Meet the Hosts

April 19, 2024

Transcript

Dr. Kade Goepferd: This is Talking Pediatrics, a clinical podcast by Children’s Minnesota, home to the Kid Experts where the complex is our everyday. Each episode, we bring you intriguing stories and relevant pediatric health care information as we partner with you in the care of your patients. Our guests, data, ideas and practical tips will surprise, challenge and perhaps change how you care for kids.

Welcome to Talking Pediatrics. I’m your host, Dr. Kade Goepferd. We’re excited to debut some new segments in 2024. One of our new hosts this year is Ian Wolfe. He is our director of ethics here at Children’s Minnesota and will be hosting the segment “A Question of Ethics” as a part of our Talking Pediatrics podcast. Ian, thanks for joining me today.

Ian Wolfe, PhD: Thanks for having me.

Dr. Kade Goepferd: Tell our viewers a little bit about you and what you do. What does it mean to be an ethicist? What is the work that you are doing here at Children’s Minnesota?

Ian Wolfe, PhD: Well, a clinical ethicist is someone who has professional training in identifying, analyzing, and hopefully, resolving ethical questions that arise, I would say, every day in clinical practice.

Dr. Kade Goepferd: How long have you been with Children’s?

Ian Wolfe, PhD: I’ve actually been on Children’s over 10 years. Started out as an ICU nurse here in our Pediatric ICU, and then went back to graduate school for many, many years, and then a pediatric bioethics fellowship, and then was fortunate enough to return here and work as a clinical ethicist before taking over the department.

Dr. Kade Goepferd: What got you interested in doing a podcast on ethics?

Ian Wolfe, PhD: Well, my colleague, Shika Kalevor, who is also a clinical ethicist here, is fond of saying that we do ethics every day, and that’s our practice here at Children’s and in the ethics department is that clinicians do ethics every day. Nobody’s walking around the hospital or the clinic doing unethical things, rather we get into situations where we are not sure what the right thing to do is, or there’s complexities that overshadow what might be the right thing. That’s where ethics comes in to try to provide advice and guidance, help families, as well as clinicians, navigate through medical facts and personal values, complexity and uncertainty, in trying to find the best path forward for both the team and family.

Dr. Kade Goepferd: What can listeners expect from a question of ethics from your podcast segment?

Ian Wolfe, PhD: Listeners can expect to hear about ethical issues that arise in their everyday practice, not some of the big ethical issues you might see in the news, but some of the ones that don’t really have perfect answers that I will be able to provide them with some guidance to take into their everyday practice.

Dr. Kade Goepferd: So the idea is that you may not be giving everyone the solution to all of their ethical problems, but maybe providing a framework or a way for them to think about how they might incorporate some of the tools you use every day as an ethicist into their clinical practices.

Ian Wolfe, PhD: Right. There’s not always a lot of easy answers in ethics, and sometimes there’s not really any particular right or wrong answer, but my hope is to provide guidance for clinicians and even maybe some patients and families on how to navigate some of these situations that come up.

Dr. Kade Goepferd: Ian, before we wrap up getting to know you today, I’d love to hear a little bit of a teaser or preview that you might be able to give us of some things that you are excited about that you might be talking about on a question of ethics.

Ian Wolfe, PhD: Well, lately, and it seems like the last couple of years I’ve really been talking a lot about the ethics in adolescent decision-making, and I’ve done a grand rounds here in unpacking bedside bioethics at the University of Minnesota Center for Bioethics. It’s always a very welcome topic and one of my first episodes is going to be on what we consider a harm reduction approach that is often one that we take in dealing with adolescents, particularly adolescents with medical conditions on the more chronic side of things.

Dr. Kade Goepferd: Sure.

Ian Wolfe, PhD: One that I’m really excited for, and I just said that we weren’t going to do big meta-ethical issues, and it will be a little bit on a big topic, but I’m hoping to drill down on the importance of the guidance that it will provide for clinicians and pediatricians, and even obstetricians, around the area, and that’s going to be on some of the updated considerations around interventions for trisomy 13 and 18.

Dr. Kade Goepferd: Sure.

Ian Wolfe, PhD: It’s been a very complex topic with a very large paradigm shift. Often the practice in the hospitals is a little bit ahead of where some of the education is or some of the education still lingers. We’re hoping to have some pretty exciting guests on for that talk and, hopefully, provide an overview of what the new current paradigm and treatment approach here at Children’s is, and that’s one that’s expanding across the United States and provide some guidance then for clinicians in other settings of how to consider these patients.

Dr. Kade Goepferd: Those both sound like great episodes, certainly would be helpful for my practice, and I think for many others. Welcome to Talking Pediatrics. Thanks for joining our crew, and I look forward to hearing more from you.

Ian Wolfe, PhD: Thanks. Looking forward to it.

