Health & Fitness Episodes

In this Preston-led episode, we take a deep dive into the history of lithium and its use in psychiatry. But because Preston is very literal, we are starting at the very beginning, inside of stars where lithium was formed at the beginning of the universe. Then we will follow this wonderful atom through history and past its FDA approval in 1970 to where we are today.

In this episode of historical psychiatric diagnoses we continue the “arc” (get it) with the story of a young girl with vivid hallucinations who galvanized the French army and a wise king who lost his sanity late in life. The interesting thing about these cases, however, is that they may have more underlying medical issues and in fact, the psychospiritual and somatic issues of the past are just as intertwined as they are today. Even to the point where we have to correct ourselves and realize that we may have been calling these incorrectly for a while.

Today we'll talk through this one study from 2010 out of the Oxford Department of Experimental Psychology, "Task-related default mode network modulation and inhibitory control in ADHD: effects of motivation and methylphenidate", that I want to walk you through, because the way it reframed ADHD for me as a resident is one of the more useful brain-flips I've had this year.

I figured we'd do something I've been wanting to do for a while: story time. Specifically, the kind where I take some of history's most famous figures, walk you through what actually happened to them, and then put on my psychiatry resident hat and try to figure out what we'd actually diagnose them with today. We will be analyzing King of France, Charles VI and Mary Todd Lincoln. Get ready to hear me yap about psychiatric history!

We're doing a throwback! This was our second episode ever, way back when I was at the beginning of fourth year of med school and Margaret and I were still figuring out the rhythm of this whole podcast thing. I'm now at the end of my first year of child fellowship, and somehow attachment theory keeps coming back around no matter what lens I try to look through, existential therapy, child psych, even our death anxiety episode. Pretty much every road leads back to it. So we wanted to bring it back, dust it off, and let y'all hear where we started.

In this episode we are joined by my co-resident, @undercoverdoc who has a special interested in fitness culture and bodybuilding. With the protein intake, food weighing and gym discipline also comes “extracurriculars,” or anabolic steroids. Rob describes his observations being in the fitness space as both an athlete and a physician and we discuss the impact of steroid use, its prevalence and what it can actually look like.

Code ORANGE. We had to break the between-seasons hiatus for this one. If you've been on healthcare TikTok in the last month and you haven't seen the burnt-out fruit basket emerging, you have some catching up to do. And it all started with Dr. Orange. Margaret and I sat down with the anonymous primary care doctor behind the orange filter that's been unleashing the truest, funniest, most honest takes on what it's actually like to practice medicine in 2026. We get into all of it. Why she finally hit record. How she picked an orange. What she actually wishes she could change about her day-to-day if she had a magic wand. Her thoughts on direct pay, PSLF golden handcuffs, and the unhinged loyalty arc she's developing toward Tropicana.

Margaret and I decided to tackle the questions that have been circling our DMs, including the controversial continuum of harm reduction, where does "good enough" care end and "enabling" begin? We also touch on the complexities of diagnosing autism across genders, the "stolen valor" of internet neuroscientists, and why I’m convinced that oppositional defiant disorder (ODD) might sometimes just be a side effect of adults who’ve forgotten how to listen.

I’m flying solo for most of this one while Margaret is off saving dolphins (or just finishing a hospital admission ), but I’ve brought in a heavy hitter to help me tackle one of the most awkward parts of medical training: feedback. Paul Tran, the creative force behind Alimentary School, joins me to discuss why the feedback we give and receive in the clinic usually, to put it bluntly, sucks. We dive into the "Politeness Concept," where supervisors give a quick "good job" just to save face and get out of the room, leaving learners with zero actionable data. Paul introduces the concept of "Wise Feedback", 19 words that can completely change how a student engages with their work, and we break down the "Four T’s" of delivery: Tact, Timing, Intent, and Tone. From the trauma of childhood soccer critiques about our noses to the "glass-shattering" realizations of a former competitive figure skater, this episode is about turning subjective observations into meaningful coaching.

In this journal club episode, we break down the recent findings from a landmark (in my opinion) study on the associated risks between caffeine consumption and dementia risk. Spoiler alert! More coffee might actually be protective against dementia; however, we need to take these findings with a grain of salt (or creamer) and understand how the nuance of this information can help both our lives and our understanding of neurodegenerative diseases.

