite an amputation, she died of metastatic cancer ten weeks later. Coley’s search for a better answer led him to Coley’s toxin, a bacterial treatment now recognised as an early form of immunotherapy. In 1921, pathologist James Ewing treated a fourteen-year-old girl with a wrist tumour he believed was osteosarcoma. Coley’s toxin failed. Radiotherapy, tried next, worked, even though osteosarcoma is classically radiotherapy-resistant. The tumour turned out to be a different disease entirely, now known as Ewing sarcoma, accounting for around 15 percent of bone sarcomas. Dr Travis Brown traces both stories in detail, then turns to two guests for the clinical picture in 2026. Dr Liz Connolly, medical oncologist at Peter MacCallum Cancer Centre and oncology research fellow at ProCan Children’s Medical Research Institute, covers staging (localised versus advanced), chemotherapy regimens for osteosarcoma and Ewing sarcoma, targeted therapies, and why immunotherapy has so far shown limited benefit in these cancers. She also discusses five-year survival, which sits around 70 percent for localised osteosarcoma or Ewing sarcoma, and why chondrosarcoma remains difficult to treat with drugs. Professor Angela Hong, clinical professor at the University of Sydney and radiation oncologist at Royal Prince Alfred Hospital, explains why Ewing sarcoma responds so well to radiotherapy while osteosarcoma and chondrosarcoma do not, how multidisciplinary teams decide between surgery and radiotherapy, current dosing and an active Australian phase III trial, and why early referral to a sarcoma centre matters regardless of where a patient lives. What to listen for: the diagnostic overlap between early bone sarcoma symptoms and everyday musculoskeletal complaints, and what that means for when to consider imaging and referral. This is the story of Bone Sarcoma Part 2. Find Part 1 here. Useful links: Australia and New Zealand Sarcoma Association: https://sarcoma.org.au/ Find a sarcoma specialist: https://sarcoma.org.au/pages/about-sarcoma/find-a-sarcoma-specialist Sarcoma guidelines: https://sarcoma.org.au/pages/sarcoma-guidelines Seeking a second opinion: https://sarcoma.org.au/pages/about-sarcoma/seeking-second-opinion Useful patient information: https://sarcoma.org.au/pages/about-sarcoma/patient-and-carer-sarcoma-information Our Special Guests: Dr Liz Connolly is a medical oncologist who specialises in treating and researching sarcomas Professor Angela Hong is a radiation oncologist and clinical professor at the University of Sydney Listen: This Medical Life podcast is available on all podcasting services, Apple Podcasts, YouTube, and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E106
August 3 · 57 min
Episode 106: Bone Sarcoma Part 1 | Osteosarcoma, Chondrosaroma & Ewing Sarcoma
Bone sarcomas are rare, accounting for 0.2% of all cancer diagnoses, with around 200 cases diagnosed in Australia each year. The three main types differ by age and site: osteosarcoma (around 30 to 35% of cases, often in the arms, legs and pelvis, with peaks in adolescence and again in the seventies and eighties), chondrosarcoma (around 30% of cases, typically in adults over 40), and Ewing sarcoma (around 15% of cases, most common in children). Professor Fiona Maclean, an anatomical pathologist, describes bone sarcoma diagnosis as a pattern-recognition challenge made harder by rarity, noting that tumour type and stage are the two most useful pieces of information for a GP reading a pathology report. A/Professor Richard Boyle, an orthopaedic oncological surgeon, outlines the red flags, including unexplained deep bone pain and night pain, and the diagnostic pathway from X-ray through biopsy to multidisciplinary review. This is the story of Bone Sarcoma Part 1. Useful links: Australia and New Zealand Sarcoma Association: https://sarcoma.org.au/ Find a sarcoma specialist: https://sarcoma.org.au/pages/about-sarcoma/find-a-sarcoma-specialist Sarcoma guidelines: https://sarcoma.org.au/pages/sarcoma-guidelines Seeking a second opinion: https://sarcoma.org.au/pages/about-sarcoma/seeking-second-opinion Useful patient information: https://sarcoma.org.au/pages/about-sarcoma/patient-and-carer-sarcoma-information Our Special Guests: A/Professor Richard Boyle who is a Sydney-based orthopaedic oncological surgeon and head of the NSW Sarcoma unit. Professor Fiona Maclean who is an anatomical pathologist and professor from Macquarie University. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E105
July 20 · 1 hr
Episode 105: Soft Tissue Sarcoma Part 2 | Adjuvant Therapies
