The Bitter Pill podcasts

Italy has a distinctive place in the world of Haemophilia. In this episode, we hear the reflections of two physicians from Italy as they talk about the difficulties they experienced as doctors and how being part of the solution sustained them through the difficult years. 

Through the years of evolving knowledge, how did doctors think, feel, and communicate? How did optimism and reassurance work? How was knowledge handled? And how do they feel about it now? In this episode, we hear them talk about how they dealt with those years. We hear about what the younger doctors thought about their senior colleagues. We hear about the impact of those years now.

How do doctors share decision-making with their patients? This episode addresses paternalism, patient-centredness, and the axes of shared care in practice, including the care of the dead. It then discusses the notion of clinical freedom and the role of professional networks in shaping thought and practice. It ends with comments on the precautionary approach in medicine and the changing perception of negligence. 

The severity of the AIDS epidemic differed across countries. In this episode, we explore events in the Netherlands. The Netherlands had a relatively low level of severity and three haematologists discuss how that situation may have come about. One of them, a trainee doctor at that time, reflects on her experience and how it has shaped her as a doctor and a teacher, and why memories matter. The episode ends with a reflection on the nature of apology.

Once HIV was recognized as an evolving problem in their patients, haemophilia doctors had to make decisions on how to modify their treatments, how to balance safety with effectiveness. This period lasted a couple of years while heat treatment technology was developed as an effective means of eliminating HIV in donated plasma. This episode deals with the dilemmas in evaluating treatment options and making decisions about treatment during this period of evolving knowledge. When presented with the same level of data and evidence, how do our decisions differ? Stay tuned for next Sunday's episode 'Amsterdam'.  

What are the dilemmas confronting a doctor in testing for an infection about which knowledge is still evolving? We heard from Professor Allain in the previous episode on how he was a 'good soldier' as he grappled with the problem of how to communicate results to his patients. In this epidode we take a deeper look at this essential aspect of clinical care. When a new test becomes available for a newly identified infection, how are medical responses shaped? What have we learnt from the 80s? Stay tuned for next Sunday's episode 'Decision time'.

The societal impact of transfusion-transmitted infection of HIV varied across countries. In this episode, we discuss the impact in France. Professor Jean-Pierre Allain talks about the clinical and personal predicaments of that time. 

This episode is a brief introduction to the series. What the series is about, why I made it and why it matters.