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Ditch The Labcoat

Dr. Mark Bonta
Ditch The Labcoat
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  • The Value of Being Vulnerable with Dr. Paul Fedak
    In this deeply human episode, Dr. Mark Bonta sits down with cardiac surgeon, scientist, and writer Dr. Paul Fedak for an honest look at the hidden cost of excellence in medicine. Dr. Fedak shares the story of the injury that forced him out of the operating room and into a profound reckoning with identity, purpose, and the culture of silence that surrounds clinician suffering.Drawing from years as Professor at the University of Calgary and Director of the Libin Cardiovascular Institute, he unpacks why perfectionism is so common in medical training, how surgeons learn to mask pain behind composure, and why emotional detachment has long been mistaken for professionalism. Together they explore the unseen burden clinicians carry, the pressure to perform without pause, and the moments when the mask finally cracks.Dr. Fedak speaks candidly about ego death, vulnerability, and rebuilding a life after losing the work that once defined him. He describes the colleagues who opened up only after he shared his own story, highlighting how connection and honesty can transform a profession built on quiet endurance.This episode examines the human side of medicine that rarely makes it into textbooks. Identity. Injury. Recovery. Presence. What it means to care for others while trying to stay whole yourself.A moving conversation for anyone in healthcare or anyone who has ever struggled with the weight of impossible expectations.Paul Fedak, MD, PhD's website : paulfedak.comEpisode Takeaways1. Surgeons are trained to push through pain, not acknowledge it.Medical culture rewards resilience and persistence, but that same conditioning prevents clinicians from recognizing and responding to their own injuries.2. Perfectionism is wired into medical training.Traits like list making, obsessive task completion, and performance under observation are common in medicine and often go unexamined despite their psychological cost.3. The mask of competence becomes automatic.Clinicians become so skilled at hiding distress that even close colleagues fail to notice warning signs. This silence leaves suffering invisible.4. Vulnerability creates connection and protects lives.When Dr. Fedak shared his story, dozens of peers came forward with their own hidden experiences. Openness is not weakness. It is safety.5. Ergonomic injuries in surgery are far more common than most people realize.The physical demands of operating are intense, yet surgeons lack the protections that other healthcare workers receive.6. Leadership shows the true burden physicians carry.Once in leadership roles, clinicians see the depth of burnout, fear, and quiet endurance happening behind the scenes.7. Losing the identity of “surgeon” creates an existential crisis.Stepping out of the operating room forced a complete reevaluation of purpose, ego, and self worth.8. Technical excellence is not the full measure of a doctor.Relational skill, empathy, presence, and human connection matter just as much as procedural skill.9. Medicine needs protected space for reflection.Without pause and presence, clinicians lose touch with themselves and the people they care for. Healing requires time, community, and grounding.10. System structures shape clinician wellbeing.The fee for service model rewards quantity over recovery, creating pressures that make self care feel impossible.11. Paying clinicians to care for themselves could change outcomes.If mental health visits, ergonomic care, and recovery time were compensated, more clinicians would seek help early.Episode Timestamps07:10 How one surgeon’s work related injury forced a career pivot and a deeper conversation about wellbeing.08:25 The secret stories colleagues shared only after Paul opened up about his own suffering.10:30 Independent contractor status and why doctors lack the ergonomic protections nurses receive.13:00 The unseen emotional toll behind surgical careers and what leadership reveals about clinician suffering.16:00 Training teaches perseverance, but injury demands honesty. The conflict surgeons are never taught to navigate.17:28 Medical trainees and perfectionism. Why obsessive traits are six times more common in medicine.19:10 When the mask becomes permanent. How clinicians hide distress even from each other.20:00 Two tragic losses and the lessons Paul learned about checking in with colleagues.22:00 Vulnerability as leadership. Why sharing your story opens the door for others to heal.28:57 Did speaking out come with professional risks. What changed when Paul stopped protecting his own ego.31:55 Losing the identity of “surgeon.” The ego death that followed leaving the operating room.33:40 Beyond technical mastery. Why excellence must include human connection, empathy, and presence.34:46 How medicine can “create space” for reflection, grounding, and real conversations.37:50 The hidden financial pressures behind surgical work and how billing shapes clinician behavior.DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 
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  • Free Speech Is Good For Mental Health with Dr. Chloe Carmichael
    Clinical psychologist Dr. Chloe Carmichael joins Dr. Mark Bonta for an important and timely conversation about free speech, emotional regulation, and the psychology of open dialogue. Drawing on her clinical work and her new book, Dr. Carmichael explains how suppressing opinions affects stress, anxiety, and even physical health. She describes her own experience with media self censorship, the impact of masking policies during COVID, and how moving from New York to Florida revealed the mental health benefits of open discussion.The episode explores how naming emotions reduces amygdala activity, how repressing thoughts can lead to acting out, and why honest conversation promotes neural coupling and lowers cortisol. Together they examine bullying, victimhood, groupthink, and how language can unintentionally shut down dialogue instead of inviting clarity and connection.Listeners will learn practical tools for navigating political disagreements, managing emotional overload during difficult conversations, and practicing reflective listening to stay grounded and curious rather than reactive.Dr. Carmichael’s message is simple and powerful. Dialogue matters. Open conversation strengthens emotional regulation, builds healthier relationships, and supports mental clarity. Her invitation to the audience is to have more honest disagreements and to rediscover the psychological value of speaking freely.Dr. Chloe Carmichael Link : https://www.drchloe.com/Episode Takeaways1. Free Speech Supports Mental Health: Speaking openly improves emotional regulation, strengthens relationships, and reduces anxiety.2. Suppressing Thoughts Has Consequences:Bottling emotions disrupts emotional processing and can lead to acting out, stress, and internal tension.3. Labeling Emotions Lowers Fear Response: Simply naming what we feel reduces amygdala activation and increases clarity and control.4. Self Censorship Takes a Psychological Toll: Avoiding truthful expression to fit social expectations erodes authenticity and increases distress.5. Groupthink Is Dangerous: Institutions that suppress debate become vulnerable to poor decisions and intellectual stagnation.6. Open Disagreement Is Healthy: Learning to disagree politely strengthens community bonds rather than damaging them.7. Authoritarian Environments Harm Wellbeing: Chronic suppression of speech leads to anxiety, helplessness, and depressive patterns across populations.8. Language Can Shut Down Dialogue: Words like bullying or victim can be used as shields, stopping rational discussion and reflection.9. Listening Does Not Mean Agreeing: Separating listening from endorsement allows conversations to stay civil and productive.Episode Timestamps01:23 – Dr. Carmichael’s clinical background and early media experience03:40 – Moving from New York to Florida over masking policies04:38 – Mark on masking, speech development, and emotional suppression06:32 – Why naming emotions lowers amygdala activity07:00 – Emotional suppression and how bottling feelings leads to acting out10:00 – Media censorship and limiting acceptable viewpoints13:00 – Listening versus agreeing and the psychology of disagreement17:00 – Thought replacement as a tool for staying grounded20:00 – Why political conversations feel dangerous and how to navigate them24:00 – Groupthink in institutions and intellectual environments26:32 – How suppressing discussion harms innovation and clarity27:10 – Authoritarian environments and mental health consequences28:16 – Living with hidden thoughts and long term anxiety30:24 – The power of labels like bullying to shut down dialogue32:00 – Victimhood culture and the upside down bully victim dynamic35:45 – Why shutting down dialogue creates conflict rather than reducing it40:16 – Dr. Carmichael’s call for more open, happy disagreements42:21 – Closing reflections and holiday dinner table dynamics42:52 – Invitation to join discussion groups with her book purchaseDISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 
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  • Making Mental Health & Addiction Visible with Matteo Esposito from the Invisible Challenge
    In this powerful conversation, Matteo Esposito shares the story that shaped his mission to help others reclaim their lives from addiction and mental illness. Matteo is a Certified Addiction Recovery Coach and co-founder of Invisible Challenge, a movement focused on ending the stigma around invisible illnesses including bipolar disorder, substance use disorders, and suicidality.Mark and Matteo explore the difficult reality of dual diagnosis, the limits of our current system, and the lived experience behind manic episodes, depression, and the pull of addiction. Matteo explains how suffering, time, and honest acceptance led him to recovery, and why connection is often stronger than willpower alone.They discuss the gaps in psychiatry, the trial and error of medications, the danger of self-medication, the unpredictable nature of relapse, and the emotional toll on families who walk beside a loved one in crisis. Matteo also opens up about rebuilding his life, repairing relationships, and using his lived experience to support others who are still trying to find their footing.This is an honest and deeply human look at mental illness, addiction, and what it truly takes to heal.Matteo Esposito, Certified Addiction Recovery Coach : https://invisiblechallenge.org/Episode Takeaways 1. Invisible illnesses are often dismissed because they do not show up on scans, yet they can be as disabling as any physical condition.2. Dual diagnosis is complex. Treating bipolar disorder and addiction separately does not work. Both must be addressed together.3. Self medication hides deeper problems. Many people use alcohol or cannabis to manage anxiety, insomnia, or early psychiatric symptoms.4. Mania