Show Me the Science

In this episode, Washington University researchers discuss the Food and Drug Administration's recent full approval of the drug Leqembi (lecanemab) and what it could mean to the future of Alzheimer's disease treatments. The drug is approved for use in people with mild dementia from Alzheimer's disease, but researchers at Washington University's Charles F. and Joanne Knight Alzheimer Disease Research Center (ADRC), believe the drug, along with other medications in clinical trials, one day may help prevent the development of memory loss and problems with thinking in people who have Alzheimer's pathology in the brain but who have not yet developed clinical symptoms of the disease. Barbara Joy Snider, MD, PhD, a professor of neurology and director of clinical trials at the Knight ADRC, says that although Leqembi doesn't cure Alzheimer's disease, it slows the decline in memory and thinking, and it also slows the progression of the disorder by removing some amyloid plaques from the brain. John Morris, MD, director of the Knight ADRC, says with amyloid PET brain scans, blood tests and cerebrospinal fluid tests to detect problems before clinical symptoms of Alzheimer's appear, it soon may be possible to delay or even prevent the development of Alzheimer's dementia in some people at high risk. The podcast, "Show Me the Science," is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we discuss new research into psychedelic drugs as potential therapies for psychiatric illness. Several studies have suggested that drugs, such as psilocybin, may be useful in treating problems such as post-traumatic stress disorder, addiction and depression. Psychiatry researchers at Washington University School of Medicine in St. Louis have been using a brain-imaging technique called precision functional mapping to learn how psilocybin affects certain networks in the brain. Principal investigator Ginger Nicol, MD, an associate professor of child psychiatry, says scientists have suspected since the 1950s that there may be benefits from some psychedelic drugs, but because the drugs were classified as schedule one substances, researchers weren't allowed to study them. Recently, that has changed and Nicol, with fellow psychiatry researcher Josh Siegel, MD, PhD, gave a lecture sponsored by Washington University's Taylor Family Institute for Innovative Psychiatric Research, outlining some potential benefits of psychedelics in addressing hard-to-treat psychiatric problems. Using high-tech brain scans, they have been able to see what happens in the brain when a person takes psychedelic drugs, and they've found that the drugs cause more rapid changes than other medications used in psychiatry. What they want to learn next is whether the responses they've observed in brain scans translate into similar responses in the clinic, which could lead to improved mental health. They are planning to participate in a phase 3 clinical trial using psilocybin to treat people with treatment-resistant depression. The podcast, "Show Me the Science," is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we hear from two physician-scientists who have been leaders in the U.S. effort to deal with two medical crises that emerged almost 40 years apart: HIV/AIDS and COVID-19. Anthony S. Fauci, MD, the recently retired director of the National Institute for Allergy and Infectious Diseases at the National Institutes of Health (NIH), spoke to Washington University School of Medicine's 2023 graduating class. His role at NIH made him a leader in the worldwide effort to understand and develop treatments for HIV/AIDS, beginning shortly after the virus first was recognized. Also, in those early days of HIV/AIDS, William G. Powderly, MD, tested emerging therapies at the School of Medicine's AIDS Clinical Trials Unit, which he oversaw. Powderly, now the Larry J. Shapiro Director of the Institute for Public Health, co-director of the Division of Infectious Diseases, and the J. William Campbell Professor of Medicine and director of the Institute of Clinical and Translational Sciences at the School of Medicine, points to key similarities and differences between the nation's response to HIV/AIDS and to COVID-19. In both cases, he says, the key to a successful response involved embracing science and battling against theories that are untrue. In his Commencement speech, Fauci told the 110 newly minted physicians who graduated this spring that they must push back on destructive forces that dispute science. He advised the new doctors to push back with civility, but also with all of the strength they can muster. While he was at Washington University, Fauci also spoke to the St. Louis press corps about the end of the COVID-19 emergency and where we go from here. The podcast, "Show Me the Science," is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we visit a recent event sponsored by the Becker Medical Library at the School of Medicine. Called "In Our Words: Connection," the storytelling event brought together 12 faculty members, medical students, residents and fellows who told stories about how their lives have been affected by medicine as caregivers, those receiving care or otherwise. The idea behind the evening was to share stories and assist physicians and trainees in better understanding that they face many of the same challenges that their patients and colleagues face. Knowing that can help prevent burnout among physicians and help them to provide better care for their patients. Emily Podany, MD, is a hematology/oncology fellow who works with cancer patients, many of whom know their time is short. Her story detailed a meeting several years ago with a patient whose only goal was to make it back home one more time to be with her children and her dogs. Podany made it her mission as a provider to help her patient do just that. We also hear from Amy Riek, MD, an associate professor of medicine in the Division of Endocrinology, Metabolism & Lipid Research. Riek was preparing to give birth to her second child when she discovered a lump in her breast. Her story dealt with how cancer can rob patients of the feeling that they have any control over their lives. The podcast, "Show Me the Science," is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we report on the disturbing spike in maternal mortality rates in recent years. Although rates of maternal death have long been higher in the