This Medical Life

Willem J Kolff was an intern when he saw a 22 year old man die of kidney failure. He realised that the patient’s life could have been saved if his blood could have been detoxified. Willem set to work and developed the first ever dialysis machine (initially the ‘rotating drum kidney’). While dialysis is a lifesaving treatment, it is one that we hope to avoid for patients. In this episode, we discuss two topics that are the largest contributors to chronic kidney disease: Diabetes, and Hypertension. This is the story of Chronic Kidney Disease (Part 2). Our special guest: Dr Richard Phoon who is the Senior Medical Advisor at Westmead Hospital and has worked full-time as a Nephrologist at Westmead and Blacktown Hospitals since 2007. Useful links: CKD Management in Primary Care handbook (KHA) Link: https://kidney.org.au/health-professionals/ckd-management-handbook Kidney Health 4 Life: Kidney Health 4 Life – Better kidney health, for life Health professional webinar here: Kidney Health 4 Life Healthcare Professional Webinar – YouTube For health professionals looking for printed posters and brochures for their clinic or unit: Kidney Health 4 Life Print Materials Or contact the Kidney Health Australia Helpline on 1800 454 363See omnystudio.com/listener for privacy information.

One in 10 Australians over the age of 18 years are living with signs of Chronic Kidney Disease (CKD) with the number of patients needing treatment for kidney failure has doubled in the last 20 years. Early detection and intervention can slow the progression of CKD by up to 15 years or longer. Our understanding of kidney disease can be traced back to Dr Richard Bright, one of the founding fathers of nephrology. He noted that heating a patient’s urine with kidney disease could form a precipitate – nowadays we’d call this albuminuria (albumin in the urine) and it is a marker of kidney damage. Today, there are a range of conditions that can reduce kidney function, cause kidney damage, and can cause significant morbidity and early mortality in patients. By screening patients, we can reduce the progression of CKD and significantly affect the health of patients in the long term. This is the story of Chronic Kidney Disease (Part 1). Our special guests: Maddie Williams who is a Registered Nurse with Kidney Health Australia who was diagnosed with kidney disease at the age of 17 requiring haemodialysis, peritoneal dialysis, and received a renal transplant. Dr Richard Phoon who is the Senior Medical Advisor at Westmead Hospital and has worked full-time as a Nephrologist at Westmead and Blacktown Hospitals since 2007. Useful links: CKD Management in Primary Care handbook (KHA) Link: https://kidney.org.au/health-professionals/ckd-management-handbook Kidney Health 4 Life: Kidney Health 4 Life – Better kidney health, for life Health professional webinar here: Kidney Health 4 Life Healthcare Professional Webinar – YouTube For health professionals looking for printed posters and brochures for their clinic or unit: Kidney Health 4 Life Print Materials Or contact the Kidney Health Australia Helpline on 1800 454 363 Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page.See omnystudio.com/listener for privacy information.

The statistics of Intimate Partner Violence (IPV) and Domestic Violence prevalence are staggering. 1 in 6 adult women and 1 in 16 adult men have experience physical or sexual abuse at the hands of their partner. Approximately 2.5 million Australians (13%) experienced abuse during their childhood. However, IPV is a topic that is rarely discussed. As healthcare professionals, we need to change this. A recent study by our guests on this episode, Timelines of psychological, physical and sexual intimate partner violence among a nationally representative sample of Australian women, studied the timeline of psychological, physical, and sexual intimate partner violence. They highlighted that early warning signs of an abusive partner include isolation, controlling behaviour, and intense jealously. We discuss these important findings and other take home messages of this study and how we can apply it to everyday practice. This is the story about intimate partner violence. Our special guests: Dr Elizabeth McLindon is a Research Fellow in the Department of General Practice and works in the Sexual Abuse and Family Violence (SAFE) program. Elizabeth is the Deputy Director of the Centre for Family Violence Prevention at the Royal Women’s Hospital in Melbourne. Professor Kelsey Hegarty is an academic general practitioner who holds the joint Chair in Family Violence Prevention at the University of Melbourne and the Royal Women’s Hospital. She also leads the Safer Families Centre. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page.See omnystudio.com/listener for privacy information.

Oral cancer was a fatal disease even into the twentieth century. Patients required extensive surgery and often had a painful recovery or went into palliative care but the result was the same. Modern medicine has thankfully provided much to our understanding, the treatment and management of patients with oral cancer. In recent times, patients have been able to be stratified into two general but distinct categories: the first are older with a strong history of heavy smoking and/or alcohol use; the second are younger and have a history of multiple sexual partners. The distinction is important as the treatment and management are different between the two groups with the second group having a much better prognosis. This is the story of oral cancer. Our special guests: Dr Rebecca Morrow is an anatomical pathologist and deputy head of department at the Royal Adelaide Hospital with SA Pathology. Dr Rowan Valentine is a paediatric and adult Ear, Nose and Throat Surgeon. Listen: This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page.See omnystudio.com/listener for privacy information.

The first medical description of pernicious anaemia is from 1821. It is written by Dr James Combe and describes a previously well 47 year old corn-merchant who presented with pallor, weakness, and neurological symptoms. It would take over a hundred years before we would know how to treat this condition, and another decade after that to understand why the treatment worked. Vitamin B12 is an essential component of our diet and only found in animal products. Deficiency in vitamin B12 can present with fatigue, anaemia (macrocytic), and neurological symptoms. The most at risk from a dietary perspective are vegetarians, vegans, and the elderly. Patients may also have an autoimmune condition (pernicious anaemia) that interferes with gastric parietal cells and intrinsic factor; the way our body can absorb vitamin B12 from our diet. This is the story of vitamin B12. Our special guest: Our special guest is Professor Ken Sikaris who is a chemical pathologist and Director of Chemical Pathology at Dorevitch Pathology.See omnystudio.com/listener for privacy information.

One of the most difficult cancers to detect early has been lung cancer. Patients often present with advanced disease that and can often be fatal. In April 2025, a new National Lung Cancer Screening program has been rolled out in Australia to detect asymptomatic patients with a significant smoking history (30 Pack-Year). Suitable patients are eligible for a free low-dose CT (computer tomography) scan on their lungs to identify any potential lesions suspicious for cancer. This is the story of lung cancer screening. Our special guests: A/Professor Nicole Rankin is Head of the Evaluation and Implementation Science Unit in Melbourne School of Population and Global Health (University of Melbourne) and led the team that developed the Australian National Lung Cancer Screening Program Guidelines. Dr Julie Teague is an Anatomical Pathologist with an interest in thoracic and gastrointestinal pathology.See omnystudio.com/listener for privacy information.

In 1966, the Chief of Urology asked the Chief of Pathology at the Minneapolis VA Hospital to develop a system to communicate the results of prostate cancer to researchers. The Chief of Pathology was Donald Gleason and he developed a system that would revolutionise our understanding of prostate cancer. Today, every prostate cancer worldwide is classified using the Gleason score, named after Donald Gleason. Prostate cancer is one of the most common cancers worldwide and accounts for 15% of all male cancers. Its incidence of prostate cancer is estimated to double by 2040. This is the story of prostate cancer. Our special guests: Professor Fiona Maclean is a Clinical Professor, Anatomical Pathologist, author, past President of the Australasian Division of the International Academy of Pathology (IAP), and advisor in Pathology Artificial Intelligence. Dr Joanna Olphert is a urologist and robotic surgeon involved in genitourinary reconstructive surgery, robotic uro-oncology, and open complex peritoneal surgery. Dr Carole Harris is a medical oncologist, senior lecturer, and senior research fellow.See omnystudio.com/listener for privacy information.

Over the last 100 years, numerous types of implants (i.e. ivory, glass, wool) and injections (i.e. epoxy resin, beeswax, paraffin) have been used in an attempt for breast augmentation but the results were poor. In 1962, the first operation using silicone implants was performed and it revolutionised breast surgery. Breast augmentation surgery (cosmetic and reconstructive) is one of the most common cosmetic surgeries in Australia, United States, and the United Kingdom. As one of the most common cosmetic surgeries, it is important for doctors and patients to know about the risks and myths of this procedure. In this episode, we discuss breast augmentation surgery and our discussion includes common complications, risks, and breast implantation illness. This is the story of breast augmentation Our special guest: Our special guest is plastic surgeon Dr Andrew Campbell-Lloyd from ACL Plastic surgery in Adelaide.See omnystudio.com/listener for privacy information.