has clear warning signs. Loss of sleep, high energy, pressured speech, and risky decisions are red flags that should never be ignored.5. Addiction is a brain illness. It is not a moral failure, not a weakness, and not a lack of willpower.6. Suffering often precedes change. For many people, the turning point comes only after repeated lows and accumulated exhaustion.7. Connection is protective. Recovery becomes possible when someone is surrounded by people who understand the journey.8. Professional guidance matters. Matteo credits his progress to finally following recommendations from clinicians instead of relying on his own judgment.9. Peer support accelerates healing. Helping others in recovery strengthens sobriety and reduces the risk of relapse.10. Families carry their own burden. Loving someone with addiction or mental illness is heavy, complex, and often painful.11. Recovery is a daily commitment. Even years later, it is maintained one decision and one day at a time.12. Hope is a vital tool. Matteo reminds anyone struggling that change is possible, suffering is not permanent, and no one is alone in the process.Episode Timestamps 01:27 – Matteo describes entering the mental health system and navigating inconsistent levels of care. 02:21 – Mark breaks down substance use disorders and explains the limits of current treatments. 03:38 – Matteo discusses early experiences with psychiatrists and the difficulty of treating substance use and bipolar disorder together. 04:39 – Matteo explains when his mania first escalated and how substances intensified the symptoms. 05:49 – Matteo talks about the relationship between depression, self-medication, and worsening addiction. 06:11 – Mark explains why people self-medicate with alcohol or cannabis when their mind starts to unravel. 07:11 – Matteo shares how he gained partial stability with bipolar disorder before realizing his addiction was growing. 08:20 – Matteo describes the moment he recognized he had lost control over weed and alcohol. 09:57 – Mark explains the difference between mood disorders and personality disorders and why bipolar is often misunderstood. 10:23 – Matteo identifies the behavioral warning signs of mania, including loss of sleep, pressured speech, and risky decisions. 12:24 – Mark explains mood-stabilizing therapy and how medications level out extreme highs and lows. 12:47 – Matteo reflects on the importance of connection as the opposite of addiction. 14:30 – Matteo explains why suffering and time were the two forces that finally pushed him toward recovery. 15:54 – Mark outlines why addiction treatment has low success rates and why relapse is common. 17:24 – Matteo discusses peer support and how helping others helps him stay sober. 20:47 – Matteo describes how following professional guidance instead of his own instincts became a turning point. 23:13 – Matteo reflects on repairing relationships with family and how addiction strains loved ones. 25:08 – Matteo discusses how families struggle with the line between love and enabling. 27:29 – Matteo shares words of encouragement for people who feel hopeless in addiction or mental illness. 30:45 – Mark and Matteo discuss therapy, lived experience, and the need for ongoing self-awareness in recovery. DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 
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  • Voice: The 5th Vital Sign with Dr. Kang Hsu
    Your voice says more than you think.In this episode, Dr. Mark Bonta sits down with Dr. Kang Hsu, Chief Medical Officer of Canary Speech, to explore how AI and vocal biomarkers could make the human voice the next vital sign in medicine.They unpack the science behind this breakthrough, showing how subtle shifts in tone, rhythm, and cadence can reveal early signs of depression, anxiety, Parkinson’s, or cognitive decline long before symptoms appear.Dr. Hsu shares the origin story of Canary Speech, the research that powers its models, and how voice-based screening is already being used in healthcare, from telehealth visits to smart devices.It is a look into a future where a 40-second voice sample could help doctors detect disease, personalize treatment, and bring empathy back into digital medicine.Guest Link : https://canaryspeech.com/Timestamps00:00:00 — Welcome and opening reflections00:00:07 — A candid start: location, context, and conversation00:01:32 — Meet Dr. Kang Hsu, Chief Medical Officer of Canary Speech00:02:44 — How voice became medicine: the story behind Canary Speech00:03:29 — Why this conversation matters to clinicians and patients alike00:04:05 — Making science accessible: breaking down complex ideas00:05:59 — Behind the mic: how each episode comes together00:06:59 — Keeping it real: refining, revising, and staying authentic00:08:00 — Can your voice reveal your health? The rise of vocal biomarkers00:12:00 — From telehealth to wearables: real-world applications00:18:00 — The uphill climb: innovation vs. healthcare resistance00:24:00 — The road ahead: what the future of voice in medicine could look like00:30:00 — Closing thoughts and a glimpse into what’s nextEpisode Takeaways1. Voice as a Vital SignYour voice holds more data than you realize. Subtle changes in tone and rhythm can reveal early signs of depression, anxiety, or even cognitive decline.2. Objectivity Through AICanary Speech uses vocal biomarkers to turn speech into measurable data, giving clinicians objective insight where surveys and self-reporting fall short.3. New Frontiers in TelehealthVoice analysis can run quietly in the background of virtual visits and smart devices, creating a noninvasive way to monitor mental and physical health between appointments.4. The Challenge of ChangeHealthcare moves slowly. Adoption depends on awareness, trust, and showing how accessible technology like this can ease strain on overburdened systems.5. A Future Built on ListeningIn time, voice may join heart rate and blood pressure as a standard vital sign. It can help detect disease earlier and make care more personal, not less.DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 