Dr. Kade Goepferd: Another segment we’re excited to introduce to you this year is “Specialty Spotlight with Siva”, one of our segments that delves into the complexities of pediatric and medical-surgical subspecialties. I’m delighted to have our host of that segment, Dr. Siva Chinnadurai with us to talk a little bit more about him and his work and the new segment we’re introducing. Welcome, Siva.

Dr. Siva Chinnadurai: Thank you for having me. I’m happy to be here.

Dr. Kade Goepferd: All right. Let’s first learn a little bit about you. You are a pediatric otolaryngologist and facial plastic surgeon. Tell me a little bit about why that field of pediatrics and medicine really enticed you.

Dr. Siva Chinnadurai: When I started medical school, I didn’t really know what I wanted to be, except that I knew I wanted to be a doctor, and I was influenced a lot by my mother, who is a pediatrician. I kind of came in with a little bit of that bias, but not much direction beyond that. My first day of medical school, I met someone who went on to become my best friend through my whole life since that point. I knew him for a couple of years before I knew that he had a cleft lip, and he had that repaired in infancy, and he was the most outgoing, friendly, gregarious, least self-conscious person I’ve ever met.

The idea that someone could make such a small change early in someone’s life that sets them on a course like that was really exciting to me. From that moment on, I knew I wanted to get engaged in head and neck and facial plastic surgery. With the bias that I inherited from my mom as a pediatrician, it was kind of a one-way track to pediatric head and neck and facial plastic surgery.

Dr. Kade Goepferd: Yeah. You mentioned cleft lip. Do you find yourself specializing in any particular area within that field, or are you kind of doing a little bit of everything?

Dr. Siva Chinnadurai: There are two principal areas that I focus on, head and neck reconstruction, and that involves primarily cleft lip, cleft palate, and one of the more specific subspecialties is ear reconstruction for children who are born without ears or children who have had a lot of facial trauma, and the other area that I focus on and started a program here for at Children’s is complex airway reconstruction.

Dr. Kade Goepferd: Let’s talk a little bit more about this new area for you, which is podcasting. You actually approached me and said you’d be interested in getting involved in the podcast, and we are launching this new segment with you. What is it about being involved in a podcast or this sort of area specifically that draws you in?

Dr. Siva Chinnadurai: Well, there’s a lot of different things that I’ve done over my time in medicine, my time at Children’s working in research, working in surgical administration as the associate chief of surgery and several other roles. What a lot of those have in common is that we’re bringing together a diverse group of people, whether that’s different subspecialists, or research and clinical personnel, students and residents, but we’re bringing together a lot of different kid experts to achieve the best outcomes for children. I thought this was a natural extension of that where we can bring a spotlight onto subspecialty care and share that with our pediatrician community to kind of bring together different groups of people to achieve the best outcomes for kids.

Dr. Kade Goepferd: I think there’s so much that we do for kids and families here at Children’s Minnesota that I wish more people, not just here in the region, but really nationally and even internationally, knew about ways that we are able to intervene for kids. I’m really excited to see where you take the podcast. As you think about your segments, are there particular topics you’re really excited about or areas that you hope to get into a little bit more specifically?

Dr. Siva Chinnadurai: Yeah. When I look at the podcast, the things that I think about are when kids are ill for families, that’s a time of real fear and uncertainty, a lot of complexity. The most trusted person for that family outside of immediate family members is the pediatrician. They are the ones who they turn to in those times of need. I try to select topics that really can serve the needs of the primary care pediatricians who are counseling families during these relatively frequent times of need. Those are things like management of pediatric anesthesia, management of congenital heart disease, things that we may have some warning about and a lot of uncertainty about for the family that the pediatricians as that trusted resource can help the families kind of ease in, make the connections, ease the referral stream, the work upstream, and really be prepared partners on the front end to achieve those best outcomes for those families.

Dr. Kade Goepferd: As my role as the chief education officer, I’m working really closely in seeing how so many of our trainees, whether they’re pediatric residents or subspecialty residents, family medicine residents, advanced practice students, and folks getting training who are coming here and they get an up close and personal sort of look at so many of the subspecialties and care that we provide, but then they go out into practice. They’re out in practice for several years and a distance develops where they’re not up-to-date on what the newest changes are or how we’re managing something like pediatric anesthesia. I’m excited to hear what types of updates and new information you can bring. Thank you again, Siva, for jumping in with two feet to launch this new segment for Talking Pediatrics, and we’re excited to hear more.

Dr. Siva Chinnadurai: I’m excited to be here. Thank you very much for having me.

Dr. Kade Goepferd: Also joining us this year as our new guest host, Dr. Courtney Herring, who will be hosting “Evidence-based Charm: Guidelines with Courtney”. Courtney, thanks so much for joining us on Talking Pediatrics.

Dr. Courtney Herring: Thank you. Thank you, Kade. It’s so nice to be here.

Dr. Kade Goepferd: All right, so first and foremost, you are one of our expert pediatric hospitalists here at Children’s Minnesota. I’d love to hear a little bit about you being a hospitalist. How did you get into being a hospitalist? What do you love about it?

Dr. Courtney Herring: For those who aren’t hospitalists, it’s hard to compare, but from young age, thought I was going to be a “baby doctor,” ended up long term into pediatric training and hit something called inpatient medicine, taking care of children while in the hospital, something really magical to be able to sift through not only the medicine and the clinical conditions of children, but also be able to still be a social touch point for each encounter with every young and adolescent child that we see. I’m currently just loving being a bedside physician, and also, specifically, the inpatient side gives you the tools to really dig deep into the longitudinal side of pediatric care. It’s a beautiful, beautiful profession. I have also about 50-plus partners in my division currently who are all pretty amazing.

Dr. Kade Goepferd: Well, you make me want to go back to hospital medicine now. You are an amazing hospitalist, and you’ve done a lot of work on the administrative side in really helping to make sure that the care that we provide is evidence-based and based on guidelines. I know you’re going to talk about that on your segment. Talk to me a little bit about what you’re hoping to bring, particularly in your segment.

Dr. Courtney Herring: Yeah. Definitely, not to steal any secrets here, but it’s a deep dive into synthesizing what used to be very hard to access information on how to better care for certain pediatric conditions. In light of that, we have a core group at Children’s Minnesota, but also in other pediatric healthcare centers, who have taken the time to put all of this evidence-based and expert panel-driven information into algorithms that we can say these are pivotal clinical decision points. How do we help children with this pediatric condition, put it into a frame that anyone can use it, any clinician can use it, and also be able to share information in the public? That’s what we do at Children’s Minnesota very well is we publish our guidelines for anyone to use. It’s a great translational piece of work that we do here, and we do it all the time. We have so much to be proud of with the number of clinical guidelines we publish every single year.

Dr. Kade Goepferd: Obviously, you can go online and read a guideline and kind of get the gist of it, but I think being able to hear it and talk through it is another way to kind of lay down the information and understand it.

Dr. Courtney Herring: Well, a hundred percent. It’s a different type of synthesis, right? Reading kind of a pathway that is built that, of course, hopefully, is palatable to almost any clinician is very different than being able to sit down and actually discuss some of those pivotal points and saying, “Why? Why do we do this interpretation versus not?” I think it’s even elevated because we get amazing guests who are usually a part of the creation of such guidelines, and so that just brings it to another level.

Dr. Kade Goepferd: In your title, we threw in a little evidence-based charm. You are from the South yourself, and I’ve known you for many years, and I do appreciate your Southern charm. Maybe talk to me about the twist that you’ll bring, particularly with sort of your Southern charm to this work.

Dr. Courtney Herring: Well, I will have to hold myself back on not bringing in too many anecdotes, especially Southern-isms as I call them, because, I mean, one, how do you translate them to the Midwest sometimes? But I think the big thing is being from the South is a different perspective. It also brings, not uncommonly in different areas of the world, a lot of kind of folklore around medicine and kind of like, what did your grandmother do, maybe. I think bringing humor to medicine is always important, and the South is well known for humor because at some points, what else did we have? In the scheme of things, I hope I bring a good dollop of humor, but obviously, with the structure and framing that this is serious business of taking care of children. We always want to be able to provide great information and also an outlet for people to give feedback.

Dr. Kade Goepferd: One of the things I love the most about podcasting is the storytelling aspect, so I’m really excited to hear how you can weave the evidence-based information and the expert guidelines with a little bit of that storytelling.

Dr. Courtney Herring: Yeah, I agree. Just for anyone listening in, so my grandmother is MeMa. I almost can guarantee there’s going to be some MeMa-isms coming your way because, one, smartest person I’ve ever met in my life, and second, you can’t do any better than having a loved one like my MeMa, so more to come.

Dr. Kade Goepferd: Well, and so many of our patients have their own MeMas, and if we’re not paying attention to what MeMa says, we’re not going to get it right.

Dr. Courtney Herring: Definitely missing out.

Dr. Kade Goepferd: Well, thank you so much, Courtney. We’re really excited to have you joining us this year on Talking Pediatrics, and really excited for your segment.

Dr. Courtney Herring: Thanks, Kade.

Dr. Kade Goepferd: Thank you for listening to Talking Pediatrics. Come back next time for a new episode with our caregivers and experts in pediatric health. Our showrunner is Cora Nelson. Episodes are produced, engineered and edited by Jake Beaver and Patrick Bixler. Our marketing representatives are Amie Juba and Krithika Devanathan. For information and additional episodes, check us out on your favorite podcast platform or go to childrensmn.org/talkingpediatrics.