The interplay between genetics and medications is important but complex. Pharmacogenomic testing provides doctors with information about how individual patients may respond to certain medications (ie. fast and slow metabolisers). The RCPA recently released guidelines for doctors about requesting patient pharmacogenomic testing before prescribing some medications. These guidelines have identified 35 medications into three pharmacogenomics testing categories: recommend, consider, and no consensus. We discuss this testing with our guest today. This is the story of pharmacogenomics. RCPA guidelines: https://www.rcpa.edu.au/Library/Practising-Pathology/Pharmacogenomic-Indications-in-Australia Our special guest: Our special guest is Professor Luke Hessen who is the manager of the Genetics Department at Douglass Hanly Moir and co-Chair of the RCPA Pharmaogenetic Advisory Group.See omnystudio.com/listener for privacy information.

In 1924, a surgeon and a pathologist had a conversation about some patients with multiple bowel polyps. The pathologist, Dr Cuthbert Dukes, and the surgeon, Mr JP Lockhart-Mummery, noted that patients had a family history of bowel cancer and could have hundreds of colonic polyps. They, with the help of HRJ Bussey, set up the Polyposis Registry. The registry collected information about these patients and the families from 1918 to 1954. They found that patients developed polyps in childhood, the risk of affected children was 50%, and cancer took 15 years to develop from first diagnosis. This was clearly a familial disease. Today, we know this a Familial Adenomatous Polyposis or FAP. The genetic basis for this condition was identified in the 1980s and 1990s. Professor Sir Walter Bodmer led a team to map the location of the Adenomatous Polyposis Coli (APC) gene involved. This is the story of Familial Adenomatous Polyposis (FAP) Our special guests: Professor Sir Walter Bodmer is a professor of the Cancer and Genetics laboratory and Department of Oncology at Oxford University. Areas of research include: HLA, population genetics, Human Genome Project, and mapped the APC gene. He was knighted in 1986. Dr Tristan Rutland is an Anatomical Pathologists, recipient of the Konrad Muller RCPA Outstanding Teaching Award (2020), and recipient of the Resident Advocate Award from the College of American Pathologists. Dr Emelia Ip is a trained medical oncologist, staff specialist in cancer genetics, and co-chair of EviQ Adult Cancer Genetics Reference Committee. Help support us on our donation page.See omnystudio.com/listener for privacy information.

We have come a long way in our understanding of epilepsy and seizures. Historically, epilepsy was associated with possession and demonic forces. Modern medicine has helped us to understand that epilepsy is an electrical disorder of the brain that can affect an area or the entire brain itself. Unfortunately, a lot of stigma and misinformation remains about epilepsy and it is an important condition to be aware of. This is the story of epilepsy. Our special guest: Professor Mark Cook who is the Director of Neurology and Chair of Medicine at St Vincent’s Hospital in Melbourne. He was awarded the Order of Australia in 2023. Help support us on our donation page.See omnystudio.com/listener for privacy information.

It is evident from paintings that Leonardo da Vinci and Michelangelo suffered some form of underlying hand pathologies. These have been the focus of discussions and journal articles amongst many academics. Our understanding of different disease processes involving the hand have come a long way. There are a lot of options for patients both medical and surgical that we discuss in this episode. This is the story of hand pathology Our special guest: Dr Paul van Minnen is a plastic and reconstructive surgeon who runs his own private practice in Adelaide called ‘Grip surgery’. Help support us on our donation page.See omnystudio.com/listener for privacy information.

Hyponatraemia, the most common electrolyte disturbance in clinical medicine, is often subtle but can be serious. In this episode, we trace the surprising history of fluid replacement back to the 1832 cholera riots in Liverpool, where experimental saline saved lives amidst chaos and mistrust. We then bring the conversation into modern practice, exploring diagnostic steps, common causes, and when GPs should refer patients to hospital. This is the story of Hyponatraemia. Our special guest is: Dr Michael Page, Chemical Pathologist and CEO of Clinipath. This Medical Life podcast is available on all podcasting services and Spotify. Help support us on our donation page.See omnystudio.com/listener for privacy information.

In 1958, Dr Denis Burkitt was working in Uganda when he saw multiple children with large and aggressive jaw tumours. He had never seen anything like this before and he investigated further. Over the next few years, he discovered that these tumours had a geographical distribution across equatorial Africa and also was related to rainfall. This led to the discovery of an aggressive form of lymphoma that we now know as Burkitt lymphoma as well as the Epstein-Barr virus (EBV). It is a remarkable story of intellectual curiosity, scientific discovery, and commitment. Éanna Mac Cana was diagnosed with Burkitt lymphoma in 2017. This diagnosis led him to the story of Dr Denis Burkitt and how we first learned about this disease. He has created a documentary using never-before-seen archival footage of Dr Denis Burkitt and his discovery, and included his own journey with this disease. This is the story of Burkitt lymphoma. Our special guests include: Éanna Mac Cana who is a documentary filmmaker from Belfast in Ireland. Professor Jonathan Bond from the University College Dublin and works in paediatric molecular haemato-oncology. This Medical Life podcast is available on all podcasting services and Spotify.See omnystudio.com/listener for privacy information.

