Episode Transcript
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(00:00):
The following is brought to youby the committee to protect
healthcare.
Chris (00:05):
In the emergency department, we see real time
consequences of people nothaving access to health care.
Expansion of Medicaid inWisconsin would mean less cases
to the emergency department.
It would prevent closures ofhospitals in our communities,
and most importantly, savelives.
The majority of states in thecountry have expanded Medicaid
with bipartisan support, yetlegislators in Wisconsin are
blocking expansion of Medicaid.
(00:27):
They're blocking the opportunityfor our patients to have a
healthier life.
Tell your legislator to savelives and pass Medicaid
expansion.
Welcome to pulse check,Wisconsin.
(01:19):
Good morning.
Good afternoon.
Good evening.
Whatever it may be for you.
This is Dr.
Ford again with Pulse CheckWisconsin.
I want to welcome everybody backfor season two now which is very
exciting to get into.
I hope you guys had a goodsummer.
I know that my crew did here forall the kids out there.
(01:40):
Welcome back to another schoolyear.
I wish you all the bestspecifically all the kids that
are starting on the date of thisrecording which is September
3rd.
I believe all the MilwaukeePublic schools are back in
session.
So best of luck to you guys thisyear.
You're going to do amazingthings Looking forward to all
(02:02):
the things that you willaccomplish all the bright minds
here in Milwaukee andthroughout, Wisconsin We got a
good episode for you here today.
We are going to have with us acardiologist who is also a
contributor to to a number ofnews outlets.
Her name is Dr.
Morgan She is a cardiologist.
(02:23):
She's an African Americancardiologist who specializes in
being an outlet to the public.
and sharing with us some of herexpertise, some of her specialty
specifics as well.
And we're very fortunate to haveher here today.
We're going to get into a coupleof topics regarding cardiology
(02:44):
in general.
Cardiology affects multiplepopulations throughout the state
of Wisconsin specificallyunderserved minority populations
as well.
We see a disproportionate amountof bad outcomes related to heart
failure related to heartattacks, exacerbations
(03:04):
associated with high bloodpressure, diabetes, things of
that nature.
So I want to do everything thatwe can to skew these numbers so.
With that being said what we'regoing to do is we're going to
get started with one of ourcases.
This case will be a case that Isaw in the emergency department.
(03:25):
This was right around the timeof COVID 19.
So the hospitals had been seeingless volume at the very
beginning of the pandemic.
Because a lot of folks stayedhome.
So I won't give too much away.
We'll go ahead and get into ourfirst case.
(03:48):
Patient is a 64 year old femalewho is presenting to the
emergency department withconcerns of nausea, vomiting and
some tooth pain along the leftjawline.
The patient states that thispain started Roughly a couple
days ago she was at home andnoted that she had some pain.
(04:08):
She was going to make anappointment with her dentist
coming up.
Patient denies any fevers athome.
She denies any chest pain.
She denies any difficultybreathing.
But states that today shestarted to get increasingly
nauseous.
And felt as though she was goingto throw up.
And as such, thought that shecould be having an infection of
a tooth.
That may be causing thesesymptoms.
(04:31):
When patient came back to theemergency department room she
was noted to be afebrile,meaning she didn't have a fever.
She was still nauseated and shejust appeared to be not well.
Her skin color was a little bitgrayish.
She looked as though she wasvolume down, meaning that she
looked dehydrated.
(04:53):
She had a tachycardic heart rateto the 120s.
Usually heart rate normally issitting somewhere between 60s
and 90s.
Anything above a hundred, weconsider it to be a fast heart
rate or tachycardic heart rate.
She had a blood pressure whichwas lower.
Her blood pressure was in the80s systolic.
We usually want to see thatabove 90 Again, this was during
(05:15):
the pandemic.
So in the very beginning, familymembers were allowed in the room
towards kind of the middle ofthe pandemic family members were
not allowed, but in this case,we brought the family members
back just how unwell that shelooked and the fact they could
provide a little bit morehistory.
Patient had no cardiac history.
She was only taking medicationsfor blood pressure, but that was
(05:37):
about it.
I noticed that her heart ratewas fluctuating.
It was going from 120 to 140 to160.
And again, the striking thingwas, was that her blood pressure
was exceptionally low.
As such, we got an EKG for herthat showed an irregular heart
rhythm, which was atrialfibrillation.
(05:58):
With the patient's bloodpressure being low, we placed
some pace pads on her.
We got a formal EKG performedfor the patient as well to
determine, aside from the atrialfibrillation, if there was
anything else going on.
We explained all this to thepatient and why we were placing
these pads, because in somecases you will see that an
(06:21):
irregular heart rate itself cancause the blood pressure to be
low, and in those casessometimes we need to shock the
heart back into a normal rhythm.
As I was taking a look at hercondition, EKG.
I noted that it was somethingfamiliar, but it's something
that looked to be concerningoutright.
(06:42):
It looked as though she had whatwe call ST elevation or a
segment of the EKG that looksconcerning for heart attack.
I went back and talked to thepatient again.
The patient stated again thatshe had no chest pain, she had
no difficulty breathing, and wasjust a tooth pain and the
nausea.
(07:03):
We ordered some labs for thepatient, and while we were
waiting on that, after her fluidwas completed, I didn't like the
fact that the patient's bloodpressure still was low, so we
ended up placing a central linefor the patient a central line
is a line that we can use inorder to provide some medication
to the patient to bring theblood pressure up.
(07:23):
We had discussion with thepatient if she would want to be
Cardioverted meaning to shockthe heart and she did not want
to do that and with this STelevation My concern was that
there was something else goingon as well I took a look with an
ultrasound at bedside for thepatient.
We're able to do this in theemergency departments just with
(07:44):
a Bedside ultrasound we're ableto take a look at your heart in
real time And what it lookedlike was a portion of her heart,
her right ventricle, was notbeating as well as the left side
of her heart, and it appeared tobe dilated as well.
After we placed the centralline, we ended up having our
cardiology colleagues come downand see the patient.
(08:06):
We started the patient on whatwe call vasopressors or
medications to improve the bloodpressure.
I shared with our cardiologycolleagues that I was concerned
that this patient may have had aheart attack.
And after talking with her againin the beginning of the story,
it seems as though her symptomsstarted a couple of days ago.
(08:27):
The cardiologist agreed withthis and was also concerned that
the patient not only had a heartattack, but may have had this
heart attack two days prior whenthe symptoms first began.
What we were seeing in thispatient's case was what the
eventual diagnosis was.
Not only did she have a heartattack, but she also had what we
(08:52):
know as cardiogenic shock.
So this patient's case is reallyinteresting, and it really
underlines one of the thingsthat we talk about in cardiology
as well as in emergencymedicine.
Both cardiology and emergencymedicine doctors see an
exorbitant amount of EKGs everyday.
(09:13):
Cardiologists may see more inthe clinic.
However, in the emergencydepartment, you know, the
average ER doctor that's at alevel one center or at a large
metropolitan area center may seeup to 30, 40 plus EKGs every
day.
In those cases, we have to bereally good at picking up things
that are concerning because inthese cases you only have
(09:34):
seconds to minutes in order tomake a decision as to what to do
with those patients next.
And if a patient is at increasedrisk, if we need to move on it.
In this patient's case, again,she did not have any typical
chest pain and this is somethingin recent years, I would say in
the last 10, 15 years that wehave harped on as a medical
(09:56):
discipline as well as educatorsin medicine that women typically
don't have the typical crushingchest pain, stabbing chest pain
with radiation up through thejaw or down the arm.
In fact, in this patient's case,the chest pain actually had an
equivalent, or we call it chestpain equivalent which was
(10:18):
nausea, and in addition she hadthat tooth pain on the left.
It's been well documented inrecent years that women will
have different presentations toheart attacks than men.
And in this case this wasSimilar to what we're seeing in
multiple chart reviews thatwe've done this atypical pain to
(10:41):
the jaw or to the tooth or Youknow could even be just feeling
fatigued or feeling weak orfeeling nauseated in this
patient's case Again, becauseCOVID hit us so hard folks were
afraid to come to the emergencydepartment.
In some cases, folks were toldto not come to the emergency
(11:02):
department unless they felt asthough there was an emergency,
just given how overran we wereat the beginning of the pandemic
and how little we actually knewabout COVID 19.
In her case, we were told Whathappened was she actually had a
heart attack two days prior.
And what happens commonly is ifyou have that heart attack, Over
(11:25):
time, that heart muscle, will beaffected.
A heart attack effectively iswhen you have a portion of your
heart that is not getting enoughblood supply through a thrombus
or, or some blockage that'scausing that decreased blood
flow.
In her case, she had decreasedblockage to that right heart.
(11:46):
And that was the abnormalitythat we were seeing on the
ultrasound.
What happens is, the musclebecomes what we call ischemic,
or doesn't get blood to it.
And so over time that musclebegins to break down.
And with it, the functionalityof the heart begins to erode as
well.
(12:06):
We were seeing, on the formalultrasound that we were able to
get at bedside, she had somevalvular abnormalities.
Subsequently, what happened wasthis affected not only what we
call the ionotropy or thesqueeze of the heart, but also
affected some of the chronotropyor how fast the heart was going.
It affected the electricalsignal pathway that the heart
(12:28):
typically undergoes, which waswhy she was in that dysrhythmia,
that atrial fibrillation.
In addition, as we mentionedbefore This patient had what we
call cardiogenic shock oressentially the heart not
functioning as well as it canand so you can see fluctuations
in blood pressure.
She had a very low bloodpressure.
(12:48):
And this is a condition that canbe exceptionally dangerous.
In fact, this patient not onlywas taken to the cath lab, she
was admitted to a cardiac ICUfollowing.
Fortunately for this patient,she had a great outcome.
She was able to have cardiacstents placed.
She was able to follow up as anoutpatient with our cardiologist
and our electrophysiologist.
And as of the last access that Ihad to her chart, she was back
(13:12):
at home.
So this case in itselfunderlines the importance of a
couple things.
So first off, for all women whohave a family history of heart
disorder or any cardiacdisorders, diabetes,
hypertension if you have astrong family history as well,
You want to make sure thatyou're looking out for when
things are not feeling wellbecause again, you know A lot of
(13:34):
times you're not going to havethat typical crushing chest pain
typical radiation of the pain upthe jaw or down the arm There
may be more subtle presentationslike in this this patient's case
when she had some Nauseaassociated with it.
And there are some contextual.
Reasons for this that we'll getinto.
(13:56):
When we speak with Dr.
Morgan as to why.
We are just now taking a look atthe differences between men and
women and their presentationswith heart attacks.
So make sure that you're On thelookout for those symptoms, make
sure that you are checking ineither with your doctor or go to
(14:17):
the emergency department.
If you're experiencing somethingthat just doesn't feel right.
Secondarily you want to makesure that you're seeing your
cardiologist or seeing yourdoctor regularly as much as
possible.
during the season, we're goingto talk about the importance of
primary care, a couple of goodprimary care clinics in the
Milwaukee area to make sure thatwe get to you before.
(14:39):
Your presentation gets to thispoint, making sure that we're
optimizing your health care asmuch as possible.
So that was our case.
Now I want to open up theconversation with our special
guest for the day, Dr.
Morgan, who is going to discusswith us some very high yield
(15:01):
concepts in cardiology.
We're so lucky to have her hereand we'll go ahead and start.
Hi, welcome back to my channel.
Dr Morgan (15:43):
My name is Dr.
Jane Morgan.
I'm a cardiologist.
A lot of my background has beenreally in research that came up
through the industry reallypharma industry device industry
doing real R.
and D.
heart, you know, research anddevelopment, writing protocols
and rolling people in trials.
Traveling, identifying studysites.
So that bread and butter gruntwork of how drugs come to
(16:06):
market.
I did that for a number ofyears.
I practiced both before that andafter that.
And And then even was atPiedmont Healthcare, which is
largest healthcare system in thestate of Georgia for 9 years
leading their cardiovascularresearch program.
And then for COVID being thehead of the COVID task force,
and then really branching offquite a bit into brand growth
(16:29):
and marketing.
Currently, I'm the vicepresident of medical affairs for
Hello Heart, which is a digitalhealth company focused on
hypertension, reducing heartdisease.
It is an app that you use tocontrol your blood pressure, but
also interact with that app, getreal data and information.
And we're looking to reallyclose the gap, especially in
(16:53):
health care for women and forminority populations, who
oftentimes are not gettingaccurate information, not
getting timely information.
We don't feel empowered to askthe questions.
Well, now we've got an app.
that can help guide you throughall of that and even direct you
for when you need to go to the,to the physician.
I do a lot on social media.
(17:13):
I have a series called thestairwell chronicles which I
usually post on Wednesdays and Isit on my stairs and give One
piece of medical advice in 60seconds or less.
I usually ask a question ofmyself and answer it in 60
seconds.
I like to say that's my housebecause it is those are my
stairs.