The treatment of soft tissue sarcomas is a highly specialised area. The first effective chemotherapy agent against sarcomas was only identified in the 1960s and benefits of adjuvant radiotherapy treatment began in the 1970s. We continue to learn as new agents become available and tailor treatments to each patient. This is the story of Soft Tissue Sarcoma (Part 2). Here is the link to Part 1. Useful links: Australia and New Zealand Sarcoma Association: https://sarcoma.org.au/ Find a sarcoma specialist: https://sarcoma.org.au/pages/about-sarcoma/find-a-sarcoma-specialist Sarcoma guidelines: https://sarcoma.org.au/pages/sarcoma-guidelines Seeking a second opinion: https://sarcoma.org.au/pages/about-sarcoma/seeking-second-opinion Useful patient information: https://sarcoma.org.au/pages/about-sarcoma/patient-and-carer-sarcoma-information Article from the RCPA about reviewing soft tissue tumours and obtaining second opinions: https://pubmed.ncbi.nlm.nih.gov/41390329/ Our Special Guests: Professor Peter Grimison who is a medical oncologist at Chris O’Brien Lifehouse and clinical professor at University of Sydney Associate Professor Stephen Thompson is a radiation oncologist at Prince of Wales hospital and conjoint associate professor at the University of New South Wales The treatment of soft tissue sarcomas is a highly specialised area. The first effective chemotherapy agent against sarcomas was only identified in the 1960s and benefits of adjuvant radiotherapy treatment began in the 1970s. We continue to learn as new agents become available and tailor treatments to each patient. This is the story of Soft Tissue Sarcoma (Part 2). Here is the link to Part 1. Useful links: Australia and New Zealand Sarcoma Association: https://sarcoma.org.au/ Find a sarcoma specialist: https://sarcoma.org.au/pages/about-sarcoma/find-a-sarcoma-specialist Sarcoma guidelines: https://sarcoma.org.au/pages/sarcoma-guidelines Seeking a second opinion: https://sarcoma.org.au/pages/about-sarcoma/seeking-second-opinion Useful patient information: https://sarcoma.org.au/pages/about-sarcoma/patient-and-carer-sarcoma-information Article from the RCPA about reviewing soft tissue tumours and obtaining second opinions: https://pubmed.ncbi.nlm.nih.gov/41390329/ Our Special Guests: Professor Peter Grimison who is a medical oncologist at Chris O’Brien Lifehouse and clinical professor at University of Sydney Associate Professor Stephen Thompson is a radiation oncologist at Prince of Wales hospital and conjoint associate professor at the University of New South Wales Listen: This Medical Life podcast is available on all podcasting services and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E104
July 6 · 1 hr 21 min
Episode 104: Soft Tissue Sarcoma Part 1 | Avoiding The Whoops Lesion
Soft tissue sarcomas are tumours that arise from connective tissue, fat, muscle, and blood vessels. They are distinct from epithelial malignancies (carcinomas) in both morphology and behaviour. Unfortunately, due to their rare occurrence, these tumours can be mistaken clinically and pathologically which affects patients management and prognosis. As part of sarcoma awareness month, we are doing a series on soft tissue sarcomas as well as bone sarcoma in conjunction with the Australian & New Zealand Sarcoma Association to raise awareness and help provide education about these diagnoses. This is the story of soft tissue sarcoma (part 1). Useful links: Australia and New Zealand Sarcoma Association: https://sarcoma.org.au/ Find a sarcoma specialist: https://sarcoma.org.au/pages/about-sarcoma/find-a-sarcoma-specialist Sarcoma guidelines: https://sarcoma.org.au/pages/sarcoma-guidelines Seeking a second opinion: https://sarcoma.org.au/pages/about-sarcoma/seeking-second-opinion Useful patient information: https://sarcoma.org.au/pages/about-sarcoma/patient-and-carer-sarcoma-information Article from the RCPA about reviewing soft tissue tumours and obtaining second opinions: https://pubmed.ncbi.nlm.nih.gov/41390329/ Our Special Guests: Associate Professor Richard Boyle who is an orthopaedic oncologist and surgeon who specialises in the bone and soft tissue sarcoma. Professor Fiona Maclean is an anatomical pathologist who specialises in soft tissue pathology and clinical professor at Macquarie University. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E103
June 29 · 45 min
Episode 103: Clinical ethics | Eternal conundrums
Ethics, codes of conduct, and challenging decisions are universal constants in medicine. Difficult situations and trying to do the right thing are not always obvious particularly when these decisions involve lots of emotions, family members, and have life and death implications. Ethics, and ethics committees, can help to provide a clear and consensus path for clinicians, patients, and family members. We discuss the role ethics and ethics committees have in modern medicine with our special guest. This is the story of clinical ethics. Useful links: Free critical thinking course through UQ school of philosophy Clinical Ethics Society of Australasia – Great organisation focusing on clinical ethics, with affordable membership and lots of access to resources. They run an excellent ‘ethics intensive’ and yearly symposium as well as other masterclasses throughout the year. Australasian Association of Bioethics and Health Law – Major organisation for ethics and health law. Excellent conference each year. Links to Dr Melanie Jansen’s poetry Instragram: @drmelaniejansen_poetry Dr Melanie Jansen’s debut poetry collection, All That Could Be Lost, is available online from 5 Islands Press and at independent bookstores. Our Special Guest: Dr Melanie Jansen who is a clinical ethicist and paediatric intensive care consultant Listen: This Medical Life podcast is available on all podcasting services and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E102