U.S. than in other wealthy countries, the rate recently reached its highest level since 1965. The number of deaths of mothers has risen from 17.4 deaths per 100,000 births in 2018 to 20.1 deaths in 2019 and 23.8 in 2020 — the first year of the pandemic. Then in 2021, the most recent year for which statistics are available, there were 32.9 deaths per 100,000 births. In all, about 1,200 people died during pregnancy, or within six weeks of giving birth, a 40% increase from the previous year. Ebony B. Carter, MD, an associate professor of obstetrics & gynecology at Washington University School of Medicine in St. Louis, says the groups most likely to be affected by these rising numbers are poor. Many tend to live far away from medical care, and many are members of minority groups. The maternal death rate among Black Americans was 69.9 per 100,000, 2.6 times higher than the rate for pregnant white Americans. Carter says physicians and scientists at Washington University and Barnes-Jewish Hospital are working hard to provide good prenatal care, but she explains that when people get pregnant, they often already have serious health issues that can contribute to maternal death, such as diabetes or hypertension, and put them and their babies at risk. She says the time to try to intervene is before chronic illnesses develop and make an eventual pregnancy risky. That, she says, will require an intentional focus from health-care professionals and systemic changes in how health care and other social services are provided in the United States. The podcast, "Show Me the Science," is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we report on a major international study involving psychiatry researchers from the School of Medicine who are working to identify causes and effects of the early stages of schizophrenia in young people — an illness characterized by significant changes in thoughts, feelings and behavior that may include a loss of contact with reality. The goal is to improve early diagnosis and treatment to potentially prevent the most devastating effects of the disorder. The study's principal investigator is Daniel Mamah, MD, a professor of psychiatry. He has a clinic in St. Louis, where he works with young people to identify biomarkers in the blood and the brain that may help predict risk of debilitating psychiatric illness. He also studies potential drug targets for treating such conditions. In addition, Mamah and his colleagues have expanded their efforts to East Africa. Working with collaborators in Kenya, the researchers are launching a site in Africa to study young people at risk for schizophrenia in hopes of learning more about what causes the illness, as well as how to potentially prevent it. Mamah previously has collaborated with researchers at the Africa Mental Health Research and Training Foundation, and now the scientists are working to identify and compare risk factors for schizophrenia in patients from North America and from Africa. The podcast, "Show Me the Science," is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we head to the emergency department. Doctors in most emergency departments around the country are dealing with fewer COVID-19-positive patients than before, but they continue to be faced with a different epidemic of sorts: the 20% to 30% of patients with dementia-related cognitive issues who seek emergency care. As the U.S. population ages, it's more common for emergency physicians to find themselves treating older people who are living with dementia. Further, during the thick of the COVID-19 pandemic, such patients were not allowed to have relatives stay with them to help navigate and better understand what is happening during their visits to the emergency department. While completing his medical training, Christopher Carpenter, MD, a professor of emergency medicine, had a bad emergency department experience involving his grandfather, who was suffering from dementia at the time. For more than two decades since then, Carpenter has looked for ways to make the emergency department experience easier for those who are living with dementia and their family members and caregivers. He is part of a national effort known as the GEAR Network, which stands for Geriatric Emergency Care Applied Research Network. The organization is studying ways to better identify and serve older patients with dementia. Carpenter says it's essential to improve emergency care for people living with dementia because as the U.S. population continues to age, the number of such people seeking treatment in emergency departments will continue to increase. The podcast, "Show Me the Science," is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we learn more about one of the leading problems associated with long COVID-19. Those who have been infected with the virus are at increased risk for a range of neurological conditions in the first year after an infection. Research conducted at the School of Medicine and the Veterans Affairs St. Louis Health Care System has found that strokes, cognitive and memory problems, depression, anxiety and migraine headaches are more common in people who have had COVID-19 than those who haven't. The most common neurological symptom, called brain fog, makes it more difficult for some people to remember things such as names, daily tasks or where they parked the car. Ziyad Al-Aly, MD, a clinical epidemiologist, says that since the pandemic began, COVID-19 has contributed to more than 40 million new cases of neurological disorders worldwide. Infections even have been associated with movement disorders — from tremors and involuntary muscle movements to epileptic seizures — hearing and vision problems, and issues with balance and coordination. We also speak with Robyn Klein, MD, PhD, director of the Center of Neuroimmunology & Neuroinfectious Diseases at Washington University School of Medicine in St. Louis. Her team studied the brains of hamsters and brain tissue from people who died of COVID-19 infections and found that although the virus doesn't seem to get into neurons directly, it does increase the numbers of immune cells, called microglia, in brain structures important to learning and memory, potentially explaining why some of those structures in the brain may not function as well during and after COVID-19 infections. The podcast, "Show Me the Science," is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

In this episode, we visit the team at the Washington University Living Well Center. It was launched to improve outcomes for patients with orthopedic issues. For example, if someone needs hip-replacement surgery, that person also can receive help losing weight, stopping smoking and taking other actions to make it more likely the outcome from their surgery will be as good as possible. The center uses dietary counseling, physical therapy, massage, acupuncture and behavioral therapy to prepare some patients for surgery, while helping others improve without surgical intervention. In addition to orthopedic issues, health professionals at the center work with cancer patients, long COVID-19 patients and others. The idea, according to Devyani M. Hunt, MD, a professor of orthopedic surgery and the center's medical director, is to treat the whole patient and to do it all in one place. Specialists at the center work together to apply the "pillars of lifestyle medicine including using food as medicine, encouraging physical activity and exercise, addressing sleep issues, managing stress and addressing anxiety and depression, avoiding risky substances such as tobacco, and encouraging patients to make positive social connections. The center has had more than 200 patients come through its doors the last few years, and the outcomes for those patients suggest the approach is working. The podcast, "Show Me the Science," is produced by WashU Medicine Marketing & Communications at Washington University School of Medicine in St. Louis.

As we get deeper into autumn and winter approaches, we discuss COVID-19 vaccines. New boosters have been developed to rev up the immune system not only to fight the original strain of the virus but also to boost the immune system against more recent omicron strains of SARS-CoV-2. In this episode, we discuss the boosters — now approved for use in children as young as 5 — with infectious diseases specialist Rachel M. Presti, MD, PhD, an associate professor of medicine and medical director of Washington University's Infectious Diseases Clinical Research Unit. New vaccines may be on the horizon, too. A nasal vaccine developed by Washington University scientists recently was approved for emergency use in India, and that technology has been licensed to Ocugen, a U.S.-based biotechnology company focused on developing and commercializing novel gene and cell therapies and vaccines. Ocugen plans to seek approval for the nasal vaccine in the U.S., Europe and Japan. The nasal vaccine was developed by Washington University virologist and immunologist Michael S. Diamond, MD, PhD, the Herbert S. Gasser Professor of Medicine and a professor of molecular microbiology, and of pathology & immunology; and David T. Curiel, MD, PhD, the Distinguished Professor of Radiation Oncology. The hope is that the nasal vaccine will stoke the immune response in the nose and throat so that the virus never gets farther into the body. Current vaccines require a person to be infected before antibodies revved up by the vaccine can fight it. As a result, Diamond and Curiel say a nasal spray may be more effective at preventing infections and at keeping vaccinated people from spreading the virus to others. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

If you were coughing, running a fever and felt short of breath, what would you think? Those are common symptoms of COVID-19. But not everyone with such symptoms is infected with the virus. In this episode, we tell the story of a Michael Moffitt, a young man who grew up in St. Louis but was been working in the oil and gas fields of New Mexico. He got sick in November 2020 with a cough, fever and shortness of breath, initially leading his doctor to assume he had COVID-19. Moffitt's tests for the virus came back negative, but for weeks, his health-care providers in New Mexico wondered whether the tests were accurate. He was being treated with antibiotics, but when Moffitt lost 30 pounds in three weeks and needed supplemental oxygen, he knew he needed another opinion. After his wife and mother-in-law drove 14 hours to bring him to St. Louis, Moffitt saw infectious diseases specialist Andrej Spec, MD — an associate professor of medicine and a specialist in fungal infections. Spec put him in the hospital and quickly solved the medical mystery. Moffitt had a fungal infection, likely acquired while exploring caves in New Mexico. Spec started him on strong antifungal medications, and he fully recovered. Spec says the majority of people who have symptoms of COVID-19 actually do have that viral illness. But when treatments don't work, he says, it's important for doctors to think a little differently and consider other factors that may cause illness. Many people have fungal infections in their lungs at some point in their lives, he says. Most of those infections are asymptomatic or feel like bad colds, but in some instances, the infections can become life-threatening without proper treatment. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Infections and hospitalizations are rising again. During this latest wave of COVID-19 infections, many fully vaccinated people are getting sick, as are people who previously were sick with the virus, even those infected in the very recent past. The new strains of omicron — BA.4 and BA.5 — have stricken some well-known, fully vaccinated people, including President Joe Biden and Dr. Anthony Fauci. In this episode, we speak with William G. Powderly, MD, the J. William Campbell Professor and co-director of the Infectious Diseases Division at Washington University. Powderly says the recent increases in cases and hospitalizations are a reminder that, even after two-plus years, the pandemic is not over. Vaccines seem to protect many people from serious disease, but infections among those who are fully vaccinated have become more common as BA.4 and BA.5 have become the virus's dominant strains. Rachel M. Presti, MD, PhD, an infectious diseases specialist and an associate professor of medicine at Washington University, is among those testing new vaccine boosters engineered specifically to target those new strains. Presti, medical director of the university's Infectious Diseases Clinical Research Unit, says it's still too early to be certain but that the updated boosters seem to provide better protection than the currently FDA-approved vaccine. Of course, how long protection provided by the updated booster might last may depend on how quickly the virus continues to evolve. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

Brain-computer interfaces connect activity in the brain to an external device by means of a computer. Research has shown it's possible to use such interfaces to move robotic arms and perform other tasks. Almost 30 years ago, Washington University researcher Eric Leuthardt, MD, a professor of neurosurgery, demonstrated that he could hook electrodes to the brains of epilepsy patients who were waiting to have brain surgery, and those patients then could play video games just by thinking about moving things on a screen. Over the years, Leuthardt's team has learned to detect similar brain signals noninvasively. He co-founded the Washington University startup company Neurolutions Inc. to develop a brain-computer interface to help stroke patients recover function in their hands and arms. In this episode, we learn about that device, known as the IpsiHand Upper Extremity Rehabilitation System. The IpsiHand involves a sort of cap that picks up brain signals from a stroke patient and transmits the signals to an exoskeleton fitted over the patient's paralyzed hand. While wearing the system, patients think about moving the affected hand, and the IpsiHand translates that intention into actual hand movement. Over time, the patient's brain slowly learns how to move the hand by itself. In addition to Leuthardt, we'll also speak to a man who helped test an early version of the device years after a stroke left him unable to use his right hand. After working with the IpsiHand, the stroke patient, Mark Forrest, regained enough use of his right hand that he was able to build himself a boat. We'll ride on that boat with him as he catches some fish and discusses his recovery. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

