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The Emergency Medicine Residents' Association (EMRA) is the voice of emergency medicine physicians-in-training and the future of our specialty. EMRA*Cast is created "for Residents, by Residents."
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Join David Puder as he covers different topics on psychiatry and psychotherapy. He will draw from the wisdom of his mentors, research, in-session therapy and psychiatry experience, and his own journey through mental health to discuss topics that affect mental health professionals and popsychology enthusiasts alike. Through interviews, he will dialogue with both medical students, residents and expert psychiatrists and psychotherapists, and even with people who have been through their own ment ...
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Bridging Health and Humanity: Gender-Affirming Care Saves Lives
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In this episode of EMRA*Cast's "Bridging Health and Humanity," host Natalie Hernandez interviews Dr. Jailyn Avila about the importance of gender-affirming care in the emergency department. Dr. Avila highlights the significant health disparities and challenges faced by LGBTQIA+ patients, including a reluctance to seek care in the ED due to fear of d…
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"AI Psychosis": Emerging Cases of Delusion Amplification Associated with ChatGPT and LLM Chatbot Use
1:19:46
1:19:46
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1:19:46
Prolonged conversations with ChatGPT and other LLM chatbots have created rapid developments of severe delusions, paranoia, and even death by suicide in some cases. In this episode, Dr. David Puder sits down with Columbia researchers Dr. Amandeep Jutla and Dr. Ragy Girgis to unpack five shocking real-world cases, explain why large language models ar…
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Whether you're days from becoming an attending or just trying to figure out how to get a BP on a pulseless patient, this episode will help you go from fear to confidence in managing LVADs in the emergency department. Join EMRA*Cast host Dr. Maiya Smith and guest Dr. Anna Ciullo as they review how to assess perfusion, manage complications, and decid…
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Genetic and Environmental Influences of Schizophrenia
1:19:13
1:19:13
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In this episode, Dr. Puder is joined by Dr. Liam Browning and Dr. Nicholas Fabiano to explore the complex genetic and environmental factors that contribute to schizophrenia. They unpack how heritability is measured, what twin and genome-wide association studies reveal, and why the "missing heritability" problem matters for our understanding of ment…
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Essential Tips on Laceration Repair for ER Physicians
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Laceration repair is not uncommon in the emergency department. In this episode, we get some expert tips for emergency physicians from a plastic surgery colleague. Join Dr. Kimberly Fiscella of Albany Medical Center and host Dr. Blythe Fiscella of ChristianaCare to pick up some essential pearls on suturing and skin/soft tissue injury management in t…
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Combatting the Negative Effects of Sleep Deprivation
1:08:26
1:08:26
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In this episode, Dr. David Puder and Dr. Brandon Luu explore the science of sleep deprivation. How missing sleep impacts your brain, metabolism, emotions, and long-term health. Discover evidence-based strategies that can help you protect cognitive performance and recover from sleep loss, including exercise, creatine, caffeine, and bright light ther…
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Devaluation, Transference, Narcissism with Diana Diamond
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In this episode, Dr. David Puder is joined by world-renowned psychologist Diana Diamond, PhD to explore devaluation, narcissism, attachment, and transference in psychotherapy. Together they examine why patients with narcissistic personality traits or narcissistic personality disorder (NPD) often devalue their therapists, how dismissing and disorgan…
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Intergenerational Trauma Explained: The Role of Reflective Function and Mentalization in Healing Attachment
1:10:34
1:10:34
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In this episode, we explore how intergenerational trauma shapes attachment patterns and how reflective function (RF) and mentalization can help break the cycle. Drawing on research from Fonagy, Slade, and Berthelot, we examine how trauma-specific reflective functioning influences disorganized attachment and how therapies such as Mentalization-Based…
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From the ED to The Pitt: Dr. Mel Herbert on Medicine, Storytelling, and the Power of Hollywood
20:52
20:52
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In this EMRACast episode, hosts Lauren Rosenfeld and D'Monte Farley sit down with Dr. Mel Herbert, emergency physician, educator, and writer/medical consultant for The Pitt, the hit TV drama inspired by life in the emergency department.