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  • Erections: A Window into Cardiovascular Health? with Dr. Eliott Justin
    Welcome back to Ditch the Labcoat. This week, host Dr. Mark Bonta sits down with Dr. Elliot Justin, emergency physician, innovator, and founder of FirmTech, for a conversation that’s equal parts fascinating, funny, and paradigm-shifting. Together, they explore a topic that most people find awkward to talk about—but everyone is curious about: male sexual health.Dr. Justin shares how a personal injury and a deep curiosity about human physiology led him to develop an unexpected form of wearable technology—an erection ring that can not only enhance sexual performance but also collect valuable health data. Beneath the humor and candor lies something revolutionary: nocturnal erections, it turns out, may be one of the most powerful predictors of cardiovascular health we’ve been overlooking.In this episode, Dr. Bonta and Dr. Justin unpack what it means when men stop getting morning erections, how this can serve as an early warning sign for heart disease, and why the term “erectile dysfunction” might need to be retired altogether. They explore the complex interplay between vascular, neurological, and psychological factors that drive sexual performance; and how rebranding “dysfunction” into erectile fitness reframes the conversation around men’s health, confidence, and relationships.From bedside humor to hard science, Dr. Justin reveals how FirmTech’s technology has already identified hidden cardiac disease in users, improved relationships, and empowered men to take charge of their health in a completely new way. The discussion ranges from cardiovascular physiology to the social stigma surrounding male sexual health—and how technology might just be the bridge that makes it easier to talk about.If you’ve ever wondered what your body might be trying to tell you, why sex can be one of medicine’s most underused diagnostic tools, or how innovation can transform intimacy and health alike, this episode is for you.Let’s ditch the lab coat and get real about the science—and future—of erections.Dr. Elliot Justin, MD, FACeP, CEO of FirmTechhttps://myfirmtech.comEpisode Timestamps 01:00 Introduction to Health Metrics02:56 The Journey to Sexual Health Technology05:48 Understanding Nocturnal Erections09:13 The Role of Vascular Health11:57 Redefining Erectile Dysfunction14:54 The Impact of Technology on Sexual Health17:53 The Importance of Venous Return21:06 Patient Experiences and Relationship Dynamics24:02 The Power of Data in Sexual Health26:56 Safety and Usage of the Technology29:57 Future of Sexual Health Screening32:54 Concluding Thoughts on Sexual HealthEpisode TakeawaysNocturnal erections can serve as a leading indicator of cardiovascular health, offering a non-invasive way to monitor heart health.The technology developed by Elliot provides a dual-purpose solution: tracking nocturnal erections and serving as an erection ring to maintain sexual performance.Elliot's personal journey from emergency medicine to developing this technology highlights the importance of addressing sexual health as a vital component of overall well-being.The conversation challenges the stigma around erectile dysfunction, advocating for a shift towards discussing "erectile fitness" to promote a positive and proactive approach to sexual health.The data collected from the wearable technology can help differentiate between psychogenic and physiological causes of erectile issues, providing valuable insights for personalized treatment.Elliot emphasizes the need for a personalized approach to health, where individuals can use data to understand their unique health needs and make informed decisions.The episode underscores the potential of wearable technology to disrupt traditional medical practices by providing actionable insights and empowering individuals to take control of their health.Dr. Mark Bonta and Elliot discuss the broader implications of their work, suggesting that it could lead to new standards of care for men over 45 or those with specific health conditions.The conversation highlights the importance of open dialogue about sexual health, encouraging listeners to consider the benefits of integrating sexual health monitoring into their wellness routines.Elliot's innovative approach to sexual health technology is positioned as a tool for enhancing relationships and improving quality of life, beyond just addressing medical concerns.DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 
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Candid conversations between healthcare experts, every Wednesday at 5am EST on Labcoat.fm, your destination for evidence-based insights into the world of medicine, with no holds barred debate about hot topics in healthcare. This is for all the closet doctors, nurses, pharmacists and all others who are deeply fascinated about medicine but view the headlines with science-based skepticism.
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