Recent genetics studies have shown that ancient Humans and Neanderthals coexisted around 50,000 years ago for approximately 7,000 years. There is evidence of these different human species mixing and having offspring. Around 2-4% of modern humans can be traced back to Neanderthals. This is the story of Humans and Neanderthals. Our special guests: Our special guest is Associate Professor Bastien Llamas who is affiliated with the Australian Centre for Ancient DNA. This Medical Life podcast is available on all podcasting services and Spotify. See omnystudio.com/listener for privacy information.

And we’re back for 2025. We thought we’d ease into this season with some medical stories. From the Manhattan project and the demon core to the inspirational stories of Dr Elizabeth Blackwell, Dr Elizabeth Garrett Anderson, and Dr Emma Constance Stone. We are reaching back into the medical archives. Our special guests: Dr Travis Brown, himself! This Medical Life podcast is available on all podcasting services and Spotify.See omnystudio.com/listener for privacy information.

Throughout history, humanity has been captivated by heroes overcoming immense challenges—from ancient legends to modern Marvel icons. In this episode, Dr Travis Brown and Steve Davis are honoured to have Janine Watson, a Paralympian athlete who reached out to us after our episodes on Chronic Traumatic Encephalopathy (CTE) (Episode 53 and Episode 54) opened her eyes to the unrecognised trauma her brain and body have endured. This is the story of Janine Watson’s journey from MS diagnosis to history making Paralympian. And how listening to a particular episode of This Medical Life changed her future. Our special guest: Paralympian, Janine Watson. This Medical Life podcast is available on all podcasting services and Spotify. See omnystudio.com/listener for privacy information.

Patients with colorectal cancer often have their diagnosis, treatment, and care discussed at a regular multidisciplinary team meeting. This includes: gastroenterologists, surgeons, oncology, radiation oncology, pathologists, home care nurses, oncology nurses, genetic councillors, care coordinators plus others. This is the third episode of a three part series on colorectal cancer. This episode focuses on management. Many thanks to Dr Tristan Rutland who helped organise this series. This is the story of colorectal cancer (part 3). Our special guests: Dr Stephanie Lim: medical oncologist who works at GenesisCare and Macarthur Cancer Therapy Centre Dr Meredith Johnston: radiation oncologist who works at Liverpool hospital Dr Emilia Ip: medical oncologist and cancer geneticist at Liverpool hospital This Medical Life podcast is available on all podcasting services and Spotify.See omnystudio.com/listener for privacy information.

The lifetime risk for colorectal cancer is 1 in 23 men and 1 in 25 women. Detecting and diagnosing cancer is a critical step in managing a patient’s health as well as the multidisciplinary team where their care is discussed. This is the second episode of a three part series on colorectal cancer. This episode focuses on diagnosis. Many thanks to Dr Tristan Rutland who helped organise this series. This is the story of colorectal cancer (part 2). Our special guests: Dr Milan Bassan: gastroenterologist and Director of Endoscopy at Liverpool Hospital and returning guest Dr Scott Mackenzie: surgeon and senior lecturer at the Liverpool Hospital and returning guest Dr Tristan Rutland: lecturer, award winning anatomical pathologist for teaching and regular guest This Medical Life podcast is available on all podcasting services and Spotify.See omnystudio.com/listener for privacy information.

Colorectal cancer accounts for ~10% of all new cancer diagnoses. Fortunately, over the last three decades, the 5 year patient survival has increased from 56% to 71%. As with most cancers, the key to good outcomes is early detection. This is the first episode of a three part series on colorectal cancer. This episode focuses on screening. Many thanks to Dr Tristan Rutland who helped organise this series. This is the story of colorectal cancer (part 1). Our special guests are: Professor Ken Sikaris: chemical pathologists, Director of Chemical Pathology at Dorevitch Pathology and regular guest Dr Milan Bassan: gastroenterologist and Director of Endoscopy at Liverpool Hospital and returning guest Dr Tristan Rutland: lecturer, award winning anatomical pathologist for teaching and regular guest This Medical Life podcast is available on all podcasting services and Spotify.See omnystudio.com/listener for privacy information.