Zoom is foie gras of the brain [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

“We lack the necessary signaling of the nonverbal cues when only looking at one’s face. The presenter’s large face only a few inches from our screen may evoke our primordial threat response with its resulting cascading transmitters. The angulation of computer and phone cameras causes facial distortions. Unless one aligns oneself to be at the same level as the camera, the camera angulation may cause one to feel either looked down upon or looked up to, but rarely on the same playing field.

Our neurons are living and breathing cells, and they need to eat and rest. The brain is responsible for filtering through vast quantities of homeostatic signaling from the rest of our bodies, which may affect the limitation of information that we can process. Our neural circuitry limits our information processing capacity. Just ask why can’t we pay attention to two ongoing conversations at one time? Electrical circuits have breakers for overload. We just have coffee.”

Lester Gottesman is a colorectal surgeon.

He shares his story and discusses his KevinMD article, “Zoom is foie gras of the brain.”

Did you enjoy today’s episode?

Please click here to leave a review for The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out!

Do you know someone who might enjoy this episode? Share this episode to anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Lester Gottesman. He is a colorectal surgeon, and he wrote the KevinMD article “Zoom is foie gras of the brain.” Welcome to the show.

Lester Gottesman: Thank you, thank you.

Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and your journey to where you are today in 25 words or less?

Lester Gottesman: I had a lot of forks in the road. I was going to go into internal medicine, and in my last year of medical school, I had an epiphany that I would go into surgery, which I did. I trained in New York City and then did a couple of fellowships, one in surgical oncology and then colorectal surgery.

And then, you know, people choose their specialty based on mentorship, basically, and the person I most admired, and who I wound up working with, was someone who I truly admired and loved. We were fellow adventurers in physical stuff; we both did a lot of expeditions and mountaineering trips. And also intellectually, we shared a lot of common passions about learning stuff and interesting people and that sort of stuff. And then I joined him, and that was a wonderful time, and then he retired, and so here I am.

Kevin Pho: And from the standpoint of a colorectal surgeon, tell me how the pandemic is affecting your practice and what you’re seeing.

Lester Gottesman: Well, what we’re seeing as a colorectal surgeon is a drop-off in preventive medicine, so there’s a drop-off in colonoscopy screenings. People tend to ignore taking care of themselves. Typically they do a lot of doctor Googling and come up with stuff, or they have telemedicine consultations with their primary care doctors, who have a tough time getting colorectal disease right when they see the patient. So now it’s even worse, because a lot of perianal disease is visual, and it’s very hard for a non-specialist to take care of those patients. So that’s the big impact. They’re going longer, and there is data that colorectal cancer rates are increasing, and it’s very at presentation, increasing also.

Kevin Pho: All right, let’s transition into your KevinMD article, “Zoom is foie gras of the brain.” Now, for those who haven’t read the article, can you just walk my audience through it and share the story of why you decided to write it?

Lester Gottesman: I’m sure many of you are doing a lot of Zoom conferences. And then on top of it, because we’re self-selected as a curious bunch, and I think we’re smart, we tend to do a lot of extracurricular Zoom activities. I’m a voracious book reader, but now I have access to all these phenomenal Zoom lectures, and so I started signing up for a million Zoom lectures on everything and anything under the sun. And then I just found that I had the mandatory medical lectures and CME lectures, and then I would do my few hours of extracurricular lectures.

I was walking home one day, and I said, “I am just stuffing these things into my brain. My brain is exploding. I feel like a goose getting stuck in order to make delicious liver food for humans.” And so that’s where the idea came from.

But the more I researched it, I think what I’m trying to say in the article is that we’re doing a disservice to ourselves by attempting to just keep on stuffing information into our heads. There’s some data on the bad effects to the brain of doing this, and there’s data that you’re not helping yourself. We should sort of step back and just say, one, we have to have the problem with Zoom etiquette on chats, congresses, and calls, and that we should be more self-selected in what we do. Not just take a CME course just for credit, but if we really need to learn something. So we should be the guardians of our brain, self-select which courses we want, and be kinder to ourselves. So that’s sort of the gist of my article.

Kevin Pho: So one thing you mentioned was Zoom etiquette. Tell me about some of the issues related to that in some of the Zoom CME conferences that you’ve attended.

Lester Gottesman: One of the things that I mentioned in the article is this chat function that we have. Basically, as a speaker, if you keep on chatting somebody during the talk, that’s like interrupting them. It’s like giving grand rounds and someone’s getting up every two seconds and screaming something at you, and it’s very distracting to the speaker. Because it’s virtual, people don’t think twice about it, but I think we should not have chats in real time. We should sort of save the chats till the end, like we do normally. We don’t interrupt speakers, typically.

And the other thing is the camera. There’s some decent data that says that if your camera is faced one way, you appear higher than the other person on Zoom, or lower, or if you get too close, that sets up this startled response where you feel threatened. So there has to be a lot of setting up of the calls and just being kind to each other, and being cognizant of the limitations of the camera and the screen, and cognizant of the chat function that basically amounts to interruption.

Kevin Pho: Now, as a participant in several of these Zoom CME conferences, do you have any advice and tips for other participants in terms of how they can get the most out of that Zoom experience?

Lester Gottesman: Choose which ones you want to go to. A lot of people do CMEs just to get points. So I think that if that’s what you’re trying to do, just be honest with yourself, and don’t share video, and read a book while you’re doing the conference, and you’ll get your CME. It’s not ethical, but trying to fill your brain with garbage is also not good. So I think just pick; there are so many CMEs available now that are free. Just pick the ones that you feel like you will get something out of, and just avoid the ones that are, you know, every society has 20 million CME conferences. Just don’t feel like you’re obliged to take them. I think that would be the best advice I could give.

Kevin Pho: We’re talking to Lester Gottesman. He is a colorectal surgeon, and he wrote the KevinMD article “Zoom is foie gras of the brain.” Lastly, we are speaking in the beginning of January, and hopefully by this time next year, the pandemic will be behind us. What do you see as the role of Zoom and other virtual tools in the conference world after the pandemic?

Lester Gottesman: I think they will continue. Historically, if you look at contemporaneous literature from the 1918 flu epidemic and the bubonic plague and different ones, there’s something that happens after each of these plagues. In the States, we had the Roaring Twenties after the 1918 pandemic. And I think there will be a rebound once the vaccinations get to what people think, or herd immunity. I think there will be a swing all the way to get rid of Zoom conferences, and then they’ll come back with some happy medium. I think there will be a swing against teleconferencing, and then we’ll find some happy medium, where patients will ask for more teleconferences for convenience’s sake, because they could do it. And I think the Zoom conferences will be an adjunct to live conferences, so that most every live conference will have a Zoom-type link with it.

Kevin Pho: Yeah, people do want that connection, the company of people. And my final question, Lester: What’s your take-home message that you want to leave with the KevinMD audience?

Lester Gottesman: My take-home message is the same one that I give my residents. It’s always: Question everything. Just look at everything as, how can you make it better? What’s wrong about what we know? And just try to improve what you have to make it better for the next person.

Kevin Pho: Lester, thank you so much for sharing your time and insight, and thanks again for being on the show.

Lester Gottesman: Kevin, pleasure.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes