Dr. Adam Schiavi is an assistant professor of anesthesiology and critical care medicine and neurology at the Johns Hopkins University School of Medicine. His areas of clinical expertise include anesthesiology, neurological critical care, disorders of consciousness and brain death diagnosis, clinical ethics, critical care medicine, and traumatic brain injury.

In this episode, Therese Markow and Dr. Adam Schiavi discuss how the definition of death has changed throughout history, what the current definition is, and how that is determined by the medical technology of the time. Brain death is the current definition of death, medically, but what happens to a body after brain death is determined can vary depending on the state you live in. This can be a trying time for families and for the providers involved with the now-deceased patient as the definition of death is not understood by everyone. They also discuss how brain death differs from other states of consciousness and how people often confuse the terminology of those different states, as well as the ability to hope for healing from all but brain death.

Key Takeaways:

• The total cessation of all functions of the brain is the current definition of brain death in the United States. This definition is based on a clinical exam testing all parts of the brain, typically done by somebody certified in doing brain death determinations.

• You have to have a reason for the neurologic exam to be declining. Without a reason, you can't call somebody brain dead.

• You can replace every organ in the body, but you cannot replace the brain and when the brain dies, the body dies all the time 100% unless those organ systems are artificially supportive.

"Our culture changes with technology and the way we define death is a part of culture. As that culture has shifted, the way we define death has also shifted with our new technologies of how we can actually determine whether people are dead." — Dr. Adam Schiavi

Connect with Dr. Adam Schiavi:

Johns Hopkins Bio: Adam Schiavi, MD, PhD, MS

Email: aschiav1@jhmi.edu

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: theresemarkow@criticallyspeaking.net

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

In this episode, Therese Markow and Dr. Katie Pelch discuss the harmful and pervasive effects of PFAS, also known as "forever chemicals." Found in various consumer and industrial products, contaminating air, water, and soil, they never break down. Dr. Pelch works for the Natural Resources Defence Council (NRDC) and has been studying PFAS throughout her career. Along with their many uses PFAS have been linked to serious health issues, including cancer and reduced vaccine effectiveness. The NRDC advocates for banning non-essential uses of PFAS and encourages public awareness and involvement in regulatory efforts. Dr. Pelch shares with us the prevalence of PFAS, its dangers, and the regulation or lack thereof.

Key Takeaways:

• When you heat the nonstick cookware above a certain temperature, some of the PFAS can migrate from the pan and into the food you’re going to eat, or they could enter the air that you breathe.

• Exposures from the air that we breathe and from our skin have generally been less well studied, but there is evidence to suggest that PFAS do enter our skin.

• Per the CDC, at least 98% of people in the United States have PFAS in their bodies.

• The EPA stepped up in a big way this year by finalizing the regulation of six PFAS in drinking water. This ban was preceded by many states proactively setting enforceable limits to PFAS in drinking water, some banning the unnecessary use of them entirely by 2032.

"Not only are PFAS persistent in the environment, but they're also persistent in our bodies, and in most cases, we don't have a great way to get PFAS out of our bodies. So the two most highly studied PFAS can last in our bodies for years." — Dr. Katie Pelch

Episode References:

• Dark Waters: https://www.imdb.com/title/tt9071322/

• The Devil We Know: https://www.imdb.com/title/tt7689910/

• Environmental Working Group: https://www.ewg.org/

• PFAS Exchange: https://pfas-exchange.org/

Connect with Dr. Katie Pelch:

Professional Bio: https://www.nrdc.org/bio/katie-pelch

LinkedIn: https://www.linkedin.com/in/katiepelch

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: theresemarkow@criticallyspeaking.net

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

In this episode, Therese Markow and Dr. Alex Hinton explore the potential for genocide in the U.S., highlighting historical and contemporary atrocities. Dr. Hinton emphasizes that genocide can target groups based on social constructs such as race, gender, and sexuality, among others. They discuss the rise of white supremacism and hate speech, and Dr. Hinton identifies risk factors such as political upheaval, economic instability, and armed militias. Dr.Hinton also stresses the importance of critical thinking and depolarization to prevent genocide, and suggests an easy way for everyone to do so without committing 40 hours per week to stay abreast of all of the issues and topics.

Key Takeaways:

• Genocide and mass violence are not typically planned from the beginning. They often evolve from other behaviors stemming from upheaval and past atrocities, scapegoating, grievance, and legitimation of formed hierarchies.

• Hate speech is everywhere—left, right, and center. Wherever someone is on the political spectrum, they can agree it's bad. The problem is that people sometimes disagree about what constitutes it.

• People are busy. Trying to keep informed can be a full-time job. One little thing everyone can do pretty easily to begin to do this in general, as we enter the political cycle, just pick a left-leaning, more centrist, and right-leaning news media source then on the top of the hour, turn on the TV, and flip between them and see the headlines.

"Ideology is central to all genocides, in some sense. Ideologies provide legitimation to disempower groups, and to legitimate different forms of hierarchy within a society and in the extreme. That then lays the basis for saying that groups are inferior." — Dr. Alex Hinton

Episode References:

• We Charge Genocide - The 1951 Black Lives Matter Campaign: https://depts.washington.edu/moves/CRC_genocide.shtml

• 2019 Citizenship Amendment Act: https://www.uscirf.gov/resources/factsheet-citizenship-amendment-act-india

Connect with Dr. Alex Hinton:

Professional Bio: https://sasn.rutgers.edu/alex-hinton

Twitter: https://x.com/AlexLHinton

Center for the Study of Genocide & Human Rights: https://x.com/Rutgers_CGHR

Check out Dr. Hinton’s writings mentioned in this episode:

• It Can Happen Here: White Power and the Rising Threat of Genocide in the US: https://www.amazon.com/Can-Happen-Here-Rising-Genocide-ebook/dp/B08L9JHRN6

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: theresemarkow@criticallyspeaking.net

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

In this episode, Therese Markow and Dr. Alan Rogol discuss the complexities of gender, sex, and identity in elite sports, with a focus on the societal expectations and controversies surrounding gender eligibility in sports. Dr. Rogol touches on some of the history of women’s identities in elite sports, including some from the recent 2024 Paris Summer Games. Throughout the discussion, Therese and Dr. Rogol highlight the need for inclusive politics and having a respectful approach to athletes’ identities. This is a complicated topic, still undecided as to what is fair and acceptable.

Key Takeaways:

• When women were allowed to compete in the Olympics, originally it was only allowed in three events: croquet, golf, and tennis. All were considered socially appropriate, with no bodily contact, and while wearing normal clothes of full, layered skirts.

• Sex and gender are not the same thing. Gender is self-identified, an expression, and is changeable. There are also varieties of sex - sex at birth, sex of rearing, legal sex, and chromosomal sex.

• Many of the girls who find out they have an XY chromosome after being identified as female at birth often don’t find out until later in life. Because while they had testosterone, they also had a gene that prevented their bodies from responding to it. These girls never developed as males, and in fact went through female puberty, but lacked a uterus.

• The IOC has many drugs that are banned except for certain situations. These include testosterone, endocrine drugs, growth hormones, and insulin among others.

"It is not the level of absolute testosterone that you have that counts. What counts is the stuff that is biologically active, and that is very complicated, and that's why numbers aren't so helpful." — Dr. Alan Rogol

Episode References:

• Personal Account: A woman tried and tested by Maria José Martínez-Patiño: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673605678415.pdf

• The New York Times: Running in a Body That’s My Own by Caster Semenya: https://www.nytimes.com/2023/10/21/opinion/running-body-semenya.html

• Critically Speaking Episode 9: You Go Girl: Testosterone with Dr. Alan Rogol: https://criticallyspeaking.libsyn.com/009-dr-alan-rogol-you-go-girl-testosterone

Connect with Dr. Alan Rogol:

Professional Bio: https://med.virginia.edu/faculty/faculty-listing/adr/

LinkedIn: https://www.linkedin.com/in/alan-rogol-49b18018/

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: theresemarkow@criticallyspeaking.net

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

In this episode, Therese Markow and Dr. Charles Easley IV discuss the significance of a father’s lifestyle before conception and its effects on prenatal development. This comes about not by mutations in the sperm DNA, but through heritable changes in the way the father’s genes are turned on and off during the development of the fetus. THese changes are referred to as epigenetic. So it’s not just about the mom, They thus explore the paternal origins of health and disease, highlight animal studies and human cohort studies that demonstrate intergenerational transmission of epigenetic changes, and discuss the dangers of toxic chemical exposure on male sperm.

Key Takeaways:

• To study the paternal effects on the fetus, we are able to do animal studies in the lab, however, for human studies, we can only study in cohorts after the fact, such as with the Dutch Famine, Michigan PBB, or, lately, the effects of COVID-19.

• Gary Miller is one of the leaders studying how paternal exposure prior to conception can have profound effects on the lifespan and healthy aging of future offspring.

• While we cannot pinpoint all the chemicals as having a lasting effect yet, it is important to try to be as healthy as you can. Certain chemicals, such as BPA and certain pesticides, have been studied to have an effect. And not just the mother during pregnancy.

