I speak a little Spanish, but just barely. Not even well enough to know the curse words, unfortunately. Basically I’m able to order food and chat about the weather. If I don’t panic when I miss a word or two, I usually understand enough to follow the broad themes of a conversation. I just try to relax and enjoy the experience of immersion.
This is analogous to how I listen to the Puscast podcast, a bimonthly review (in English) of the infectious disease medical literature. I speak Medical Literature about as well as I speak Spanish. Fortunately, I do know how to use Google for clarification.
Puscast host Mark Crislip is an infectious disease doctor practising in Oregon. He is a writer and editor for the Science Based Medicine blog, and heads up his own multimedia empire, where he houses archives and links to his several podcasts, blogs, and book.
The target Puscast audience is physicians. I may be out of my depth for parts of it, but I’m curious and interested in the subject. I try to just listen without worrying too much about, say, the details of how different antibiotics target various bacterial cell receptors. I can always look that up later.
The discussion is surprisingly diverse. Dr. Crislip brings snarky humor to bear on all manner of medical pseudoscience and on mistakes and misguided studies published in established journals as well. What I find especially interesting are Dr. Crislip’s thoughts about how the studies translate to real-world situations and clinical practice. I enjoy learning about how the new data gets applied in medicine. It’s reassuring to note that, for the most part, science-based medicine increases in efficacy over time.
Puscast includes this Black Box Warning:
The following podcasts may include sarcastic comments, snide asides, and rants off the topic of infectious diseases and may cover political, societal, and popular culture concerns. I think it is part of the charm of the podcasts, but if you do not like smartass, then these podcasts may not be your cup of tea and you should go elsewhere. But you can’t say you were not warned.
Some broad thematic trends that I’ve noted include:
- Antibiotic overuse is very, very bad. This comes up frequently in discussions about newly resistant diseases.
- Tropical diseases like dengue fever and disease vectors like rabid vampire bats appear to be moving north with global climate change.
- Previously rare vaccine-preventable diseases are becoming more common in correlation with declining vaccination rates.
- Dr. Crislip doesn’t like tattoos.
- HIV therapies are amazing. I’m embarrassed to admit that two recent Puscast episodes have exposed my own myopia. One study looked at serodiscordant couples where one partner is HIV+. I live in such a bubble of ignorance that it didn’t occur to me that such couples exist. I assumed that everyone is either + or – or that the relationships dissolved once one of the partners was diagnosed. I had to pause and wrap my mind around this new-to-me but obvious paradigm.
Crislip discussed a couple of interesting HIV studies:
This first study looked at drug therapies which can prevent the spread of HIV to the non-infected partner. Which is awesome, but the regimen is not without risks. If the positive partner’s HIV is suppressed, then maybe the risks outweigh the benefits. Take home: use a condom. Which is generally a good idea anyway regardless of HIV status.
The second study looked at couples where both partners are HIV+. Doctors generally still recommend condom use to prevent the spread of other diseases 
and also because the partners may have different variations of the HIV virus. In this case, I had assumed that condoms were moot. I had no idea there are various types of HIV, and the other diseases in addition to HIV simply weren’t on my radar.
Again, in hindsight this should have been obvious to me. I like to think I’m so tolerant and enlightened, but clearly I need to bring more humility and humanity to how I think about HIV and its victims.
Dr. Crislip’s Puscast is endlessly interesting and entertaining. It’s challenging in a good way and fairly accessible to most audiences. It’s especially enlightening when it spotlights uncomfortable truths about myself.
Images from wikimedia commons
An earlier version of this article appeared at Does This Make Sense.
Interesting information, A.U. I knew there were married couples who stayed together after one was diagnosed with HIV, such as a very well known basketball player who ended his career in order to avoid possibly infecting fellow players with accidental blood spill. I also know a couple who both have herpes, and had it when they met, but I’ve never asked what they do to keep it under control if they have, or one of them, has an outbreak.
I love Science Based Medicine, Quackwatch, What’s the Harm and other resources that give good information that can keep you from getting sick, or at least prevent spending money on worthless remedies. I’ve never listened to PusCast – I’ll download a few episodes :-)
Thanks for reading Wendy! I’m always amazed by how little I know about the world around me. Puscast is steep sledding for me at times, but I enjoy challenging myself. Regarding HIV, I’ve seen some news a number of times recently that seniors have the highest rate of new infections. They weren’t steeped in the prevention message the way younger folks were, and often the topic is taboo for them. Which is both culturally interesting and very sad.
I am a big fan of puscast…