Those are my clothes.
That's my question.
(17:34):
So if you ever submit questions,I might answer your questions as
well.
I talk a lot about cardiologyand clinical trials and research
and health equity and women'shealth, but also all kinds of
other things as well.
And then other places you maysee me is I do quite a bit of
media interviews doing medicalanalysis.
I do that for CNN, for ScrippsNews.
(17:55):
for the weather channel even forABC News affiliates, WSB TV.
So you may see me doing those aswell.
Just kind of breaking downcomplex science information,
making it relatable to thepublic and explaining it on
media.
Chris (18:10):
Yeah.
And, and, you know, I, Iinitially came across you just,
you know, like you said, it'sthrough some of those media
interviews, especially, yourstate staircase series as well.
And just some of the questionsthat you were answering and some
of the information that you weregiven out, I thought would be
perfect for our audience becauseI often get asked in the
emergency department, some ofthese very same questions.
And so, you know, I appreciateall the amazing things that
(18:31):
you're doing, both in thecommunity.
I'm sure the state of Georgiawould say the same as well, but
but I want to thank you.
Dr Morgan (18:37):
Yeah, no, thank you, Dr.
Ford.
And I appreciate being on today.
And if people If anybody wantsto follow me, I'm at Dr.
Jane Morgan.
It's just D R D R J a Y N E.
I've got a Y in my first nameand M O R G A N.
I had nothing to do with it.
I was born.
That's the way it was.
Instagram, you know, X threads,Tick Tock, and I'm on LinkedIn
(19:00):
as well.
Please.
I do a lot of professionalposts, Jane Morgan, MD.
Chris (19:05):
Definitely.
And definitely follow So, youknow, we'll go ahead and kick
off here.
What inspired you to pursue acareer in cardiology?
And before we get in that youknow, happy women in healthcare
month as well.
Dr Morgan (19:19):
You know, how I came into medicine, you know, maybe
it was kind of interesting.
And even before I went intocardiology I, you know, I was
growing up and my neighbors oneither side of us, we had a
family practitioner lived on oneside of us.
The other side of us was adermatologist across the street
was an orthopedic surgeon.
And then the next house down wasanother orthopedic surgeon, and
(19:41):
then around the corner with adentist and I babysat for them.
And so we had so manyprofessionals just right there
in our environment.
I was playing with theirchildren.
My parents were not physicians.
My mother was a tenuredprofessor at Spelman College.
And my father was sort of upperlevel management at the U.
S.
Post office.
Both of my parents worked.
(20:02):
and worked full time in orderfor us to live there in that
neighborhood.
Whereas the other homes with thephysicians they were all male
physicians.
The men worked and the wiveswere stay at home wives, and
many of them also hadhousekeepers.
So we lived there as well.
But both of my parents worked.
We were latchkey kids.
(20:23):
I came home.
There was no housekeeper waitingfor me.
But what I would say in that isthat my best friend across the
street, her name is Gina Scott,I would go to their house and
play.
Her father was an orthopedicsurgeon.
He would have all these booksdown in his office and we were
never supposed to go in there.
So of course, we love sneakingin there.
And I would like to open hisbooks and look at all those
(20:45):
really icky, icky pictures ofthose weird diseases and those
people.
And I think it was there that Istarted to develop an interest
because those books, as much asthey kind of repulsed me, they
were fascinating.
I always wanted to kind of lookat them and I wasn't reading
them.
I just was looking at thepictures.
I had never seen people thatlooked like this and diseases
(21:05):
like that.
So when I went to med school, Iactually went to medical school
to become an orthopedic surgeon.
Okay.
Because I don't know, that's allI knew, right?
Doctors are orthopedic surgeons.
And then of course, you know,your world opens and your world
expands.
You start learning about thingsyou never heard of, rheumatology
and psychiatry.
And so I started going throughthese rotations.
(21:27):
Every time I went throughrotation, I was thinking, I
think I want to be that.
Oh, that's interesting.
So I was changing my mind.
I was all over the place.
I was a chameleon.
So I ended up going intointernal medicine because.
You know, who could make adecision, right?
So
Chris (21:42):
I
Dr Morgan (21:43):
did internal medicine and I was there and I was kind
of thinking maybe I'll just be ageneral practitioner, be able to
be an internist.
And I started doing criticalcare rotations and I liked
critical care a lot.
I liked the ICU.
I wasn't so in love withpulmonary though, but I liked
critical care.
And then I did cardiology andcardiology.
I really like cardiology and itcombined the critical care.
(22:05):
And so really, I went intocardiology just by being open to
exploring my world and exploringmy profession and learning and
not being set in one thing andbeing able to grow and being
willing to grow.
And in doing so, I discoveredCardiology.
(22:26):
So I went to med school tobecome an orthopedic surgeon and
hello, I am a researchcardiologist.
Chris (22:34):
And we see that so often, right?
Especially there's a lot ofmedical students.
We just had someone that areparticipating in a program where
They're taking kids from theinner city of Milwaukee and
they're doing a pathway tomedical school just to kind of
get that representation there.
And you see it in so manymedical students.
You come in with the idea thatyou're going to be one thing.
(22:54):
And it's not until you kind ofwalk that walk and you kind of
see what you want to do.
My story was the same waypersonally.
I love to see, I love everythingthat I saw.
Like, oh, pediatrics.
Oh, I love that.
Oh, surgery.
Oh yeah, I want to do all that.
And it wasn't until third orfourth year where I was like,
Oh, I really like just going tothe emergency department for all
the consults.
So why don't I just do that?
Right.
So, yeah, that's a good, that'sa good point.
(23:14):
You know, you guys just don't,don't come fixing your ways,
just be open and you never knowwhere you may end up.
Dr Morgan (23:20):
That's right.
Because you know, it's a greatexample of life.
Sometimes you only know what,you know, you don't know what
you don't know.
So always be willing.
I like to say even today that Iam a forever student of
medicine.
There's always something tolearn.
I'm never a master.
I'm always a student and I cameto cardiology from orthopedic
(23:42):
surgery because I was always astudent.
And as long as you're alwayswilling to learn and evolve,
then you don't really know whereyou will end up in life.
Chris (23:53):
You got it.
And you know, one of the thingsyou brought up there too was,
you know, the ability to seeright, the ability to grow up in
a neighborhood where you couldsee folks who were orthopedic
surgeons or see folks who werephysicians coming up as a
cardiologist or at least acardiologist in training.
You know, our numbers in termsof african americans in general,
(24:13):
as well as african americanwomen are very finite.
What, what if any challenges didyou experience just being an
african american woman coming upthrough the cardiology range?
Did you experience and you know,what how did you overcome them
in those, in those, in thoseroles?
Dr Morgan (24:29):
You know, and I recognize, you know, after I had
grown up that my upbringing wassomewhat unusual just to be
surrounded by homes of, ofphysicians and and it was only
then when looking back, when Istarted to make comparisons, as
I said, that we were there, butboth of our parents were working
a lot of those kids in the otherhouses were in private schools.
I went to public school.
(24:50):
But the fact of the matter is wewere still living in that
neighborhood and it, and itshaped you.
And it was only when I becameolder that I realized there were
some people who had never evenmet a black doctor, who had
never even seen a black doctor.
And then when I look back on it,I didn't see any female doctors.
Every physician in ourneighborhood, including the
(25:11):
dentist, were all men.
Chris (25:15):
So
Dr Morgan (25:15):
in that way, I had no role model.
And in fact, when I look back onit, I originally was thinking I
wanted to be a nurse because Ithought men were doctors and
women were nurses.
I don't know where I got that inmy head, but maybe TV or society
somehow.
I didn't see it.
So sometimes you can't be, ifyou can't see it.
Chris (25:35):
Right.
Dr Morgan (25:36):
So in that way, my, my neighborhood was very helpful
in shaping the idea that I couldbe something, and I didn't
realize that.
It wasn't something that I couldbe and that there were people in
the world who've never even seenblack doctors and here I am
living in a whole neighborhoodof them.
I didn't know that.
And this is what I'm saying.
(25:56):
You don't know what you don'tknow.
And so later when I became acardiologist there when I say
there are very few black femalecardiologists, I really didn't
know any.
I knew myself.
I didn't know anybody else.
I joined an organization calledthe Association of Black
Cardiologists and met someothers.
And then I'll tell you an eyeopening experience.
(26:16):
I came to Piedmont Healthcareand that was in 2015.
And when I walked in, there wereOh my gosh, were there six black
physicians?
Like you could have knocked meover with a feather.
I don't even know if I've everin my life even been in a room
with that many.
Did I even know that many?
We had let's see, Tara Hrabowskiwas in heart failure.
(26:40):
There we had another male therein heart failure, we had a, a
surgeon, a female cardiacsurgeon.
Let's see, David Montgomery wasthere in cardiology out of
Morehouse.
I came out to Spelman.
So, you know, we are connected.
Chris (26:53):
I
Dr Morgan (26:55):
was amazed at the richness of that environment.
And, you know, just a mini topicthat maybe we'll get into today.
None of those doctors are eventhere today and in medical
environments.
are not conducive to support theblack physician, the black
(27:20):
specialist physician, even therarity, the rarity of seeing
black cardiologists and having acluster of them at one
institution.
It was not even recognized assomething that was so special
and abnormal.
And one by one, all of thosedoctors have gone and gone on to
(27:43):
do other things when there wasan opportunity for there to be
something so incredibly specialthere at that time of
cardiologists.
Black female cardiologists makeup less than 1%.
Of the profession.
And at the time, I think therewere three or four at one
institution.
I never even seen that manyinstitutions have them, but the
(28:06):
value wasn't there.
I don't think people recognizethat this was something, you
know, it was something that hadhappened by happenstance.
It was not intentional, just byhappenstance, all of these
physicians were there.
We recognized it amongst eachother, but the big institution
didn't recognize how rare andwhat a very special cluster of
(28:27):
physicians they had and how rareit was to have them.
And so that's a great example ofthey're all gone.
It's hard.
It is difficult.
You're not valued.
You're not seen as somethingspecial.
You are othered and you'reothered in very subtle ways that
(28:48):
erode your ability to have agreat quality of life that
interfere with your ability togive your patients the care that
you really know they need.
And that sometimes only you cangive them from a congruent
perspective.
probably stay longer than youshould because you're dedicated
(29:09):
to your patients, even thoughit's not working for you.
So these are all things that wegrapple with all the time.
Our our commitment anddedication to our community
versus What commitment do I haveto myself if it's not moving
forward?
And so, you know, I think blackphysicians in particular, always
(29:31):
in that sort of quagmire of theyin and the yang.
Chris (29:36):
Yeah.
And you brought up a couple ofgood points there.
You know, one thing is, is thata lot of those physicians were
losing them.
Right?
Like we're losing them to otherinstitutions if they feel as
though that pressure is too muchor if they feel unsupported, you
know, a lot of times we see, Imean, when I started at my
hospital and that currently wehave maybe three or four African
(29:57):
American doctors, period.
Period, not even period.
Right.
And so and so, and
Dr Morgan (30:03):
not to mention cardiologist.
And then I will say, I'm sorry,I forgot the No, no, no.
Go for it.
Yeah.
Blanking on the names.
Dr.
Kelly McCants was there.
Dr.
Africa Wallace was there.
Tara David Montgomery.
They, we were all black.
Dr.
Jane Morgan showed up inresearch and lemme tell you
something.
The black cardiologists who werethere when I arrived had never
seen a black cardiologyresearcher.
(30:24):
Like they all came over to go,Oh my gosh, you're doing
research.
We've never met somebody who'sdoing research.
It was so special.
And yet we recognize how hard itwas because the bigger
institution didn't value howspecial it really was.
And all of us were having suchchallenges just maintaining what
(30:45):
we were doing.
And here you are, just as yousaid, Dr.
Ford, you're at yourinstitution, let alone
specialists.
You all didn't even have four.
That's
Chris (30:54):
it.
Right.
And it's so rare because one ofthe other things that we'll kind
of segue into our next questionis, How important that is not
only from a physician, justhaving you there to see right
for patients to see for kids tosee in the community, et cetera,
et cetera, but taking away, youknow, even the color aspect is
the cultural aspect, right?
(31:15):
And you made mention of that tounderstanding the culture,
understanding where people arecoming from has been shown
objectively to improve patientoutcomes in a lot of situations.
And so it just, it going fromthat.
How has your background and howhave, you know, where you come
from kind of from a culturalstandpoint, how do you feel that
that's influenced your approachto, you know, your perspective
(31:36):
on medicine, you being acardiologist and taking that
extra step for your patients?
Dr Morgan (31:42):
You know, I thought originally it wasn't an impact
and I think because I wasdetermined to say I'm not going
to be othered.
I am a physician and I deserveto be here and I'm going to be
in the mainstream and this ishow it is.
And I'm not going to look ateverything from a black lens
because.
I have arrived and I am notgoing to be othered.
(32:04):
So I'm not going to raise myhand.
But yet there are things thatyou can't unsee as you're going.
You can not speak on them, butyou can't unsee them.
Chris (32:16):
And.
Dr Morgan (32:18):
You know, dermatology.
I mean, that was just insane.
I mean, at one point I asked myprofessor, What does this look
like on black skin?
And I answer was, just likethis.
No, just like this is not theanswer.
That's not what it's going tolook like on our skin.
I mean, just everything.
The formulas that we weredealing with, the why is there a
(32:41):
race factor in there?
Well, because, you know, we knowblacks retain water, but what do
you mean they retain?
What does that mean?
I mean, and I was just allowingthe system to give me these non
answer answers.
Mostly in my defense, I'm goingto defend myself a little bit,
You're powerless.
You're, you're a cog in thewheel.
I need these people so I canfinish my degree.
(33:04):
I need to finish my medicinerotation, my medicine residence.
I've got to do my cardiology.
You know, I'm not trying toargue with people or, you know,
look as if you're the angryblack female or you're
challenging.
So you're constantly steppingback.
When you really should bestepping forward and you have a
reason to step forward.
You have a reason to challengethe system and just say, Hey,
(33:29):
this isn't right.
This is not going to work.
This is going to triage mypeople to lower levels of care
and concern.
I see that and I know that andyet the exact same situation.
Myself and other physiciansfound ourselves in, we're at
this big medical institutionthat doesn't really value the
(33:49):
specialness of having all of ustogether.
Do you stay for your patientsbecause you know, they're not
going to get that lens if youleave.
But on the other hand is killingyour soul.
What do you do?
Do you leave and leave yourpatients and you know that they
(34:10):
will be abandoned or do youknow, so we're always in that
and in that situation, even allthrough medical school for me,
do I speak up and risk lookinglike the angry black male or I
mean, like female, or they startto, You know, marginalized me,
or it becomes more difficult forme to graduate.
I need these people to getthrough.
Let me just go along to getalong and keep my mouth quiet.
(34:34):
So, and yet you can't unsee it,right?
So here we are.
Chris (34:41):
Here we are.
And that's so true.
You know, one time I rememberthe very first time I spoke out
in training was during an M andM conference.
For those that are listening, wehave a morbidity and mortality
conference where we kind of talkabout cases that we can learn
from or cases that didn't gowell, et cetera.
And so during that conversation,there was someone who was
presenting who was not AfricanAmerican.
(35:01):
Again, I was one of maybe maybea handful in the, in the, the
hospital and during that it wasbrought up right before the
case, you know, African Americanmale comes in, get shot you
know, of course he was going toBible study.
Of course he was doing this.
And of course he was, you know,he was totally innocent.
And then everybody chuckled andthey went on.
Right.
And so it, it, it, it wasbrutal.
(35:22):
Exactly.
Exactly.
And so it was brewing inside ofme the whole time because, you
know, I grew up on the southside of Chicago.
I've been out with friends, youknow, when I was growing up that
either got shot at or got shotand we were going to football
practice, right?
Like we were, we were going toX, Y, and Z, right?
We weren't involved in anything.
And so, you know, It wasn'tuntil the very end that I could
(35:44):
not hold it in anymore.
Because like you said, this isthrough all through college,
through medical school whenyou're powerless.
And I said, you know what?
To hell with it.
If I get in trouble, I get introuble.
And I stood up and I said, youknow, I don't know if this is,
you know, if I can say this inthis, in this fashion, but I
cannot stand for this anymore.
The way that we interpret andthe way that we walk around and
speak trickles down to ourpatients.
(36:06):
It trickles down to our nurses,to our tech.
And you have that AfricanAmerican male in the trauma bay
and you're moving slower oryou're not giving pain
medication or you're not doingthe followup care.
You're not doing X, Y, and Z.
Dr Morgan (36:19):
Because you know, the system and the culture will
support it.
Chuckle about it.
Chris (36:25):
That's why
Dr Morgan (36:26):
black doctors stay in jobs longer than they should
Chris (36:30):
because
Dr Morgan (36:31):
you're worried about your patients More than
yourself.
And we're the only race that hasto deal with that.
Should I stay or should I go?
Chris (36:41):
Yeah.
Yeah.
And you know, I will say I wasvery fortunate to be in a
program that that was applaudedand, you know, they, we actually
did a couple of series afterthat, talking about, you know,
cultural competency, et cetera,but that is in the minority.
those institutions.
And so you always have to belooking over your shoulder and
saying, am I going to do
Dr Morgan (37:00):
to have to speak up and know you're taking a risk,
Chris (37:06):
right?
Exactly.
Dr Morgan (37:08):
That a risk.
You have to take a risk.
We're the only race thatconstantly as physicians, are
having to balance that riskbenefit ratio with ourselves
versus our patients.
And where's our commitmenttoday?
And if I take this risk and I ampenalized, then what service am
(37:34):
I to my patients if I no longercan serve them because I've been
whatever, dismissed ordisciplined, or, you know, so
maybe I keep my mouth shut justso I can keep seeing my
patients, but then the systemdoesn't change.
And that's what, you know, so wejust go round and round.
And the fact of the matter isyou speaking up meant that you
(37:55):
were taking a personal andprofessional risk.
Chris (37:58):
Absolutely.
Dr Morgan (37:58):
That is not how it should be.
It worked out for you, But itwas a risk
Chris (38:04):
she
Dr Morgan (38:04):
decided to take, and it could have gone badly.
Chris (38:07):
Mm hmm.
Well, you know, this podcast, Iapprecia for coming out so we
can you know, because that ca ishow we get through a l we see in
health care.
On I wanted to touch on is jperspective on cardiology You
talked about the app and we'll,we'll make sure that we get it
(38:29):
on our, on our website as wellas, you know, pass it out to all
of our of our listeners, butinvolving minority communities
with cardiology specificallywhat are some of the most
pressing issues that you see asa cardiologist today?
Dr Morgan (38:44):
Yeah.
Regarding minority, the biggestissues are obesity and
hypertension.
I mean, it's just, it's justbread and butter, right?
And we know now thatinflammatory conditions are
actually the predicators ofdeveloping heart disease.
Obesity causes chronicinflammation in the body.
(39:06):
And yet, you know, obesity is socomplicated that Because it is
often driven by money, it costsmoney to eat fruits and
vegetables, to eat organicfoods.
If you haven't gotten a goodeducation, you don't have a good
(39:28):
job, or let's just say, You dohave an education and you've
been able to get a job, but youhaven't been able to get
promoted.
You're not going to be moved upin the ranks.
You always will stay where youare and people will move beyond
you.
It limits your ability to makechoices.
And those choices include kindsof foods you eat.
(39:52):
Those choices will include thetype of neighborhood you live in
and whether or not you'll beable to.
Exercise outside and have accessto parks and walkable areas.
It will impact your choices thatwill then impact your longevity.
(40:13):
And those are the things, thoseare the connections that we have
to start to make.
Obesity is driven not only byoverconsumption of calories, but
by cheap foods, processed foods,readily available foods.
Tasty foods, foods loaded withchemicals.
Why are those chemicals there?
Those chemicals there to improvethe texture, make it more
(40:37):
palatable, give it a nice color.
You know, you crave it more.
And so then this, these areempty, we call those empty
calories, and they just kind offeed on themselves.
I think obesity is huge.
And then hypertension is thenext one.
Hypertension, because it is themost undiagnosed disease.
condition, not only in theUnited States within our
(40:58):
community, but also in theUnited States can most can still
be easily treated, but listen, Ihave never treated a blood
pressure that wasn't firstdiagnosed.
Chris (41:10):
And
Dr Morgan (41:10):
most of them are still undiagnosed.
So now we're back to kind of theapp that I'm dealing with, but
also just if you're seeing yourphysician and you have been
prescribed medications, takeyour medication.
And then.
Get your follow up appointmentsand make certain we can treat
your blood pressure to goal.
When we say to goal, that meansthat top number needs to be 120
(41:35):
or ideally maybe even a littleless.
Not 140, 133.
Oh, it's good enough.
It's okay.
If your doctor tells you it'sokay, that's No bueno.
Chris (41:52):
No.
Dr Morgan (41:52):
We don't want somebody to tell you.
It's okay.
Okay.
Is code for good enough for you?
Chris (41:57):
Mm-Hmm.
Mm-Hmm?
Okay.
Dr Morgan (42:01):
You think Okay.
Means that it's okay, but DoctorSpeak means it's good enough for
you.
It needs to be 120 or less.
That top number, and that's whatyou need to say.
But Doctor, it's only, it's 133.
I was listening.
To a podcast with Dr.
Ford and Dr.
Morgan.
And they told me that you weresupposed to treat me until I got
(42:24):
to 120.
So I need you to do that.
And that's the top number andthe bottom number needs to be
80.
We need to stop accepting okay.
And it's not our fault, becauseokay generally means that it's
okay.
But in science, that's not whatit means when someone's telling
you that.
Chris (42:39):
It's a zero or a one, right?
It's a yes or a no.
Dr Morgan (42:43):
Right.
Chris (42:44):
No, and that's so true.
And a lot of times, too, whatfolks don't understand is that
especially in the cases ofhypertension, it's that silent
killer, right?
And so until it becomes an issuewhere you come and see me in the
emergency department then Icounsel, you know, Dr Morgan to
come down and check on you.
If something's going on, you,you, you are walking around day
(43:04):
to day and not feeling anyeffects from it, or maybe every
now and then, but, but not everyday.
And so it's very important totake those medications.
It's important.
If you don't have.
Exactly.
If you don't have access tothose medications, there are
programs especially now with,you know, we have been doing a
couple of things with theinflation reduction act that
some medications have becomemore affordable.
So, so make sure that you'rechecking all those lists.
(43:25):
If you can't afford yourmedication, do not skip them.
Please, please, please don'tskip them.
Dr Morgan (43:29):
And the single most important thing you can do for
yourself is if you're smokingcigarettes to stop smoking.
And it's especially importantfor women because, you know, The
deleterious or bad effects ofcigarette smoking have a higher
propensity, we call thatpropensity index, in women than
in men for the same number ofcigarette smoking.
(43:49):
And there are about fourtraditional cardiac, meaning
heart factors, four traditionalrisk factors for heart disease,
that actually, if you have themas a woman, You've got a higher
propensity index, meaning theyare going to have more of a
negative effect on you than theywill on your brother with the
(44:10):
exact same numbers.
Obesity is one of them, theother is cigarette smoking, the
other one is diabetes.
In fact, Men who are diagnosedwith diabetes have twice the
risk of dying from heartdisease, but women diagnosed
with diabetes have three timesthe risk.
And then the last one ischolesterol.
(44:31):
These are traditional riskfactors for everybody, but they
have a higher pensity index.
They have a higher A higher rateof having bad outcomes in women
than in men.
And so we need to make certainthat these are things that we
really try to modify.
We talk about that diet all thetime.
Exercise, things that you can dowith your lifestyle and avoid
(44:55):
medications.
But if you're a prescribedmedications, please take them.
Don't say, Oh, I'm not going totake it.
I'm just going to exercise.
No, take it because for somereason you're being diagnosed
now.
Go ahead and exercise.
And then later, if you don'tneed them, we can remove
Chris (45:10):
them.
You're done.
Exactly.
Exactly.
Exactly.
One of the things that we talkedabout here are those risk
factors.
So you said obesity smoking canput you at higher risk of some
cardiovascular conditions.
What are some of thecardiovascular conditions that
you're seeing that aredisproportionately affecting the
African American community?
Dr Morgan (45:28):
Yeah.
Hey, let's talk about it.
Hypertensive diseases ofpregnancy.
Talk about that.
If you have been diagnosed withhypertension in pregnancies,
sometimes they use these termslike preeclampsia or eclampsia
or something like that, or evendiabetes.
Do you know that if you arediagnosed with diabetes during
your pregnancy, your risk ofheart disease is higher than a
(45:52):
woman who has not been diagnosedfor the next 25 years after,
after the delivery of that baby?
Not only that.
If you have been diagnosed withany hypertensive disorders, you
should follow up with acardiologist because your long
term risk is going to be higher.
And what we've seen as in theentire biochemical milieu is
(46:16):
that if you're diagnosed withhypertension, you end up with an
aberration in your cholesterolprofile, your triglycerides,
your LDL, your HDL.
So for some reason, thathypertension or preeclampsia is
a marker.
For other things that arehappening in your body, that is
a wake up call.
The stress test is actually thevery, the pregnancy is actually
(46:38):
the very first stress test thata woman will have.
So here is something, if you alldon't get anything else from our
talk today, I want you to makecertain, especially women, that
whenever you go to thephysician, Between now and the
rest of your life, you give themyour obstetric history, meaning
(46:58):
your pregnancy history.
And if they don't ask before thedoctor leaves room, say, doctor,
don't you want to hear mypregnancy history?
Chris (47:08):
Be your advocate.
Dr Morgan (47:10):
And then you give it to them because That can drive
and determine the type of careand concern that you receive
later.
Pregnancy is your first stresstest and it can mark you for
things and cardiac events thatcould happen later.
And we have an opportunity tointervene early and whenever you
(47:34):
go to the doctor, that doctorneeds to know your obstetrical
history because it will guide,it should guide their thought
process.
If they don't ask, you need tojust give it to them.
I'm just gonna help you, I'mgonna, let me help you help me.
Chris (47:48):
Absolutely.
Absolutely.
And to drive that home forlisteners here in Milwaukee, we
recently, a couple of yearsback, I believe it was right
before the pandemic.
We had a African American younglady who had a cardiac
condition, a heart failureassociated with her pregnancy.
They ended up dying in one ofour emergency departments here
and they did not know.
(48:08):
That until after the fact, theywent back through her chart and
saw that someone had diagnosedher with a cardiomyopathy or
cardiac condition associatedwith her pregnancy.
So, that's just driving Dr.
Morgan's point home to say, thishappens often and again, these
are things that, you know, yourdoctor, if you bring it up.
They can look into it.
(48:28):
They can do those tests as anoutpatient so they can schedule
you.
You go to a clinic, you know,office during the day and get
that ultrasound done and thenyou know, or you don't know, but
it's key that you have thatevaluation done before it's too
late.
Dr Morgan (48:42):
Right.
Chris (48:43):
Yeah.
So Dr.
Morgan,
Dr Morgan (48:44):
take that, take that with you.
Chris (48:47):
Exactly.
Take it with you.
One of the things that we talkedabout, we did a case beforehand.
And in that case it was a caseof a 60 year old woman who came
in with Tooth pain as well assome nausea associated with it.
At the end of the day, it endedup being that she had a, am I a
heart attack?
And actually stayed home for awhile.
(49:08):
So she was actuallyunfortunately in cardiogenic
shock.
A lot of that point was to drivehome.
The fact that for women, moremyocardial infarctions or heart
attacks present a lotdifferently than they do
typically for men.
Could you talk about that alittle bit and what your
experience has been in those, inthose differences of
presentation?
Dr Morgan (49:25):
You know, and that's right.
And then, you know, and let me,and, and, you know, and women
can also present with, with the,you know,
Chris (49:31):
absolutely.
Dr Morgan (49:33):
But then we can have this other stuff too.
Chris (49:35):
And
Dr Morgan (49:36):
here's something I want to go back to our med
school.
When I talk about things wherewe were just like, pressing our
lips together, but not saying,
Chris (49:42):
yeah,
Dr Morgan (49:45):
I don't even know how to start this when.
What Dr.
Ford is talking about, thesesymptoms of jaw pain, tooth
pain, nausea, back pain, flulike symptoms which actually
could be symptoms of heartdisease in women in medical
school and in training.
And even in my cardiologyfellowship, those symptoms are
(50:08):
referred to as atypical.
They are assigned the wordatypical.
This is how you chart it.
It is the standard.
Nomenclature.
Now just think about how wordsand descriptions drive thoughts
and actions.
(50:31):
And by describing it asatypical, it's another way to
other it.
Not as important.
Something additional.
If we have time, we might learnit, but we're not going to be
tested.
It's going to be the main thing.
We're going to other that.
Well, here, here's my thought onthat.
(50:51):
Women are 51 percent of thepopulation.
We are the majority of thepopulation.
How did our symptoms get to beatypical, right?
So, maybe we're having the morestandard symptoms, and it's like
the men who need to be othered.
Chris (51:06):
No, no, no, no.
I agree.
Dr Morgan (51:11):
I'm just saying another example.
I could give you hundreds as Iknow, Dr.
Ford could going through medicalschool and training where you're
just like, Oh, I'm just going tokeep my mouth shut.
I'm not going to say anything.
You know, you're, you're, youknow, I didn't go into
gynecology for a number ofreasons, but one of them is
that.
No, they named things like yourcervix and incompetent cervix,
(51:34):
the shy bladder that all these,I just was like, Oh, does
anybody not feeling nauseous aswe're going through?
Right.
Why does a woman's cervix haveto be incompetent?
There's nothing, there's no partof the man's body, nor condition
that we term as beingincompetent.
(51:55):
So words matter.
Chris (51:57):
All
Dr Morgan (51:58):
right, I'm back to chest pain.
I've gone.
No,
Chris (52:00):
no, no.
Thank you.
Dr Morgan (52:03):
Caught up on another, another thing.
Chris (52:05):
And so
Dr Morgan (52:06):
atypical.
So don't forget it's atypical.
And that also means that you asa woman and as a man, and as
society.
You also haven't learned thesesymptoms, right?
We watch TV, we watch things,everybody has crushing chest
pain, shortness of breath, theyfall on the floor, we call 911,
they have sweating, whatever,right?
Nobody ever tells us that, hey,you might just feel run down, or
(52:31):
you might feel tired, you mighthave nausea, or you might have
jaw pain, it sends you to thedentist to check a tooth.
Nobody tells you that.
And then when you come to seeyour physician, They may not
even recognize it becauseatypical really means, eh, might
be hysteria, might be anxiety,might be, you know, I don't
know, it's a little nebulous,that kind of thing.
(52:53):
That's why I say words drivethoughts and they drive people.
Actions and the things that weare tested on the things that
are reproducible are the thingsthat we will act on and that we
will remember we are not testedon that.
In other words, we are not heldto accountability.
On those types of atypicalthings.
(53:14):
And so, the health system isalso at fault.
And so, here a woman has thesesymptoms.
She stays home for hours, days,weeks, longer than she should.
Then when she finally comes tothe medical establishment,
They're giving the proverbialpat on the back that they're
there they're there.
(53:34):
Here's an anti anxiety medicineHere's a panic or you know,
whatever Every now and and I'mgiving you this example because
this is why?
physicians stay in badsituations longer than they
should because they know if theyleave people might die.
They are.
They recognize and it is such ahard and unfortunate position to
(53:59):
place minority positions in andto place women positions in when
we're looking and treatingpatients from a different lens.
And, you know, had that patientnot come to you, but For the
sake of God, that patient mayhave perished or had a worse
outcome that would have impactedthem for the rest of their life.
How can I leave and let thathappen to people, even though
(54:24):
other things are happening tome?
that are making my lifemiserable.
We have this all of the time.
And so back to atypical chestpain.
This
Chris (54:33):
is what
Dr Morgan (54:34):
happened.
I
Chris (54:34):
know.
Everything you're saying rightnow, I'm telling you, it's the
word.
That's what we need to hear,absolutely.
Dr Morgan (54:42):
And so then when you come to the physician, what
happens?
you have a delay in getting tothe cath lab.
We know that every 30 minutes ofa delay increases your risk of
having a heart attack and losingmore heart muscle.
There is a longer and longerdelay.
Women's time getting to the cathlab is much longer than men's
(55:02):
time.
And then even after that, let'ssay you had a heart attack, you
end up with revascularization,meaning they opened your
arteries, all of these things.
for joining us.
Only 72 percent of women willeven be offered high intensity
cholesterol therapy or highintensity blood pressure
therapy, only 72 percent evenafter your event.
(55:26):
Yeah, so we have a long way togo.
This is, I talk about thesekinds of things all the time.
There is the system doesn't Workfor women.
It doesn't work for minoritiesand you only have to be a
minority woman and a physicianin the system to see it so
(55:46):
glaringly.
And, you know, I reached a pointin my career where I just felt
that I couldn't not, not speakanymore.
But I will say this, that it wastoo long.
And the reason I didn't speakearlier is because I didn't.
Want to take the risk.
(56:07):
I'm doing the risk balanceratio.
If, if I speak up and theybanish me, then I'm no good to
anybody.
And so there was at some pointwhere I got to my career, I just
had to, you know, speak up.
So, you know, and it may be youget to a point where you're just
like, what are you going to doto me now?
Or it may be that you find yourtribe, that you find and an
(56:30):
organization and people who arelike minded whose values align
with your own and you have thesupport to continue to do the
right things because we cameinto this to heal people,
Chris (56:45):
right?
Dr Morgan (56:45):
We're here to preserve life.
And what happens in medicineoftentimes to minorities and
women's is the antithesis ofthat.
Chris (56:58):
Yeah, absolutely.
So better more, what we're goingto do is I'm gonna ask you just
a couple of questions to closethis out here.
Do you, what do you think thehealthcare system can do better
to address these disparitiesthat we talked about?
Cause we talked about it fromthe standpoint of minority
health, from the standpoint ofsocial determinants, as well as,
you know, gender inequities too.
(57:18):
What are some things that youthink the in moving forward that
we all can do, I can do,patients can do, et cetera.
Dr Morgan (57:24):
Yeah, we need to have more principal investigators of
research clinical trials who areblack.
That means that the drugcompanies and research and
pharma and biotech companiesneed to train Physicians we they
don't recruit see there's somany parts of this They don't
recruit black physicians to leadtrials.
We know the number one reasonthat a patient will enroll in a
(57:47):
clinical trial is if she or heis approached by a trusted
physician.
That's any race, any creed, anyculture.
80 percent of African Americanpatients are seen by African
Americans physicians here.
in this country for all thereasons I just named, right?
We first picked people where wecan trust them.
(58:07):
We can trust that they will notfirst do us harm, that we can
believe what they're saying.
So if 80 percent of the blackpopulation is seen by black
physicians and almost 0 percentof black physicians Our trial is
Stanley clinical trial.
And we know that the number onereason that a patient will
enroll in a clinical trials.
(58:28):
If they're approached by aphysician, you can see where I'm
going where we end up withmedications.
We don't really know if theywork for us or not.
You know, we don't really knowwhat's happening.
You know, currently there's ablood pressure medicine that I'm
looking at more carefullybecause it seems to me I
continue to hear better.
Testimony and anecdotes thatblack women, when they're taking
it, start to lose their hair.
(58:51):
Well, that's not a part of theside effects from the clinical
trial profile.
But when you look into it, Oh,they didn't really enroll black
women.
So now here we are out in realworld use.
And we're losing our hair whenwe take the medication, you talk
to your doctor about it.
What does your doctor say?
Well, it's not one of the sideeffects.
Chris (59:09):
Yep.
It's in your mouth,
Dr Morgan (59:12):
which is correct, right?
So they're treating you to thetop of evidence based medicine.
Chris (59:17):
Right.
Dr Morgan (59:17):
But if you're with a black doctor, a black doctor
will say, Hmm,
Chris (59:24):
that's a big deal.
Is
Dr Morgan (59:28):
a big deal.
And so we really need to havepeople in research.
We need to have people who areleading research, like at these
big medical centers, the chiefscientific officer, the chief
research officer.
These are positions that need tobe held by women, by people of
color.
It doesn't mean that white mencan't have them.
They can also have them, butyour team needs to have people
(59:50):
who have a 360 degree lens onyour patient population in that
hospital and not just led bygroup thing.
The chief medical officerreinforces with the chief
scientific officer saying, wereinforce it with chief research
officer and nobody has anydifferent ideas.
So they just all congratulatethemselves and never, not in a
mean way, They just didn't knowthat there was another something
(01:00:12):
else to think about becausenobody brought it to their
attention and nobody brought itto their attention because
there's nobody sitting at thetable who's in power, that they
have been powered to bring it totheir attention.
And the last thing that I'll sayis the most educated demographic
in this country is the blackwoman.
Black women have the highestlevel of education and the most
(01:00:33):
degrees in this country.
And that certainly is notrepresented in the jobs that we
hold in the places that we go inthe seats that we have.
We don't have a place that thetable work hard to get to the
middle.
And we can never get furtherthan the middle.
So listen to me, listen closelyto what I'm saying.
(01:00:53):
If you need to leave, you leaveand go get your black job and
you continue to maximize all ofyour achievements because every
place won't value you.
wherever you are.
And even though I know you say,if you leave, this is going to
happen in my patients, this, butonce you can get out and achieve
more power and moreindependence, you have the
(01:01:15):
ability to influence externally.
So don't stay for the sake ofstaying.
Many of us do that.
I get it.
But just Think about how all ofthat works because we work very
hard.
We don't have the ability topass down generational wealth.
We never are promoted in jobsthat are higher, high paying
(01:01:37):
enough.
It determines the schools thatyour children will go to, the
education they will receive, thehousing that you can provide,
the foods that you can choose,whether you can have organic or
not, it's going to impact yourlongevity.
Let me tell you something.
Number one, Factor in the UnitedStates of America for long life.
It's not good cardiac health.
(01:01:59):
It's not, you know breastcancer.
It's not, if you're a runner, along distance runner, the number
one indicator for living a longlife is how much money you make.
So, when you look at Jeff Bezos,And the heads of Microsoft, you
(01:02:19):
don't have to know any of theirmedical history, but just the
fact of their financialstanding, they're going to live
longer than you are.