June 8 · 38 min
Episode 102: Lipoprotein (a) | Genetic Cholesterol
Lipoprotein (a) (Lp(a)) was discovered in 1963 by a Norwegian geneticist by the name of Kåre Berg who studied particles that carried cholesterol in the blood. He found some patients had an additional protein on the low-density lipoprotein. Studies found that patients with elevated Lp(a) had increased risks of cardiovascular disease. However, the levels were not affected by diet, environmental factors, or medications. The result is that this test was largely ignored for the last few decades. Recent dyslipidaemia guidelines released by the United States and Europe have returned a focus back on to Lp(a). They recommend that patients should have Lp(a) tested once throughout their life to assess their cardiovascular disease risk. The result can help identify which patients are at a higher risk of cardiovascular morbidity and mortality and who will benefit from lifestyle modification and early intervention. This resource is referenced during the discussion: https://www.lpaclinicalguidance.com/ This is the story of lipoprotein (a). Our Special Guests: Dr Michael Page is a chemical pathologist at Clinipath in Perth, senior lecturer at the UWA Medical School, and immediate past President of the AMA (WA). Listen: This Medical Life podcast is available on all podcasting services and Spotify. Members of the RACGP are able to log the hours as CPD (Education) that they listen to the episodes under self record via Quick log. We invite you to help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E101
May 18 · 1 hr 8 min
Episode 101: Psoriasis | Skin, Immunity, And The Marks We Carry
Skin has always told stories. For thousands of years, those whose skin behaved differently — scaling, thickening, inflaming — were feared, isolated, and misunderstood. Psoriasis was long lumped together with leprosy, its sufferers cast out rather than cared for. It would take centuries before medicine began to separate these conditions, and longer still before we understood what was really happening beneath the surface. Psoriasis is not an infection, not a curse, not a failure of hygiene. It is the immune system turning on itself, a complex, chronic inflammatory disease that affects not just skin but joints, confidence, and quality of life. It touches roughly 2-3% of the population, and for many it is a lifelong companion. Today we have a clinical dermatologist and a dermatopathologist to help us understand what psoriasis looks like to the clinician, what it reveals under the microscope, and how our understanding of its immunological roots has transformed the way we treat it. This is the story of psoriasis. Our Special Guests: Associate Professor Laura Scardamaglia, a Consultant Dermatologist, a Fellow of the Australasian College of Dermatology, and Clinical Associate Professor at the University of Melbourne. Dr Grace Liu is an Anatomical Pathologist with Histopath in Sydney, Australia. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E100
May 4 · 1 hr 6 min
Episode 100: The Artful Dodger | James McNamara
The Artful Dodger is a television series on Disney+ that is a historical medical drama set in 1850s Australia with Jack Dawkins, the Artful Dodger from the world of Oliver Twist. Jack is a former pick pocket now surgeon who is reacquainted with old partner in crime, Fagin, who is keen for Jack to resume old habits. The Artful Dodger takes pride in being one of the most historically accurate depictions of nineteenth century medicine and surgery. The hospital, surgical tools, and treatments are accurate portrayals of what we knew back then. We organised a discussion with its creator to take a deep dive into this entertaining show that both myself and Steve thoroughly enjoyed. This is the story of The Artful Dodger Our Special Guest: James McNamara who is the creator, showrunner, head writer, and executive producer of The Artful Dodger available on Disney+. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E99
April 20 · 1 hr 7 min
Episode 99: Graves’ Disease | Hyperthyroidism & Thyrotoxicosis
The complex symptomatology of hormonal diseases only started to be recognised in the 19th century as we learned about anatomy and physiology. When Doctor Robert Graves began piecing the hyperthyroid puzzle together when he saw patients with similar symptoms such as anxiousness, nervousness, aggitation, bulging eyes, and rapid/irregular heart rate. He realised this was a previously unknown condition to the medical field. It would not be until the mid-20th century before we had a full understanding of the thyroid and thyroid diseases. Today, we have tests to diagnose and medications to manage. Graves’ disease accounts for 70-80% of all cases of hyperthyroidism. This is the story of Graves’ Disease. Our Guests: Dr Liam Mulcahy who is studying physicians training with a strong interest in neurology. He was written a book called Beyond the White Coat: The Faces Behind Medical Eponyms. Professor Duncan Topliss who is a senior endocrinologist at Alfred Hospital in Melbourne and Professor of Medicine in the Department of Medicine, Monash University. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E98
