(Doctor) Dale Hutchens is a recent cochlear implant recipient. He and Jody discuss his experience with hearing loss, receiving the implant, and brain training. Stick around for a special performance by Dale at the end of the episode!

Links:

1) Dale's Performance Video

2) Sample Distortion Video 1

3) Sample Distortion Video 2

4) Sample Distortion Video 3

5) Sample Distortion Video 4

6) Sample Distortion Video 5

7) Alvin & The Chipmunks Theme

8) R2D2 Sounds

9) Mr. Roboto by Styx

Updates on current medical news, Jody's Epocrates exodus, and a review of hepatitis B pathophysiology, diagnosis, and treatment.

References:

1. Lok. A. S. F. Hepatitis B virus: Screening and diagnosis in adults. UpToDate. https://www.uptodate.com/contents/hepatitis-b-virus-screening-and-diagnosis-in-adults

2. Lok. A. S. F., Hepatitis B virus: Overview of management. UpToDate. https://www.uptodate.com/contents/hepatitis-b-virus-overview-of-management

3. CDC ACIP Presentation: https://www.cdc.gov/acip/downloads/slides-2025-09-18-19/03-su-mmrv-508.pdf

4. ACIP Recommendation Statement: https://www.hhs.gov/press-room/acip-recommends-chickenpox-vaccine-for-toddlers.html

5. Tang LSY, Covert E, Wilson E, Kottilil S. Chronic Hepatitis B Infection: A Review. JAMA. 2018;319(17):1802–1813. doi:10.1001/jama.2018.3795. https://jamanetwork.com/journals/jama/fullarticle/2679946

6. OpenEvidence Conversation: https://www.openevidence.com/ask/4dde6fd5-1bca-4a86-a6f3-3a335f0334a1

7. AAP Recommended Vaccine Schedule for Children & Adolescents: https://publications.aap.org/redbook/resources/15585/AAP-Immunization-Schedule

8. Vaccine History (Hep B Foundation): https://www.hepb.org/prevention-and-diagnosis/vaccination/history-of-hepatitis-b-vaccine/

9. Vaccine History (CDC): https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5125a3.htm

Jody reviews recent developments in the US healthcare dystopia, then discusses pathophysiology, diagnosis, and treatment of gout.

References:

1) Merriman, T. Gout: Pathophysiology. UpToDate. https://www.uptodate.com/contents/gout-pathophysiology

2) Gaffo, A. L. Gout: Clinical Manifestations and diagnosis. UpToDate. https://www.uptodate.com/contents/gout-clinical-manifestations-and-diagnosis

3) Gaffo, A. L. Gout: Treatment of Flares. UpToDate. https://www.uptodate.com/contents/gout-treatment-of-flares

4) Perez-Ruiz, F. Gout: Pharmacologic urate-lowering therapy and treatment of tophi. UpToDate. https://www.uptodate.com/contents/gout-pharmacologic-urate-lowering-therapy-and-treatment-of-tophi

5) Neogi, T. Gout: Nonpharmacologic strategies for prevention and treatment. UpToDate. https://www.uptodate.com/contents/gout-nonpharmacologic-strategies-for-prevention-and-treatment

6) https://www.science.org/content/article/attempt-oust-cdc-director-sparks-key-resignations-agency-officials

7) The CDC's Vaccine Chief on Why Quitting Was His Only Option (The Daily via Spotify)

Music:

https://youtu.be/8GliyDgAGQI?si=F8NBaxJeaezO9V2Y

In a spin-off of last week's episode, Jody discusses making life and death decisions as a healthcare professional.

Lieutenant Colonel Rick Caniglia, U.S. Army, Retired, shares medical stories from his long military career.

Links:

ACIP Website

HHS Statement on ACIP Reconstitution

Restoring Gold Standard Science Executive Order

Experts Sound Alarm After ACIP Members Removed (NFID)

NPR Article on New ACIP Members

I tried to prescribe a cognitive behavioral therapy (CBT) app to treat a patient's anxiety. It didn't go well.

F is for Fournier! Jody reviews pathophysiology, diagnosis, and treatment of this (thankfully) uncommon condition.

References:

1) Stevens, D.L., & Baddour, L.M. Necrotizing soft tissue infections. UpToDate. https://www.uptodate.com/contents/ necrotizing-soft-tissue-infections

2) Bersoff-Matcha SJ, Chamberlain C, Cao C, Kortepeter C, Chong WH. Fournier Gangrene Associated With Sodium-Glucose Cotransporter-2 Inhibitors: A Review of Spontaneous Postmarketing Cases. Ann Intern Med. 2019 Jun 4;170(11):764-769. doi: 10.7326/M19-0085. Epub 2019 May 7. PMID: 31060053.

3) Jean Alfred Fournier. Wikipedia. https://en.wikipedia.org/ wiki/Jean_Alfred_Fournier