That's how America works.
Chris (01:02:31):
Yeah, absolutely.
Dr.
Morgan, you know, I, Iappreciate you coming out and
talking to us.
I hope to have you on again,more so just, just for my own
edification.
I feel like I've been healedfrom this conversation, but
definitely thank you so much forour listeners.
Absolutely.
Please be sure to check outstairwell chronicles Dr.
(01:02:53):
Morgan.
Again, I'll post your your app'cause I definitely want to get
that out to our listeners too.
Yeah.
The Hello,
Dr Morgan (01:02:59):
hello Heart app and hypertension.
We are here to really solve thatproblem and to stand in the gap
especially for women's health,especially women in menopause.
We didn't even talk about thattoday and how your risk of heart
disease increases.
But get a chance.
Look at the Hello Heart app.
And follow HelloHeart and youcan follow me as well at Dr.
Jane Morgan, D R J A Y N E M O RG A N.
(01:03:23):
Submit a question.
I might, I might put it on mystairwell chronicle, answer the
question for you.
Chris (01:03:28):
Absolutely.
Absolutely.
Well, thank you so much, Dr.
Morgan.
We'll, we'll, we'll be sure totalk about it next time.
Thank you very much.
All
Dr Morgan (01:03:33):
right.
Chris (01:03:34):
Bye.
All
So that's it.
I want to thank Dr.
Jane Morgan for coming out andspeaking with us.
I hope she comes out again andspeaks further because there's
much more we need to get into.
Um, and I know I speak for a lotof folks out there to say that a
lot of what she had to offer.
Was very eyeopening was verymuch what a lot of folks needed
(01:03:55):
to hear.
Especially younger doctors inthe beginning of their career,
folks that are just now cominginto knowing they have diabetes
or high blood pressure, etcetera.
And how we can utilize themedications that we take.
And some of the actions that wedo in our day to day choices in
terms of exercise, in terms offoods that we choose.
(01:04:17):
If we have the choice to do so.
That may affect our health inthe long run.
Please feel free to check outher.
Feature content, which is thestairwell Chronicles.
You can check that out onInstagram.
On Tik TOK on X.
Now the former Twitter.
So feel free to check that out.
Also check out her app as well.
(01:04:37):
I will place a link to her appfor everyone out there.
Because I think that it's reallygood at terms of increasing our
awareness.
And our health and keeping us ontop of everything.
That app is called.
Hello, heart.
And again, I'll place a link toHello Heart that you all can get
that on your devices.
(01:04:59):
This is a first episode ofseason two.
This is your warning thingsabout to get real to season.
We're going to continue to bringyou content of this same ilk.
I want to make sure that we getto the core of some of the
issues.
And to be honest with you, theonly way to do that is to talk
about these issues.
It's not to skirt around them.
(01:05:20):
And we're going to continue todo that in the next several
episodes, just because we can'tkeep doing the same thing over
and over again, we have to comeup with.
Some meaningful resolutions tosome of the issues that we're
seeing over and over and overagain.
Here in the state of Wisconsin.
Next month will be our nextepisode.
(01:05:42):
And because we have.
Some pretty monumental electionscoming up.
What we're going to do is we'regoing to bring you some topics
that are going to affect yourhealth in the state of
Wisconsin.
And so we'll have some veryspecial guests that are going to
be coming on to talk a littlebit more about some of the
public health issues and some ofthe public health legislation
(01:06:03):
that is affecting the health ofWisconsinites throughout the
state.
So.
Feel free to reach out to me ifyou have any other questions.
About this episode or aboutother episodes as you've been
doing in the past, and we'relooking forward to presenting
that information.
As an aside.
What we'll be doing also is wewill be.
(01:06:24):
Putting information out therefor anyone who wants to donate
To a great cause for the braintumor foundation..
There is a nurse that I workwith.
Her name is Chelsea.
I'll put her information outthere too, but she.
Is, you know, one of these.
Superheroes amongst us that Runsmarathons.
(01:06:45):
And so, you know, my.
Support goes out to her.
She'll be running for the braintumor foundation.
And essentially what this is, isa group of runners who come out
and they will dedicate, theirrun to increasing awareness of
brain tumors, as well as tryingto garner support for research
(01:07:08):
garner funds for research, etcetera.
And so.
Brain tumors and cancers arethings that affect.
Pretty much anyone that, youknow, if you're not affected
yourself personally, having.
Had a friend of mine in college.
My good friend, Rashaun Black orBeau as we call them.
(01:07:28):
Hu.
Was a teammate of mine incollege.
Unfortunately died secondary to.
Glioblastoma multiforme I wantto make sure that we do all that
we can to support brain tumor.
Research and make sure that wedo all we can to support folks
who are doing things in thecommunity in order to eradicate,
you know, this, disease process.
(01:07:49):
So.
Feel free to support her link.
I'll put that out there as muchas we can.
As always, thank you so much forjoining us.
we're looking forward to seeingyou.
In the next couple of weeks andas always take care of
yourselves, take care of eachother.
And if you need me.
Come and see me.
The following is brought to youby the committee to protect
healthcare.
Chris (00:05):
In the emergency department, we see real time
consequences of people nothaving access to health care.
Expansion of Medicaid inWisconsin would mean less cases
to the emergency department.
It would prevent closures ofhospitals in our communities,
and most importantly, savelives.
The majority of states in thecountry have expanded Medicaid
with bipartisan support, yetlegislators in Wisconsin are
blocking expansion of Medicaid.
(00:27):
They're blocking the opportunityfor our patients to have a
healthier life.
Tell your legislator to savelives and pass Medicaid
expansion.
Welcome to pulse check,Wisconsin.
(01:19):
Good morning.
Good afternoon.
Good evening.
Whatever it may be for you.
This is Dr.
Ford again with Pulse CheckWisconsin.
I want to welcome everybody backfor season two now which is very
exciting to get into.
I hope you guys had a goodsummer.
I know that my crew did here forall the kids out there.
(01:40):
Welcome back to another schoolyear.
I wish you all the bestspecifically all the kids that
are starting on the date of thisrecording which is September
3rd.
I believe all the MilwaukeePublic schools are back in
session.
So best of luck to you guys thisyear.
You're going to do amazingthings Looking forward to all
(02:02):
the things that you willaccomplish all the bright minds
here in Milwaukee andthroughout, Wisconsin We got a
good episode for you here today.
We are going to have with us acardiologist who is also a
contributor to to a number ofnews outlets.
Her name is Dr.
Morgan She is a cardiologist.
(02:23):
She's an African Americancardiologist who specializes in
being an outlet to the public.
and sharing with us some of herexpertise, some of her specialty
specifics as well.
And we're very fortunate to haveher here today.
We're going to get into a coupleof topics regarding cardiology
(02:44):
in general.
Cardiology affects multiplepopulations throughout the state
of Wisconsin specificallyunderserved minority populations
as well.
We see a disproportionate amountof bad outcomes related to heart
failure related to heartattacks, exacerbations
(03:04):
associated with high bloodpressure, diabetes, things of
that nature.
So I want to do everything thatwe can to skew these numbers so.
With that being said what we'regoing to do is we're going to
get started with one of ourcases.
This case will be a case that Isaw in the emergency department.
(03:25):
This was right around the timeof COVID 19.
So the hospitals had been seeingless volume at the very
beginning of the pandemic.
Because a lot of folks stayedhome.
So I won't give too much away.
We'll go ahead and get into ourfirst case.
(03:48):
Patient is a 64 year old femalewho is presenting to the
emergency department withconcerns of nausea, vomiting and
some tooth pain along the leftjawline.
The patient states that thispain started Roughly a couple
days ago she was at home andnoted that she had some pain.
(04:08):
She was going to make anappointment with her dentist
coming up.
Patient denies any fevers athome.
She denies any chest pain.
She denies any difficultybreathing.
But states that today shestarted to get increasingly
nauseous.
And felt as though she was goingto throw up.
And as such, thought that shecould be having an infection of
a tooth.
That may be causing thesesymptoms.
(04:31):
When patient came back to theemergency department room she
was noted to be afebrile,meaning she didn't have a fever.
She was still nauseated and shejust appeared to be not well.
Her skin color was a little bitgrayish.
She looked as though she wasvolume down, meaning that she
looked dehydrated.
(04:53):
She had a tachycardic heart rateto the 120s.
Usually heart rate normally issitting somewhere between 60s
and 90s.
Anything above a hundred, weconsider it to be a fast heart
rate or tachycardic heart rate.
She had a blood pressure whichwas lower.
Her blood pressure was in the80s systolic.
We usually want to see thatabove 90 Again, this was during
(05:15):
the pandemic.
So in the very beginning, familymembers were allowed in the room
towards kind of the middle ofthe pandemic family members were
not allowed, but in this case,we brought the family members
back just how unwell that shelooked and the fact they could
provide a little bit morehistory.
Patient had no cardiac history.
She was only taking medicationsfor blood pressure, but that was
(05:37):
about it.
I noticed that her heart ratewas fluctuating.
It was going from 120 to 140 to160.
And again, the striking thingwas, was that her blood pressure
was exceptionally low.
As such, we got an EKG for herthat showed an irregular heart
rhythm, which was atrialfibrillation.
(05:58):
With the patient's bloodpressure being low, we placed
some pace pads on her.
We got a formal EKG performedfor the patient as well to
determine, aside from the atrialfibrillation, if there was
anything else going on.
We explained all this to thepatient and why we were placing
these pads, because in somecases you will see that an
(06:21):
irregular heart rate itself cancause the blood pressure to be
low, and in those casessometimes we need to shock the
heart back into a normal rhythm.
As I was taking a look at hercondition, EKG.
I noted that it was somethingfamiliar, but it's something
that looked to be concerningoutright.
(06:42):
It looked as though she had whatwe call ST elevation or a
segment of the EKG that looksconcerning for heart attack.
I went back and talked to thepatient again.
The patient stated again thatshe had no chest pain, she had
no difficulty breathing, and wasjust a tooth pain and the
nausea.
(07:03):
We ordered some labs for thepatient, and while we were
waiting on that, after her fluidwas completed, I didn't like the
fact that the patient's bloodpressure still was low, so we
ended up placing a central linefor the patient a central line
is a line that we can use inorder to provide some medication
to the patient to bring theblood pressure up.
(07:23):
We had discussion with thepatient if she would want to be
Cardioverted meaning to shockthe heart and she did not want
to do that and with this STelevation My concern was that
there was something else goingon as well I took a look with an
ultrasound at bedside for thepatient.
We're able to do this in theemergency departments just with
(07:44):
a Bedside ultrasound we're ableto take a look at your heart in
real time And what it lookedlike was a portion of her heart,
her right ventricle, was notbeating as well as the left side
of her heart, and it appeared tobe dilated as well.
After we placed the centralline, we ended up having our
cardiology colleagues come downand see the patient.
(08:06):
We started the patient on whatwe call vasopressors or
medications to improve the bloodpressure.
I shared with our cardiologycolleagues that I was concerned
that this patient may have had aheart attack.
And after talking with her againin the beginning of the story,
it seems as though her symptomsstarted a couple of days ago.
(08:27):
The cardiologist agreed withthis and was also concerned that
the patient not only had a heartattack, but may have had this
heart attack two days prior whenthe symptoms first began.
What we were seeing in thispatient's case was what the
eventual diagnosis was.
Not only did she have a heartattack, but she also had what we
(08:52):
know as cardiogenic shock.
So this patient's case is reallyinteresting, and it really
underlines one of the thingsthat we talk about in cardiology
as well as in emergencymedicine.
Both cardiology and emergencymedicine doctors see an
exorbitant amount of EKGs everyday.
(09:13):
Cardiologists may see more inthe clinic.
However, in the emergencydepartment, you know, the
average ER doctor that's at alevel one center or at a large
metropolitan area center may seeup to 30, 40 plus EKGs every
day.
In those cases, we have to bereally good at picking up things
that are concerning because inthese cases you only have
(09:34):
seconds to minutes in order tomake a decision as to what to do
with those patients next.
And if a patient is at increasedrisk, if we need to move on it.
In this patient's case, again,she did not have any typical
chest pain and this is somethingin recent years, I would say in
the last 10, 15 years that wehave harped on as a medical
(09:56):
discipline as well as educatorsin medicine that women typically
don't have the typical crushingchest pain, stabbing chest pain
with radiation up through thejaw or down the arm.
In fact, in this patient's case,the chest pain actually had an
equivalent, or we call it chestpain equivalent which was
(10:18):
nausea, and in addition she hadthat tooth pain on the left.
It's been well documented inrecent years that women will
have different presentations toheart attacks than men.
And in this case this wasSimilar to what we're seeing in
multiple chart reviews thatwe've done this atypical pain to
(10:41):
the jaw or to the tooth or Youknow could even be just feeling
fatigued or feeling weak orfeeling nauseated in this
patient's case Again, becauseCOVID hit us so hard folks were
afraid to come to the emergencydepartment.
In some cases, folks were toldto not come to the emergency
(11:02):
department unless they felt asthough there was an emergency,
just given how overran we wereat the beginning of the pandemic
and how little we actually knewabout COVID 19.
In her case, we were told Whathappened was she actually had a
heart attack two days prior.
And what happens commonly is ifyou have that heart attack, Over
(11:25):
time, that heart muscle, will beaffected.
A heart attack effectively iswhen you have a portion of your
heart that is not getting enoughblood supply through a thrombus
or, or some blockage that'scausing that decreased blood
flow.
In her case, she had decreasedblockage to that right heart.
(11:46):
And that was the abnormalitythat we were seeing on the
ultrasound.
What happens is, the musclebecomes what we call ischemic,
or doesn't get blood to it.
And so over time that musclebegins to break down.
And with it, the functionalityof the heart begins to erode as
well.
(12:06):
We were seeing, on the formalultrasound that we were able to
get at bedside, she had somevalvular abnormalities.
Subsequently, what happened wasthis affected not only what we
call the ionotropy or thesqueeze of the heart, but also
affected some of the chronotropyor how fast the heart was going.
It affected the electricalsignal pathway that the heart
(12:28):
typically undergoes, which waswhy she was in that dysrhythmia,
that atrial fibrillation.
In addition, as we mentionedbefore This patient had what we
call cardiogenic shock oressentially the heart not
functioning as well as it canand so you can see fluctuations
in blood pressure.
She had a very low bloodpressure.
(12:48):
And this is a condition that canbe exceptionally dangerous.
In fact, this patient not onlywas taken to the cath lab, she
was admitted to a cardiac ICUfollowing.
Fortunately for this patient,she had a great outcome.
She was able to have cardiacstents placed.
She was able to follow up as anoutpatient with our cardiologist
and our electrophysiologist.
And as of the last access that Ihad to her chart, she was back
(13:12):
at home.
So this case in itselfunderlines the importance of a
couple things.
So first off, for all women whohave a family history of heart
disorder or any cardiacdisorders, diabetes,
hypertension if you have astrong family history as well,
You want to make sure thatyou're looking out for when
things are not feeling wellbecause again, you know A lot of
(13:34):
times you're not going to havethat typical crushing chest pain
typical radiation of the pain upthe jaw or down the arm There
may be more subtle presentationslike in this this patient's case
when she had some Nauseaassociated with it.
And there are some contextual.
Reasons for this that we'll getinto.
(13:56):
When we speak with Dr.
Morgan as to why.
We are just now taking a look atthe differences between men and
women and their presentationswith heart attacks.
So make sure that you're On thelookout for those symptoms, make
sure that you are checking ineither with your doctor or go to
(14:17):
the emergency department.
If you're experiencing somethingthat just doesn't feel right.
Secondarily you want to makesure that you're seeing your
cardiologist or seeing yourdoctor regularly as much as
possible.
during the season, we're goingto talk about the importance of
primary care, a couple of goodprimary care clinics in the
Milwaukee area to make sure thatwe get to you before.
(14:39):
Your presentation gets to thispoint, making sure that we're
optimizing your health care asmuch as possible.
So that was our case.
Now I want to open up theconversation with our special
guest for the day, Dr.
Morgan, who is going to discusswith us some very high yield
(15:01):
concepts in cardiology.
We're so lucky to have her hereand we'll go ahead and start.
Hi, welcome back to my channel.
Dr Morgan (15:43):
My name is Dr.
Jane Morgan.
I'm a cardiologist.
A lot of my background has beenreally in research that came up
through the industry reallypharma industry device industry
doing real R.
and D.
heart, you know, research anddevelopment, writing protocols
and rolling people in trials.
Traveling, identifying studysites.
So that bread and butter gruntwork of how drugs come to
(16:06):
market.
I did that for a number ofyears.
I practiced both before that andafter that.
And And then even was atPiedmont Healthcare, which is
largest healthcare system in thestate of Georgia for 9 years
leading their cardiovascularresearch program.
And then for COVID being thehead of the COVID task force,
and then really branching offquite a bit into brand growth
(16:29):
and marketing.
Currently, I'm the vicepresident of medical affairs for
Hello Heart, which is a digitalhealth company focused on
hypertension, reducing heartdisease.
It is an app that you use tocontrol your blood pressure, but
also interact with that app, getreal data and information.
And we're looking to reallyclose the gap, especially in
(16:53):
health care for women and forminority populations, who
oftentimes are not gettingaccurate information, not
getting timely information.
We don't feel empowered to askthe questions.
Well, now we've got an app.
that can help guide you throughall of that and even direct you
for when you need to go to the,to the physician.
I do a lot on social media.
(17:13):
I have a series called thestairwell chronicles which I
usually post on Wednesdays and Isit on my stairs and give One
piece of medical advice in 60seconds or less.
I usually ask a question ofmyself and answer it in 60
seconds.
I like to say that's my housebecause it is those are my
stairs.
Those are my clothes.
That's my question.
(17:34):
So if you ever submit questions,I might answer your questions as
well.
I talk a lot about cardiologyand clinical trials and research
and health equity and women'shealth, but also all kinds of
other things as well.
And then other places you maysee me is I do quite a bit of
media interviews doing medicalanalysis.
I do that for CNN, for ScrippsNews.
(17:55):
for the weather channel even forABC News affiliates, WSB TV.
So you may see me doing those aswell.
Just kind of breaking downcomplex science information,
making it relatable to thepublic and explaining it on
media.
Chris (18:10):
Yeah.
And, and, you know, I, Iinitially came across you just,
you know, like you said, it'sthrough some of those media
interviews, especially, yourstate staircase series as well.
And just some of the questionsthat you were answering and some
of the information that you weregiven out, I thought would be
perfect for our audience becauseI often get asked in the
emergency department, some ofthese very same questions.
And so, you know, I appreciateall the amazing things that
(18:31):
you're doing, both in thecommunity.
I'm sure the state of Georgiawould say the same as well, but
but I want to thank you.
Dr Morgan (18:37):
Yeah, no, thank you, Dr.
Ford.
And I appreciate being on today.
And if people If anybody wantsto follow me, I'm at Dr.
Jane Morgan.
It's just D R D R J a Y N E.
I've got a Y in my first nameand M O R G A N.
I had nothing to do with it.
I was born.
That's the way it was.
Instagram, you know, X threads,Tick Tock, and I'm on LinkedIn
(19:00):
as well.
Please.
I do a lot of professionalposts, Jane Morgan, MD.
Chris (19:05):
Definitely.
And definitely follow So, youknow, we'll go ahead and kick
off here.
What inspired you to pursue acareer in cardiology?
And before we get in that youknow, happy women in healthcare
month as well.
Dr Morgan (19:19):
You know, how I came into medicine, you know, maybe
it was kind of interesting.
And even before I went intocardiology I, you know, I was
growing up and my neighbors oneither side of us, we had a
family practitioner lived on oneside of us.
The other side of us was adermatologist across the street
was an orthopedic surgeon.
And then the next house down wasanother orthopedic surgeon, and
(19:41):
then around the corner with adentist and I babysat for them.
And so we had so manyprofessionals just right there
in our environment.
I was playing with theirchildren.
My parents were not physicians.
My mother was a tenuredprofessor at Spelman College.
And my father was sort of upperlevel management at the U.
S.
Post office.
Both of my parents worked.
(20:02):
and worked full time in orderfor us to live there in that
neighborhood.
Whereas the other homes with thephysicians they were all male
physicians.
The men worked and the wiveswere stay at home wives, and
many of them also hadhousekeepers.
So we lived there as well.
But both of my parents worked.
We were latchkey kids.
(20:23):
I came home.
There was no housekeeper waitingfor me.
But what I would say in that isthat my best friend across the
street, her name is Gina Scott,I would go to their house and
play.
Her father was an orthopedicsurgeon.
He would have all these booksdown in his office and we were
never supposed to go in there.
So of course, we love sneakingin there.
And I would like to open hisbooks and look at all those
(20:45):
really icky, icky pictures ofthose weird diseases and those
people.
And I think it was there that Istarted to develop an interest
because those books, as much asthey kind of repulsed me, they
were fascinating.
I always wanted to kind of lookat them and I wasn't reading
them.
I just was looking at thepictures.
I had never seen people thatlooked like this and diseases
(21:05):
like that.
So when I went to med school, Iactually went to medical school
to become an orthopedic surgeon.
Okay.
Because I don't know, that's allI knew, right?
Doctors are orthopedic surgeons.
And then of course, you know,your world opens and your world
expands.
You start learning about thingsyou never heard of, rheumatology
and psychiatry.
And so I started going throughthese rotations.
(21:27):
Every time I went throughrotation, I was thinking, I
think I want to be that.
Oh, that's interesting.
So I was changing my mind.
I was all over the place.
I was a chameleon.
So I ended up going intointernal medicine because.
You know, who could make adecision, right?
So
Chris (21:42):
I
Dr Morgan (21:43):
did internal medicine and I was there and I was kind
of thinking maybe I'll just be ageneral practitioner, be able to
be an internist.
And I started doing criticalcare rotations and I liked
critical care a lot.
I liked the ICU.
I wasn't so in love withpulmonary though, but I liked
critical care.
And then I did cardiology andcardiology.
I really like cardiology and itcombined the critical care.
(22:05):
And so really, I went intocardiology just by being open to
exploring my world and exploringmy profession and learning and
not being set in one thing andbeing able to grow and being
willing to grow.
And in doing so, I discoveredCardiology.
(22:26):
So I went to med school tobecome an orthopedic surgeon and
hello, I am a researchcardiologist.
Chris (22:34):
And we see that so often, right?
Especially there's a lot ofmedical students.
We just had someone that areparticipating in a program where
They're taking kids from theinner city of Milwaukee and
they're doing a pathway tomedical school just to kind of
get that representation there.
And you see it in so manymedical students.
You come in with the idea thatyou're going to be one thing.
(22:54):
And it's not until you kind ofwalk that walk and you kind of
see what you want to do.
My story was the same waypersonally.
I love to see, I love everythingthat I saw.
Like, oh, pediatrics.
Oh, I love that.
Oh, surgery.
Oh yeah, I want to do all that.
And it wasn't until third orfourth year where I was like,
Oh, I really like just going tothe emergency department for all
the consults.
So why don't I just do that?
Right.
So, yeah, that's a good, that'sa good point.
(23:14):
You know, you guys just don't,don't come fixing your ways,
just be open and you never knowwhere you may end up.
Dr Morgan (23:20):
That's right.
Because you know, it's a greatexample of life.
Sometimes you only know what,you know, you don't know what
you don't know.
So always be willing.
I like to say even today that Iam a forever student of
medicine.
There's always something tolearn.
I'm never a master.
I'm always a student and I cameto cardiology from orthopedic
(23:42):
surgery because I was always astudent.
And as long as you're alwayswilling to learn and evolve,
then you don't really know whereyou will end up in life.
Chris (23:53):
You got it.
And you know, one of the thingsyou brought up there too was,
you know, the ability to seeright, the ability to grow up in
a neighborhood where you couldsee folks who were orthopedic
surgeons or see folks who werephysicians coming up as a
cardiologist or at least acardiologist in training.
You know, our numbers in termsof african americans in general,
(24:13):
as well as african americanwomen are very finite.
What, what if any challenges didyou experience just being an
african american woman coming upthrough the cardiology range?
Did you experience and you know,what how did you overcome them
in those, in those, in thoseroles?
Dr Morgan (24:29):
You know, and I recognize, you know, after I had
grown up that my upbringing wassomewhat unusual just to be
surrounded by homes of, ofphysicians and and it was only
then when looking back, when Istarted to make comparisons, as
I said, that we were there, butboth of our parents were working
a lot of those kids in the otherhouses were in private schools.
I went to public school.
(24:50):
But the fact of the matter is wewere still living in that
neighborhood and it, and itshaped you.
And it was only when I becameolder that I realized there were
some people who had never evenmet a black doctor, who had
never even seen a black doctor.
And then when I look back on it,I didn't see any female doctors.
Every physician in ourneighborhood, including the
(25:11):
dentist, were all men.
Chris (25:15):
So
Dr Morgan (25:15):
in that way, I had no role model.
And in fact, when I look back onit, I originally was thinking I
wanted to be a nurse because Ithought men were doctors and
women were nurses.
I don't know where I got that inmy head, but maybe TV or society
somehow.
I didn't see it.
So sometimes you can't be, ifyou can't see it.
Chris (25:35):
Right.
Dr Morgan (25:36):
So in that way, my, my neighborhood was very helpful
in shaping the idea that I couldbe something, and I didn't
realize that.
It wasn't something that I couldbe and that there were people in
the world who've never even seenblack doctors and here I am
living in a whole neighborhoodof them.
I didn't know that.
And this is what I'm saying.