As many as 30% of those who get COVID-19 will continue to have problems in the weeks and months after their infections. Long COVID-19 is defined as a condition in which issues persist for at least three months. But for many, the difficulties last much longer. Extreme fatigue, shortness of breath and what many call brain fog lead the list of long-term complications. Some people also develop heart problems, diabetes, psychiatric issues and trouble with pain in the weeks and months following the initial illness. In this episode, we speak with Maureen Lyons, MD, an assistant professor of medicine and director of the Care & Recovery After COVID-19 Clinic at the School of Medicine. The clinic was designed specifically to work with so-called long-haulers. She says many of her patients are frustrated at their inability to get back to life as they knew it before COVID-19. We also hear from one of Lyons' patients, Michelle Wilson. She's a nurse who became ill with COVID-19 in November 2020 and is still having problems with fatigue, shortness of breath and other difficulties. And we'll hear from epidemiologist Ziyad Al-Aly, MD, an assistant professor of medicine at Washington University who treats patients in the Veterans Affairs St. Louis Health Care System. He has found that vaccination provides some protection against long COVID-19, but just as vaccinated people still can get breakthrough infections, they also can develop long COVID-19. It's not as common in vaccinated people, but there's still a significant risk. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

In this episode, we discuss issues that were problems long before anyone ever heard of COVID-19: alcohol use disorder and opioid overdose. Both seem to have gotten worse during the pandemic. Alcohol sales rose during the early days of lockdown, and they've remained high. Laura J. Bierut, MD, the Alumni Endowed Professor of Psychiatry, says another issue is that with some people losing their jobs while millions more have worked from home, some of the guardrails that have kept people from drinking too much have just gone away. She expects the fallout from the pandemic, in terms of alcohol use, will continue being felt for years to come. And just as the pandemic has fueled alcohol problems, deaths from drug overdoses have continued to climb, with more than 107,000 overdose deaths reported in the U.S. during a recent 12-month period. One issue, according to Kevin Xu, MD, a resident in psychiatry and Evan S. Schwarz, MD, an associate professor of emergency medicine and director of the Division of Medical Toxicology, is that many who use opioids are not prescribed a drug that can reduce cravings and lower risk of future overdose. That drug, buprenorphine, is prescribed for only about half of the patients treated for opioid use disorder, and it's used even less frequently in people who use opioids along with other substances, such as cocaine, alcohol or methamphetamine. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

But for this episode, we're sticking with COVID-19. In 2020, when the pandemic shut down much of the country, our very first guest on "Show Me the Science" was Steven J. Lawrence, MD, a professor of medicine in the Division of Infectious Diseases. He also was our first guest of our second season of podcast episodes last year. And we've brought him back again, for year three. As the pandemic first gripped the St. Louis area, Lawrence was worried whether there would be adequate ventilators, ICU beds and medical staff to care for patients with COVID-19. A year later, in spring 2021, he was touting vaccines as a potential way out of the pandemic. Now, after having to deal with the delta and omicron variants of the virus, and with new worries about an even more infectious version of omicron, Lawrence has thoughts on moving forward as well as what people got right and wrong during the first two years of the pandemic. He also has some ideas regarding where we may be headed. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

The death toll isn't the only staggering statistic from the first two years of the pandemic. What's become increasing clear is that some COVID-19 patients don't get well right away. Since the earliest days of the pandemic, we've heard of survivors who continue to experience shortness of breath, extreme fatigue, lingering difficulty with taste and smell, and brain fog. But researchers at Washington University School of Medicine in St. Louis and the Veterans Administration have found that other problems also affect people long after infection with the virus. In a series of studies, epidemiologist Ziyad Al-Aly, MD, an assistant professor of medicine who treats patients in the VA St. Louis Health Care System, has found that following COVID-19 infection, people are more likely to develop kidney problems, heart issues, diabetes and mental health difficulties such as depression and anxiety. The percentage of patients who go on to have those issues is relatively low, but with so many people having been infected, the absolute number of people with lingering problems is in the millions. Meanwhile, another team of researchers at Washington University School of Medicine found that those who tested positive for the virus are more likely to report problems with peripheral neuropathy, which is characterized by pain and tingling in the hands and feet. Simon Haroutonian, PhD, an associate professor of anesthesiology and chief of clinical research at the Washington University Pain Center, found that nearly 30% of patients who tested positive for COVID-19 also reported neuropathy problems, and in 6% to 7% of those patients, the problems persisted for up to three months. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