"We've got a lot more evidence to suggest that what the father does prior to conception can have a profound effect on the genes that are expressed during development, and can have profound effects on how these organs develop in the offspring." — Dr. Charles Easley IV

Episode References:

• The Dutch Famine Birth Cohort: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934722/

• The Michigan PBB Cohort: https://stacks.cdc.gov/view/cdc/3929/cdc_3929_DS1.pdf

• The Poisoning of Michigan by Joyce Egginton: https://www.amazon.com/Poisoning-Michigan-Joyce-Egginton/dp/0870138677

Connect with Dr. Charles Easley IV:

Professional Bio: https://publichealth.uga.edu/faculty-member/charles-a-easley/

Website: https://www.easleylab.com/

Email: cae25@uga.edu

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: theresemarkow@criticallyspeaking.net

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

In this episode, Therese Markow and Dr. Daniel Aaron discuss the inadequate oversight of food additives by the FDA, particularly the agency's GRAS or “Generally Recognized as Safe” process, which allows unsafe additives to reach the market without proper scrutiny. Dr. Aaron highlights industry conflicts of interest, the lack of reporting requirements, the need for stricter regulation to protect public health, and discusses what is needed for the FDA to be better able to make impactful changes.

Key Takeaways:

• The majority of food additives in the US are not vetted by the FDA. Since 1958, food additives have been presumed safe until proven otherwise.

• The Clean Eating movement in the US is indicative of the skepticism of the American food supply.

• While the FDA used to maintain a list of GRAS substances, today, reporting to the FDA is not required.

• Europe uses a more precautionary approach to food additives. The EFSA must approve all chemical substances prior to their use in foods.

• Food additives are known to cause synergistic harm. However, the FDA poorly regulates single additives so it is not surprising that its consideration of interacting chemicals is insufficient.

"The FDA is the most accountable to corporate power. The largest impediment, in my view, to food regulation is funding. FDA’s Food Center has been underfunded for decades. Further funding from Congress is needed, but our legislators often are supported by industry that doesn't necessarily want a more robust review of food additives." — Daniel Aaron, M.D., J.D.

Episode References:

• Bystanders to a Public Health Crisis: The Failures of the U.S. Multi-Agency Regulatory Approach to Food Safety in the Face of Persistent Organic Pollutants by Katya S. Cronin: https://scholarship.law.gwu.edu/faculty_publications/1725/

• EFSA: https://www.efsa.europa.eu/en

• FDA Food Center: https://www.fda.gov/food

Connect with Daniel Aaron, M.D., J.D.:

Professional Bio: https://faculty.utah.edu/u6052921-DANIEL_G_AARON/hm/index.hml

Email: Daniel.Aaron@law.utah.edu

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: theresemarkow@criticallyspeaking.net

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.

In this episode, Therese Markow and Dr. Alexis Temkin, Senior Toxicologist at the Environmental Working Group, discuss toxic chemicals we can’t see or detect in our food and daily-use products. Dr. Temkin describes common pesticides and other chemicals used in agriculture and how they enter the human body. She also shares resources provided by the Environmental Working Group that can help keep you and your family safer.

Key Takeaways:

• Chemicals in cosmetics and other daily-use products are often considered safe until proven otherwise. It often takes years before the harm is discovered and the chemical banned

• Pesticides are introduced into our bodies through the food we consume.

• Despite a lack of EPA regulations, consumers can decrease their exposure to potentially harmful pesticides.

• Always wash your fruits and vegetables. It may not remove all pesticides, but it is good practice and will reduce at least some of your exposure to the chemicals.

"It’ll depend on the pesticide, but we’ve seen exposure to pesticides being linked to a variety of health harms. That could include brain and nervous system toxicity, we’ve seen associations with increased cancer after exposure to certain types of pesticides, impacts on reproduction, and dietary pesticide consumption has also been associated with cardiovascular health." — Dr. Alexis Temkin

Episode References:

• EWG Consumer Guides: https://www.ewg.org/consumer-guides

• Center for Biological Diversity: https://www.biologicaldiversity.org/

• EWG’s 2024 Shopper’s Guide to Pesticides in Produce: https://www.ewg.org/foodnews/summary.php

Connect with Dr. Alexis Temkin:

Professional Bio: https://www.ewg.org/news-insights/our-experts/alexis-temkin-phd

Website: https://www.ewg.org/

Email: alexis@ewg.org

LinkedIn: https://www.linkedin.com/in/alexis-temkin-46345750

Connect with Therese:

Website: www.criticallyspeaking.net

Threads: @critically_speaking

Email: theresemarkow@criticallyspeaking.net

Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.