(25:56):
You don't know what you don'tknow.
And so later when I became acardiologist there when I say
there are very few black femalecardiologists, I really didn't
know any.
I knew myself.
I didn't know anybody else.
I joined an organization calledthe Association of Black
Cardiologists and met someothers.
And then I'll tell you an eyeopening experience.
(26:16):
I came to Piedmont Healthcareand that was in 2015.
And when I walked in, there wereOh my gosh, were there six black
physicians?
Like you could have knocked meover with a feather.
I don't even know if I've everin my life even been in a room
with that many.
Did I even know that many?
We had let's see, Tara Hrabowskiwas in heart failure.
(26:40):
There we had another male therein heart failure, we had a, a
surgeon, a female cardiacsurgeon.
Let's see, David Montgomery wasthere in cardiology out of
Morehouse.
I came out to Spelman.
So, you know, we are connected.
Chris (26:53):
I
Dr Morgan (26:55):
was amazed at the richness of that environment.
And, you know, just a mini topicthat maybe we'll get into today.
None of those doctors are eventhere today and in medical
environments.
are not conducive to support theblack physician, the black
(27:20):
specialist physician, even therarity, the rarity of seeing
black cardiologists and having acluster of them at one
institution.
It was not even recognized assomething that was so special
and abnormal.
And one by one, all of thosedoctors have gone and gone on to
(27:43):
do other things when there wasan opportunity for there to be
something so incredibly specialthere at that time of
cardiologists.
Black female cardiologists makeup less than 1%.
Of the profession.
And at the time, I think therewere three or four at one
institution.
I never even seen that manyinstitutions have them, but the
(28:06):
value wasn't there.
I don't think people recognizethat this was something, you
know, it was something that hadhappened by happenstance.
It was not intentional, just byhappenstance, all of these
physicians were there.
We recognized it amongst eachother, but the big institution
didn't recognize how rare andwhat a very special cluster of
(28:27):
physicians they had and how rareit was to have them.
And so that's a great example ofthey're all gone.
It's hard.
It is difficult.
You're not valued.
You're not seen as somethingspecial.
You are othered and you'reothered in very subtle ways that
(28:48):
erode your ability to have agreat quality of life that
interfere with your ability togive your patients the care that
you really know they need.
And that sometimes only you cangive them from a congruent
perspective.
probably stay longer than youshould because you're dedicated
(29:09):
to your patients, even thoughit's not working for you.
So these are all things that wegrapple with all the time.
Our our commitment anddedication to our community
versus What commitment do I haveto myself if it's not moving
forward?
And so, you know, I think blackphysicians in particular, always
(29:31):
in that sort of quagmire of theyin and the yang.
Chris (29:36):
Yeah.
And you brought up a couple ofgood points there.
You know, one thing is, is thata lot of those physicians were
losing them.
Right?
Like we're losing them to otherinstitutions if they feel as
though that pressure is too muchor if they feel unsupported, you
know, a lot of times we see, Imean, when I started at my
hospital and that currently wehave maybe three or four African
(29:57):
American doctors, period.
Period, not even period.
Right.
And so and so, and
Dr Morgan (30:03):
not to mention cardiologist.
And then I will say, I'm sorry,I forgot the No, no, no.
Go for it.
Yeah.
Blanking on the names.
Dr.
Kelly McCants was there.
Dr.
Africa Wallace was there.
Tara David Montgomery.
They, we were all black.
Dr.
Jane Morgan showed up inresearch and lemme tell you
something.
The black cardiologists who werethere when I arrived had never
seen a black cardiologyresearcher.
(30:24):
Like they all came over to go,Oh my gosh, you're doing
research.
We've never met somebody who'sdoing research.
It was so special.
And yet we recognize how hard itwas because the bigger
institution didn't value howspecial it really was.
And all of us were having suchchallenges just maintaining what
(30:45):
we were doing.
And here you are, just as yousaid, Dr.
Ford, you're at yourinstitution, let alone
specialists.
You all didn't even have four.
That's
Chris (30:54):
it.
Right.
And it's so rare because one ofthe other things that we'll kind
of segue into our next questionis, How important that is not
only from a physician, justhaving you there to see right
for patients to see for kids tosee in the community, et cetera,
et cetera, but taking away, youknow, even the color aspect is
the cultural aspect, right?
(31:15):
And you made mention of that tounderstanding the culture,
understanding where people arecoming from has been shown
objectively to improve patientoutcomes in a lot of situations.
And so it just, it going fromthat.
How has your background and howhave, you know, where you come
from kind of from a culturalstandpoint, how do you feel that
that's influenced your approachto, you know, your perspective
(31:36):
on medicine, you being acardiologist and taking that
extra step for your patients?
Dr Morgan (31:42):
You know, I thought originally it wasn't an impact
and I think because I wasdetermined to say I'm not going
to be othered.
I am a physician and I deserveto be here and I'm going to be
in the mainstream and this ishow it is.
And I'm not going to look ateverything from a black lens
because.
I have arrived and I am notgoing to be othered.
(32:04):
So I'm not going to raise myhand.
But yet there are things thatyou can't unsee as you're going.
You can not speak on them, butyou can't unsee them.
Chris (32:16):
And.
Dr Morgan (32:18):
You know, dermatology.
I mean, that was just insane.
I mean, at one point I asked myprofessor, What does this look
like on black skin?
And I answer was, just likethis.
No, just like this is not theanswer.
That's not what it's going tolook like on our skin.
I mean, just everything.
The formulas that we weredealing with, the why is there a
(32:41):
race factor in there?
Well, because, you know, we knowblacks retain water, but what do
you mean they retain?
What does that mean?
I mean, and I was just allowingthe system to give me these non
answer answers.
Mostly in my defense, I'm goingto defend myself a little bit,
You're powerless.
You're, you're a cog in thewheel.
I need these people so I canfinish my degree.
(33:04):
I need to finish my medicinerotation, my medicine residence.
I've got to do my cardiology.
You know, I'm not trying toargue with people or, you know,
look as if you're the angryblack female or you're
challenging.
So you're constantly steppingback.
When you really should bestepping forward and you have a
reason to step forward.
You have a reason to challengethe system and just say, Hey,
(33:29):
this isn't right.
This is not going to work.
This is going to triage mypeople to lower levels of care
and concern.
I see that and I know that andyet the exact same situation.
Myself and other physiciansfound ourselves in, we're at
this big medical institutionthat doesn't really value the
(33:49):
specialness of having all of ustogether.
Do you stay for your patientsbecause you know, they're not
going to get that lens if youleave.
But on the other hand is killingyour soul.
What do you do?
Do you leave and leave yourpatients and you know that they
(34:10):
will be abandoned or do youknow, so we're always in that
and in that situation, even allthrough medical school for me,
do I speak up and risk lookinglike the angry black male or I
mean, like female, or they startto, You know, marginalized me,
or it becomes more difficult forme to graduate.
I need these people to getthrough.
Let me just go along to getalong and keep my mouth quiet.
(34:34):
So, and yet you can't unsee it,right?
So here we are.
Chris (34:41):
Here we are.
And that's so true.
You know, one time I rememberthe very first time I spoke out
in training was during an M andM conference.
For those that are listening, wehave a morbidity and mortality
conference where we kind of talkabout cases that we can learn
from or cases that didn't gowell, et cetera.
And so during that conversation,there was someone who was
presenting who was not AfricanAmerican.
(35:01):
Again, I was one of maybe maybea handful in the, in the, the
hospital and during that it wasbrought up right before the
case, you know, African Americanmale comes in, get shot you
know, of course he was going toBible study.
Of course he was doing this.
And of course he was, you know,he was totally innocent.
And then everybody chuckled andthey went on.
Right.
And so it, it, it, it wasbrutal.
(35:22):
Exactly.
Exactly.
And so it was brewing inside ofme the whole time because, you
know, I grew up on the southside of Chicago.
I've been out with friends, youknow, when I was growing up that
either got shot at or got shotand we were going to football
practice, right?
Like we were, we were going toX, Y, and Z, right?
We weren't involved in anything.
And so, you know, It wasn'tuntil the very end that I could
(35:44):
not hold it in anymore.
Because like you said, this isthrough all through college,
through medical school whenyou're powerless.
And I said, you know what?
To hell with it.
If I get in trouble, I get introuble.
And I stood up and I said, youknow, I don't know if this is,
you know, if I can say this inthis, in this fashion, but I
cannot stand for this anymore.
The way that we interpret andthe way that we walk around and
speak trickles down to ourpatients.
(36:06):
It trickles down to our nurses,to our tech.
And you have that AfricanAmerican male in the trauma bay
and you're moving slower oryou're not giving pain
medication or you're not doingthe followup care.
You're not doing X, Y, and Z.
Dr Morgan (36:19):
Because you know, the system and the culture will
support it.
Chuckle about it.
Chris (36:25):
That's why
Dr Morgan (36:26):
black doctors stay in jobs longer than they should
Chris (36:30):
because
Dr Morgan (36:31):
you're worried about your patients More than
yourself.
And we're the only race that hasto deal with that.
Should I stay or should I go?
Chris (36:41):
Yeah.
Yeah.
And you know, I will say I wasvery fortunate to be in a
program that that was applaudedand, you know, they, we actually
did a couple of series afterthat, talking about, you know,
cultural competency, et cetera,but that is in the minority.
those institutions.
And so you always have to belooking over your shoulder and
saying, am I going to do
Dr Morgan (37:00):
to have to speak up and know you're taking a risk,
Chris (37:06):
right?
Exactly.
Dr Morgan (37:08):
That a risk.
You have to take a risk.
We're the only race thatconstantly as physicians, are
having to balance that riskbenefit ratio with ourselves
versus our patients.
And where's our commitmenttoday?
And if I take this risk and I ampenalized, then what service am
(37:34):
I to my patients if I no longercan serve them because I've been
whatever, dismissed ordisciplined, or, you know, so
maybe I keep my mouth shut justso I can keep seeing my
patients, but then the systemdoesn't change.
And that's what, you know, so wejust go round and round.
And the fact of the matter isyou speaking up meant that you
(37:55):
were taking a personal andprofessional risk.
Chris (37:58):
Absolutely.
Dr Morgan (37:58):
That is not how it should be.
It worked out for you, But itwas a risk
Chris (38:04):
she
Dr Morgan (38:04):
decided to take, and it could have gone badly.
Chris (38:07):
Mm hmm.
Well, you know, this podcast, Iapprecia for coming out so we
can you know, because that ca ishow we get through a l we see in
health care.
On I wanted to touch on is jperspective on cardiology You
talked about the app and we'll,we'll make sure that we get it
(38:29):
on our, on our website as wellas, you know, pass it out to all
of our of our listeners, butinvolving minority communities
with cardiology specificallywhat are some of the most
pressing issues that you see asa cardiologist today?
Dr Morgan (38:44):
Yeah.
Regarding minority, the biggestissues are obesity and
hypertension.
I mean, it's just, it's justbread and butter, right?
And we know now thatinflammatory conditions are
actually the predicators ofdeveloping heart disease.
Obesity causes chronicinflammation in the body.
(39:06):
And yet, you know, obesity is socomplicated that Because it is
often driven by money, it costsmoney to eat fruits and
vegetables, to eat organicfoods.
If you haven't gotten a goodeducation, you don't have a good
(39:28):
job, or let's just say, You dohave an education and you've
been able to get a job, but youhaven't been able to get
promoted.
You're not going to be moved upin the ranks.
You always will stay where youare and people will move beyond
you.
It limits your ability to makechoices.
And those choices include kindsof foods you eat.
(39:52):
Those choices will include thetype of neighborhood you live in
and whether or not you'll beable to.
Exercise outside and have accessto parks and walkable areas.
It will impact your choices thatwill then impact your longevity.
(40:13):
And those are the things, thoseare the connections that we have
to start to make.
Obesity is driven not only byoverconsumption of calories, but
by cheap foods, processed foods,readily available foods.
Tasty foods, foods loaded withchemicals.
Why are those chemicals there?
Those chemicals there to improvethe texture, make it more
(40:37):
palatable, give it a nice color.
You know, you crave it more.
And so then this, these areempty, we call those empty
calories, and they just kind offeed on themselves.
I think obesity is huge.
And then hypertension is thenext one.
Hypertension, because it is themost undiagnosed disease.
condition, not only in theUnited States within our
(40:58):
community, but also in theUnited States can most can still
be easily treated, but listen, Ihave never treated a blood
pressure that wasn't firstdiagnosed.
Chris (41:10):
And
Dr Morgan (41:10):
most of them are still undiagnosed.
So now we're back to kind of theapp that I'm dealing with, but
also just if you're seeing yourphysician and you have been
prescribed medications, takeyour medication.
And then.
Get your follow up appointmentsand make certain we can treat
your blood pressure to goal.
When we say to goal, that meansthat top number needs to be 120
(41:35):
or ideally maybe even a littleless.