With the pandemic death toll approaching 1 million people in the United States, Rochelle P. Walensky, MD, the director of the U.S. Centers for Disease Control and Prevention (CDC), and a Washington University alum, visited Washington University School of Medicine on March 2 and March 3, 2022. As part of the Department of Medicine's weekly Grand Rounds series, she sat down with William G. Powderly, MD, the J. William Campbell Professor of Medicine and co-director of the Division of Infectious Diseases, for a conversation about the challenges and successes of the pandemic. During the conversation with Powderly, Walensky answered questions about COVID-19 and noted that her earlier experiences as a physician working during the HIV/AIDS epidemic influenced her thinking about this newer public health crisis. She says the AIDS epidemic demonstrated that infectious diseases tend to weigh more heavily on some communities than others, and that this unequal burden is rooted in social inequities. She also praised the rapid development and deployment of COVID-19 vaccines, even as she admitted that vaccination rates need to improve in the U.S. and around the world in order to help the planet emerge from the pandemic. And she told trainees that, as difficult as the last two years have been for health-care providers, she wanted them to remember that a pandemic like the one we have been experiencing is exactly what that they trained for. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

More than 900,000 people in the United States have died of COVID-19, and over the last year, almost all of those deaths have been among unvaccinated people. Still, many people remain unvaccinated, and many say they are not sure whether they can trust the things public health officials say about COVID vaccines. Washington University infectious diseases specialist Elvin H. Geng, MD, a professor of medicine, recently recalled similar issues with communication and trust in a Perspective essay he wrote for The New England Journal of Medicine. In the essay, Geng discussed a patient he worked with years ago who was convinced that HIV didn't cause AIDS. That patient saw no need to take anti-retroviral medication when it became available, even as he got progressively sicker. But Geng continued talking to this patient and, eventually, he changed his mind. Geng writes that similar efforts are needed to ease the fears of people who have very real concerns about the safety of COVID vaccines. He writes that "no disembodied message (even if crafted by marketing experts) can compete with someone you know who will pull up a chair." Although Geng says he understands it's difficult for doctors to make time for heart-to-heart talks with every anxious patient, he also says it's clear from the low rates of vaccination that something has to change; and he believes deeper, more empathetic conversations between doctors and patients could be an important step. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.

With U.S. hospitals crowded with COVID-19 patients for almost two years, the pandemic's relentlessness has pushed many doctors, nurses and other health-care professionals to the brink. Many have decided to leave the field or question whether to remain. Researchers at Washington University School of Medicine in St. Louis have launched a research project as part of a new program funded by the Health Resources and Services Administration of the U.S. Department of Health and Human Services. The goal is to reduce burnout and promote mental health and wellness among those in the health-care workforce. Psychiatrist Ginger E. Nicol, MD, is the study's principal investigator. She says the fact that the pandemic has dragged on for so long makes it especially difficult to handle. And co-investigator, psychiatrist Jessica A. Gold, MD, the director of wellness, engagement and outreach for the Department of Psychiatry, says the culture within health care — that although workers are willing to go to great lengths to help others, they don't like to ask for help themselves — presents a major challenge. The School of Medicine is trying to change that culture as it trains the next generation of health-care professionals. Eva Aagaard, MD, the senior associate dean and vice chancellor for medical education, says the school is working hard to identify potential burnout in students and to encourage them to seek help when problems arise. The podcast, "Show Me the Science," is produced by the Office of Medical Public Affairs at Washington University School of Medicine in St. Louis.