PLMEs create a podcast to explore the art of medicine.
Timothy Flanigan, MD, vividly recalls the first time he went to a prison to treat incarcerated patients.
“Those doors clanging shut, and dealing with the security and correctional officers is not easy,” says Flanigan, a professor of medicine and of health services, policy, and practice. “But it was overall a really wonderful experience, because when you’re taking care of somebody and you shake their hand and look them in the eye and say, ‘How are you doing? What’s going on?’ … That interaction is really the same within jail or prison as it is outside.”
One of his patients at a Massachusetts state prison, Robert, remembers just as clearly the first time they met. “
I’m sure I had an orange jumpsuit on, and I was shackled and handcuffed with a police escort, like a hardened criminal,” says Robert, whom Flanigan, an infectious disease physician, treated for HIV and hepatitis C. But “right away he showed me respect, and right away I gave him respect.”
This exchange takes place in the season one finale of Back of the Chart, a podcast launched in February by Viknesh Kasthuri ’21 MD’25 and Alexander Homer ’21 MD’25, both students in the Program in Liberal Medical Education. The podcast aims to give fellow pre-meds a deeper understanding of medicine, but it’s deliberately light on jargon, and defines terms and diseases like HIV so any listener can understand.
By documenting conversations between physicians and their patients, Kasthuri and Homer explore the art of medicine beyond their coursework. The “human connection” inspired them to become doctors in the first place, Kasthuri says: “The story is the fundamental building block of medicine.”
The podcast’s title comes from Kasthuri’s experience shadowing a cardiologist in rural Washington. The much-loved doctor asked each of his 2,000 patients about their hobbies, recent vacations, or grandchildren. When Kasthuri asked how he remembered
so many details, the doctor flipped over his medical chart, revealing notes scribbled during each patient visit.
PLME’s Whole Patient program features dinners where physicians and patients share stories with students, which helped inspire Back of the Chart. Homer and Kasthuri learned medical podcasting in a preclinical elective taught by Gita Pensa, MD, associate professor of emergency medicine, clinician educator, and Julie Roth ’99 MD’04 RES’05 F’09, associate professor of neurology and of medical science, both podcast hosts themselves.
After finding a physician to appear on their show, Homer and Kasthuri ask them, “Which patient reminds you of why you want to get up every day and practice medicine?” The doctor usually selects “somebody who they have a great relationship with and who’s likely to open up,” Homer says. They conduct pre-interviews, go over the basic story with the interviewees, and help guide the conversation during recording.
The students usually don’t know their guests beforehand, but by the end of the taping, “It feels like we’ve known them a lot longer,” Homer says. It takes hours of transcription and editing to whittle 90 minutes of audio down to about 20. They splice in brief commentary and musical interludes, but the interviews really set the scene.
The show has gained a solid following, and the pair plans to launch Season 2 later this academic year. Homer says that even if nobody listened, he’d consider it a success thanks to “the personal growth it has given the two of us, being able to talk to doctors from so many different specialties and their patients.” The experience, he adds, “has not been matched by shadowing.”