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The emergency department offers critical access to health care in our broken system. An important skillset of the modern emergency medicine physician is a set of low-risk, low-time commitment, high-benefit interventions for the management of chronic diseases. In this episode, we discuss the diagnosis and management of hypertension, type 2 diabetes,…
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Understanding Real Event OCD: When the Past Fuels Obsession
1:07:07
1:07:07
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In this episode, Dr. David Puder is joined by OCD specialist Kevin Foss to dive deep into Real Event OCD, which is a form of obsessive-compulsive disorder where real past experiences become the focus of endless rumination, guilt, and shame. Together, they unpack the symptoms, real-life examples, and how this subtype differs from PTSD, moral injury,…
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In this episode, Dr. David Puder and Mark Ruffalo dive into the history and theory of identity diffusion, from Kernberg's structural model and Gunderson's work on BPD to Akhtar's clinical descriptions. We explore how identity diffusion shows up in patients' lived experiences—feelings of emptiness, fractured self-image, lack of authenticity—and what…
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Career-switching into medicine as a second profession might not be typical, but it's not out of reach - just ask Dr. Rob Lowe, an aerospace engineer for 6+ years before trading in his flight simulator for a stethoscope. Dr. Lowe joins the show to detail his previous experiences, discuss commonalities between engineering and emergency medicine, and …
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Cannabis and Depression, Anxiety, PTSD, Sleep, and Cognitive Function Update and Review
1:10:50
1:10:50
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In this episode, we explore the latest 2025 research on cannabis and mental health. Our discussion covers how cannabis use impacts depression, anxiety, PTSD, sleep, cognitive function, and cannabis use disorder (CUD). While many patients report short-term relief from symptoms, studies reveal complex risks, including increased odds of mood disorders…
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Regulating Our Emotions as Parents with Alissa Jerud, PhD
1:14:43
1:14:43
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Parenting brings love, joy and plenty of emotional challenges. In this episode, clinical psychologist Dr. Alissa Jerud explores how parents can better understand and regulate their emotions instead of getting stuck in cycles of frustration, anxiety, or control. Drawing on exposure therapy, DBT skills, and her Emotion-Savvy Parenting approach, Dr. J…
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Bridging Health and Humanity: Barriers and Borders
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In this episode of "Bridging Health and Humanity," hosted by Dr. Natalie Hernandez, the focus is on the effects of current immigration policies and enforcement tactics on the health of vulnerable communities. The discussion features Dr. Rose Diaz and Dr. Sarah Lopez, both advocates for immigrant health, who share their insights on changes in immigr…
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Psychodynamic Psychopharmacology: Insights from Dr. David Mintz
1:14:52
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In this episode, I engage in a shared-interest conversation with Dr. David Mintz, a psychiatrist with over 30 years of experience at the Austen Riggs Center, about his book Psychodynamic Psychopharmacology: Caring for the Treatment-Resistant Patient. Mintz explores the integration of psychodynamic principles into medication prescribing, emphasizing…
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12 Essential Tips for New Emergency Medicine Interns
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July is the most exciting time of the year in the hospital - especially in the Emergency Department, when all of the new interns show up! Get 12 pieces of advice for interns reporting for their first shifts, courtesy of EMRA*Cast host Blythe Fiscella, MD, and guests Andrew Toron, MD (chief resident), Brielle Grote, DO, and Emerson Trimble, DO.…
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Gun Violence: From Practice to Policy, with Dr. Cedric Dark
27:27
27:27
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It was the tweet heard far and wide: When the NRA claimed doctors "should stay in their lane," physicians took aim at firearm safety as a matter of public health, policy, advocacy, and patient care. EMRA*Cast host Lauren Rosenfeld, MD, dives into this issue with author and policy guru Cedric Dark, MD, MPH, FACEP.…
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Catatonia in children and teens is underdiagnosed, frequently misunderstood, and potentially fatal if left untreated. In this episode, Dr. David Puder and Dr. Annabel Kuhn interview Dr. Joshua Ryan Smith—child and adolescent psychiatrist and division director at Vanderbilt University—to explore the essential clinical skills and medical knowledge ne…
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When it comes to the airway, roc rocks and succ sucks, right? You've heard it more than once. But EMRA*Cast host Peter Lorenz, MD, presents a nuanced argument in defense of succinylcholine, with guests Mike Perza, PharmD, and Patricia Simmer, MD.
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The Bear: Trauma, Personality, and Attachment with Dr. Eric Bender and Dr. David Puder
1:09:03
1:09:03
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In this episode, Dr. David Puder is joined by psychiatrist Dr. Eric Bender to explore the psychological depth of the Emmy Award-winning show, The Bear (FX). Through a psychodynamic lens, they examine Carmy's character—his trauma, complex PTSD, obsessive-compulsive personality traits, and avoidant attachment style. They also break down the borderlin…
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In this episode of EMRA*Cast's "Vacation Gone Deadly: Toxins in Paradise," hosts Maiya Smith, MD, and Lauren Rosenfeld, MD, speak with Kenneth Katz, MD, a toxicologist and practicing EM physician at Lehigh Valley Health, about toxins you might encounter while traveling, inspired by Season Three of The White Lotus.…
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Depressive Personality Style with Jonathan Shedler
1:53:38
1:53:38
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Dr. David Puder and psychologist Dr. Jonathan Shedler explore depressive personality style—how it differs from clinical depression and why it often goes unrecognized. Through a detailed role play, they demonstrate how self-criticism, unconscious guilt, emotional deprivation, and suppressed anger emerge in therapy. They discuss: How depressive perso…
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Mental health concerns drive a large number of emergency department visits in the United States. When a patient presents with an acute crisis, it's important for emergency medicine and psychiatry to work as a seamless team. Drs. D'Monte Farley and Caylon Pettis talk about how to ensure an effective psychiatry consult in the ED.…
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