Spoiler Alert! The key to not feeling isolated is to (wait for it) be around other people! Humans are naturally driven social creatures, but the ways in which we attempt to run from isolation become the problem. In this episode, we discuss how isolation is an ever-present fear, how existential isolation differs from interpersonal and intrapersonal isolation, and how meaningful, balanced relationships can form to fill the void. In our Patreon section, Margaret and I review some of Carl Rogers ' therapy film (play by play) in his humanistic approach to therapy with a central emphasis on relationship

Welcome back for season 3! For our first episode, we have on a food scientist to discuss from the industry side food myths, which we combine with our own readings from the psychiatry literature. We touch on red dye 40, food fears, the minerals in the soil, and how to slow down information from social media grocery store aisle walkers.

Margaret and I are back with part two of our conversation with Dr. Drew Ramsey and this time, things get personal. I volunteered my real-life food log for a full nutritional psychiatry breakdown… and let’s just say my “ultra-processed protein” lifestyle did not escape unscathed. What started as a casual diet review turned into something deeper. A mentoring session about joy, creativity, and what it actually means to feed your brain. Margaret brings her psychodynamic insight, Dr. Ramsey brings the science, and I bring… a whole lot of protein powder and self-reflection. If you’ve ever tried to optimize your health but ended up missing the soul in your routine, this episode is for you.

We sat down with Dr. Drew Ramsey to talk about something we all think we understand and don’t: how food shapes mood. In Part 1, we get practical and personal: what to reach for when you’re anxious, what to cook when you’re depressed, and how to think about nutrition when you’re busy, broke, or just not in the headspace to sauté anything. We talk simple swaps, what actually belongs on a “brain food” plate, and why perfection is the enemy of getting fed.

We opened up the inbox and wow… y’all really came through. In this first-ever Q&A episode, Margaret and I answer your questions about coping during med school, surviving feedback, dealing with emotional exhaustion in residency, and why outpatient goodbyes feel like actual breakups. I also overshare about marathon training (again), Margaret brings the wisdom and the theater metaphors, and we all learn what bald eagles actually sound like. It’s a mix of serious, strange, and unexpectedly honest—basically, peak us.

This week, I learned I have a pelvic floor. And yes, I realize I’m a doctor and should’ve known that already. Margaret and I talk with pelvic floor physical therapist and viral educator Dr. Alicia Jeffrey-Thomas, who somehow made me breathe through my butt on mic. We cover everything from incontinence and pelvic pain to TikTok fame, trauma-informed care, and the surprisingly emotional world of core stability. Alicia breaks down the science and the stigma behind one of the most misunderstood parts of the body—and I try to keep up while sitting on a pillow and trying not to Kegel too hard.

In Episode 16, Preston and Margaret dive into the chaos of overnight residency, the reality of sleep deprivation, and how mindfulness can backfire when your brain just won’t sit still. From ruined meditations to hot girl walks through hospital hallways, they unpack what real-world coping actually looks like—before, during, and after the hardest moments.

In this episode Preston and Margaret take a deep dive into the complex relationship between exercise, nutrition and mental health. They discuss the science behind how movement impacts the brain, debunk common myths about fitness, and explore the psychological barriers that prevent people from incorporating exercise into their lives.

In this episode Preston and Margaret embrace the season with a deep dive into Seasonal Affective Disorder (SAD). From the science behind melatonin and serotonin to the cultural and emotional frameworks that shape how we experience winter, this episode covers the biopsychosocial dynamics of seasonal depression. Along the way, they share personal anecdotes, including the surprising benefits of light therapy and reframing winter as an opportunity for growth.

In this debut episode of How to Be Patient, psychiatry residents Preston Roche and Margaret Duncan open up about their personal journeys into medicine and the challenges they’ve faced in connecting with patients—and themselves. From navigating early patient interactions to grappling with their own vulnerabilities, they explore the balance between authenticity and professionalism. With humor, candid storytelling, and a dash of introspection, this episode sets the stage for a season of thoughtful discussions on empathy, growth, and the art of being present in healthcare. Get ready for the tale of two doctors!

It’s finally time to address our professional relationships with mental health treatment in a clear, calm, and professional manner. It’s time that practitioners start to better understand ourselves, our patients, and our parallel journeys to address mental health struggles in this highly unpredictable cultural climate. It’s time a podcast trailer presented a plan to constructively explore professional development for psychiatric professionals. Perhaps, in the form of a polished audio...