April 6 · 31 min
Episode 98: Statin Dosage | Finding The Sweet Spot
It has been well established in studies and articles that cholesterol lowering medications have significant heart morbidity and mortality benefits. However, high dosage trials did not show additional survival benefits but had increasing side-effects for patients. Therefore, the maximum dose for statins is not necessarily the best dose for patients. This is the story of statin dosing. Guest: Professor Simon Dimmitt is a Consultant Physician working in General and Cardiovascular Medicine. He is Clinical Professor of Medicine at the University of Western Australia and Adjunct Professor, School of Medicine & Public Health at the University of Newcastle. His website contains Dose Tables and reviews for a modest subscription: Correct Dosing. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E97
April 2 · 38 min
Episode 97: Crucifixion | Ancient Rome & State Sanctioned Execution
Crucifixion was a form of punishment, humiliation, and execution. Adopted by the Ancient Romans, crucifixion was used on the State’s worst criminals on lower classes and slaves. As common as it was though, we know very little about how people died on the cross. In this episode, we take a closer look at crucifixion through a medical lens. This image is not historically accurate. It was crafted within the guidelines of Gemini as a stereotypical rendering of crucifixion but our episode gets into the, sadly more brutal, truth. This is the story of crucifixion. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E96
March 23 · 1 hr 49 min
Episode 96: Steroids & Testosterone (Part 2) | Anabolic Steroids
Recreational use of steroids and testosterone to enhance image and performance is on the rise. Over the last 70 years, testosterone and testosterone-like substances have been used extensively to enhance performance particularly in elite sports. Nowadays, the use is more widespread and occurs in the general community with far more drugs available to people via the internet. Unfortunately, the evidence users base their drug regimes on range from anecdotal and scant to wrong and dangerous. We discuss the use of testosterone (and other substances) to learn more, identify how we can look after patients who use anabolic steroids, and what risk factors we need to consider. This is the story of anabolic steroids. You can listen to Part One of this series here. Our special guests: Dr Tim Piatkowski is a senior research fellow at the University of Queensland on image and performance enhancing drugs. Dr Mair Underwood is a senior lecturer in the School of Social Sciences at the University of Queensland and is an anthropologist of the body. Professor Ken Sikaris is a chemical pathologist and Director of chemical pathology at Dorevitch pathology. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E95
March 10 · 54 min
Episode 95: Steroids & Testosterone (Part 1) | Male Hypogonadism
Hypogonadism is a medical condition where the body does not produce enough testosterone. This can be primary (testicular failure) or secondary (pituitary or other condition). There are a number of conditions that doctors need to be aware of that can cause hypogonadism. This is the story of hypogonadism. Image ref: https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/hypogonadotropic-hypogonadism Our special guests: Professor Duncan Topliss is a senior endocrinologist and Professor of Medicine at Monash University. Professor Ken Sikaris is a chemical pathologist and Director of chemical pathology at Dorevitch pathology. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page. See omnystudio.com/listener for privacy information.
S7 · E94
February 23 · 1 hr 18 min
Episode 94: Testicular Cancer | Check Deez Nuts
While testicular cancer is rare, it is the most common cancer in young men aged between 15 and 39 years. Like with every cancer, early detection is the key. Self-examination is important along with seeking medical attention if there are any concerns. Fortunately, overall survival is around 95%. This is the story of testicular cancer. Our special guests: Dr Nari Ahmadi who is a Urologist and coordinator of the Urological Oncology Cancer research at Chris O’Brien Lifehouse. Professor Peter Grimison who is a Medical Oncologist at the Chris O’Brien Lifehouse, VMO at the Royal Prince Alfred Hospital, and Clinical Professor at the University of Sydney. Professor Fiona Maclean who an Anatomical Pathologist, Clinical Professor at Macquarie University, and previous President of the Australasian Division of the International Academy of Pathology (IAP). Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page. See omnystudio.com/listener for privacy information.

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