Not 140, 133.
Oh, it's good enough.
It's okay.
If your doctor tells you it'sokay, that's No bueno.
Chris (41:52):
No.
Dr Morgan (41:52):
We don't want somebody to tell you.
It's okay.
Okay.
Is code for good enough for you?
Chris (41:57):
Mm-Hmm.
Mm-Hmm?
Okay.
Dr Morgan (42:01):
You think Okay.
Means that it's okay, but DoctorSpeak means it's good enough for
you.
It needs to be 120 or less.
That top number, and that's whatyou need to say.
But Doctor, it's only, it's 133.
I was listening.
To a podcast with Dr.
Ford and Dr.
Morgan.
And they told me that you weresupposed to treat me until I got
(42:24):
to 120.
So I need you to do that.
And that's the top number andthe bottom number needs to be
80.
We need to stop accepting okay.
And it's not our fault, becauseokay generally means that it's
okay.
But in science, that's not whatit means when someone's telling
you that.
Chris (42:39):
It's a zero or a one, right?
It's a yes or a no.
Dr Morgan (42:43):
Right.
Chris (42:44):
No, and that's so true.
And a lot of times, too, whatfolks don't understand is that
especially in the cases ofhypertension, it's that silent
killer, right?
And so until it becomes an issuewhere you come and see me in the
emergency department then Icounsel, you know, Dr Morgan to
come down and check on you.
If something's going on, you,you, you are walking around day
(43:04):
to day and not feeling anyeffects from it, or maybe every
now and then, but, but not everyday.
And so it's very important totake those medications.
It's important.
If you don't have.
Exactly.
If you don't have access tothose medications, there are
programs especially now with,you know, we have been doing a
couple of things with theinflation reduction act that
some medications have becomemore affordable.
So, so make sure that you'rechecking all those lists.
(43:25):
If you can't afford yourmedication, do not skip them.
Please, please, please don'tskip them.
Dr Morgan (43:29):
And the single most important thing you can do for
yourself is if you're smokingcigarettes to stop smoking.
And it's especially importantfor women because, you know, The
deleterious or bad effects ofcigarette smoking have a higher
propensity, we call thatpropensity index, in women than
in men for the same number ofcigarette smoking.
(43:49):
And there are about fourtraditional cardiac, meaning
heart factors, four traditionalrisk factors for heart disease,
that actually, if you have themas a woman, You've got a higher
propensity index, meaning theyare going to have more of a
negative effect on you than theywill on your brother with the
(44:10):
exact same numbers.
Obesity is one of them, theother is cigarette smoking, the
other one is diabetes.
In fact, Men who are diagnosedwith diabetes have twice the
risk of dying from heartdisease, but women diagnosed
with diabetes have three timesthe risk.
And then the last one ischolesterol.
(44:31):
These are traditional riskfactors for everybody, but they
have a higher pensity index.
They have a higher A higher rateof having bad outcomes in women
than in men.
And so we need to make certainthat these are things that we
really try to modify.
We talk about that diet all thetime.
Exercise, things that you can dowith your lifestyle and avoid
(44:55):
medications.
But if you're a prescribedmedications, please take them.
Don't say, Oh, I'm not going totake it.
I'm just going to exercise.
No, take it because for somereason you're being diagnosed
now.
Go ahead and exercise.
And then later, if you don'tneed them, we can remove
Chris (45:10):
them.
You're done.
Exactly.
Exactly.
Exactly.
One of the things that we talkedabout here are those risk
factors.
So you said obesity smoking canput you at higher risk of some
cardiovascular conditions.
What are some of thecardiovascular conditions that
you're seeing that aredisproportionately affecting the
African American community?
Dr Morgan (45:28):
Yeah.
Hey, let's talk about it.
Hypertensive diseases ofpregnancy.
Talk about that.
If you have been diagnosed withhypertension in pregnancies,
sometimes they use these termslike preeclampsia or eclampsia
or something like that, or evendiabetes.
Do you know that if you arediagnosed with diabetes during
your pregnancy, your risk ofheart disease is higher than a
(45:52):
woman who has not been diagnosedfor the next 25 years after,
after the delivery of that baby?
Not only that.
If you have been diagnosed withany hypertensive disorders, you
should follow up with acardiologist because your long
term risk is going to be higher.
And what we've seen as in theentire biochemical milieu is
(46:16):
that if you're diagnosed withhypertension, you end up with an
aberration in your cholesterolprofile, your triglycerides,
your LDL, your HDL.
So for some reason, thathypertension or preeclampsia is
a marker.
For other things that arehappening in your body, that is
a wake up call.
The stress test is actually thevery, the pregnancy is actually
(46:38):
the very first stress test thata woman will have.
So here is something, if you alldon't get anything else from our
talk today, I want you to makecertain, especially women, that
whenever you go to thephysician, Between now and the
rest of your life, you give themyour obstetric history, meaning
(46:58):
your pregnancy history.
And if they don't ask before thedoctor leaves room, say, doctor,
don't you want to hear mypregnancy history?
Chris (47:08):
Be your advocate.
Dr Morgan (47:10):
And then you give it to them because That can drive
and determine the type of careand concern that you receive
later.
Pregnancy is your first stresstest and it can mark you for
things and cardiac events thatcould happen later.
And we have an opportunity tointervene early and whenever you
(47:34):
go to the doctor, that doctorneeds to know your obstetrical
history because it will guide,it should guide their thought
process.
If they don't ask, you need tojust give it to them.
I'm just gonna help you, I'mgonna, let me help you help me.
Chris (47:48):
Absolutely.
Absolutely.
And to drive that home forlisteners here in Milwaukee, we
recently, a couple of yearsback, I believe it was right
before the pandemic.
We had a African American younglady who had a cardiac
condition, a heart failureassociated with her pregnancy.
They ended up dying in one ofour emergency departments here
and they did not know.
(48:08):
That until after the fact, theywent back through her chart and
saw that someone had diagnosedher with a cardiomyopathy or
cardiac condition associatedwith her pregnancy.
So, that's just driving Dr.
Morgan's point home to say, thishappens often and again, these
are things that, you know, yourdoctor, if you bring it up.
They can look into it.
(48:28):
They can do those tests as anoutpatient so they can schedule
you.
You go to a clinic, you know,office during the day and get
that ultrasound done and thenyou know, or you don't know, but
it's key that you have thatevaluation done before it's too
late.
Dr Morgan (48:42):
Right.
Chris (48:43):
Yeah.
So Dr.
Morgan,
Dr Morgan (48:44):
take that, take that with you.
Chris (48:47):
Exactly.
Take it with you.
One of the things that we talkedabout, we did a case beforehand.
And in that case it was a caseof a 60 year old woman who came
in with Tooth pain as well assome nausea associated with it.
At the end of the day, it endedup being that she had a, am I a
heart attack?
And actually stayed home for awhile.
(49:08):
So she was actuallyunfortunately in cardiogenic
shock.
A lot of that point was to drivehome.
The fact that for women, moremyocardial infarctions or heart
attacks present a lotdifferently than they do
typically for men.
Could you talk about that alittle bit and what your
experience has been in those, inthose differences of
presentation?
Dr Morgan (49:25):
You know, and that's right.
And then, you know, and let me,and, and, you know, and women
can also present with, with the,you know,
Chris (49:31):
absolutely.
Dr Morgan (49:33):
But then we can have this other stuff too.
Chris (49:35):
And
Dr Morgan (49:36):
here's something I want to go back to our med
school.
When I talk about things wherewe were just like, pressing our
lips together, but not saying,
Chris (49:42):
yeah,
Dr Morgan (49:45):
I don't even know how to start this when.
What Dr.
Ford is talking about, thesesymptoms of jaw pain, tooth
pain, nausea, back pain, flulike symptoms which actually
could be symptoms of heartdisease in women in medical
school and in training.
And even in my cardiologyfellowship, those symptoms are
(50:08):
referred to as atypical.
They are assigned the wordatypical.
This is how you chart it.
It is the standard.
Nomenclature.
Now just think about how wordsand descriptions drive thoughts
and actions.
(50:31):
And by describing it asatypical, it's another way to
other it.
Not as important.
Something additional.
If we have time, we might learnit, but we're not going to be
tested.
It's going to be the main thing.
We're going to other that.
Well, here, here's my thought onthat.
(50:51):
Women are 51 percent of thepopulation.
We are the majority of thepopulation.
How did our symptoms get to beatypical, right?
So, maybe we're having the morestandard symptoms, and it's like
the men who need to be othered.
Chris (51:06):
No, no, no, no.
I agree.
Dr Morgan (51:11):
I'm just saying another example.
I could give you hundreds as Iknow, Dr.
Ford could going through medicalschool and training where you're
just like, Oh, I'm just going tokeep my mouth shut.
I'm not going to say anything.
You know, you're, you're, youknow, I didn't go into
gynecology for a number ofreasons, but one of them is
that.
No, they named things like yourcervix and incompetent cervix,
(51:34):
the shy bladder that all these,I just was like, Oh, does
anybody not feeling nauseous aswe're going through?
Right.
Why does a woman's cervix haveto be incompetent?
There's nothing, there's no partof the man's body, nor condition
that we term as beingincompetent.
(51:55):
So words matter.
Chris (51:57):
All
Dr Morgan (51:58):
right, I'm back to chest pain.
I've gone.
No,
Chris (52:00):
no, no.
Thank you.
Dr Morgan (52:03):
Caught up on another, another thing.
Chris (52:05):
And so
Dr Morgan (52:06):
atypical.
So don't forget it's atypical.
And that also means that you asa woman and as a man, and as
society.
You also haven't learned thesesymptoms, right?
We watch TV, we watch things,everybody has crushing chest
pain, shortness of breath, theyfall on the floor, we call 911,
they have sweating, whatever,right?
Nobody ever tells us that, hey,you might just feel run down, or
(52:31):
you might feel tired, you mighthave nausea, or you might have
jaw pain, it sends you to thedentist to check a tooth.
Nobody tells you that.
And then when you come to seeyour physician, They may not
even recognize it becauseatypical really means, eh, might
be hysteria, might be anxiety,might be, you know, I don't
know, it's a little nebulous,that kind of thing.
(52:53):
That's why I say words drivethoughts and they drive people.
Actions and the things that weare tested on the things that
are reproducible are the thingsthat we will act on and that we
will remember we are not testedon that.
In other words, we are not heldto accountability.
On those types of atypicalthings.
(53:14):
And so, the health system isalso at fault.
And so, here a woman has thesesymptoms.
She stays home for hours, days,weeks, longer than she should.
Then when she finally comes tothe medical establishment,
They're giving the proverbialpat on the back that they're
there they're there.
(53:34):
Here's an anti anxiety medicineHere's a panic or you know,
whatever Every now and and I'mgiving you this example because
this is why?
physicians stay in badsituations longer than they
should because they know if theyleave people might die.
They are.
They recognize and it is such ahard and unfortunate position to
(53:59):
place minority positions in andto place women positions in when
we're looking and treatingpatients from a different lens.
And, you know, had that patientnot come to you, but For the
sake of God, that patient mayhave perished or had a worse
outcome that would have impactedthem for the rest of their life.
How can I leave and let thathappen to people, even though
(54:24):
other things are happening tome?
that are making my lifemiserable.
We have this all of the time.
And so back to atypical chestpain.
This
Chris (54:33):
is what
Dr Morgan (54:34):
happened.
I
Chris (54:34):
know.
Everything you're saying rightnow, I'm telling you, it's the
word.
That's what we need to hear,absolutely.
Dr Morgan (54:42):
And so then when you come to the physician, what
happens?
you have a delay in getting tothe cath lab.
We know that every 30 minutes ofa delay increases your risk of
having a heart attack and losingmore heart muscle.
There is a longer and longerdelay.
Women's time getting to the cathlab is much longer than men's
(55:02):
time.
And then even after that, let'ssay you had a heart attack, you
end up with revascularization,meaning they opened your
arteries, all of these things.
for joining us.
Only 72 percent of women willeven be offered high intensity
cholesterol therapy or highintensity blood pressure
therapy, only 72 percent evenafter your event.
(55:26):
Yeah, so we have a long way togo.
This is, I talk about thesekinds of things all the time.
There is the system doesn't Workfor women.
It doesn't work for minoritiesand you only have to be a
minority woman and a physicianin the system to see it so
(55:46):
glaringly.
And, you know, I reached a pointin my career where I just felt
that I couldn't not, not speakanymore.
But I will say this, that it wastoo long.
And the reason I didn't speakearlier is because I didn't.
Want to take the risk.
(56:07):
I'm doing the risk balanceratio.
If, if I speak up and theybanish me, then I'm no good to
anybody.
And so there was at some pointwhere I got to my career, I just
had to, you know, speak up.
So, you know, and it may be youget to a point where you're just
like, what are you going to doto me now?
Or it may be that you find yourtribe, that you find and an
(56:30):
organization and people who arelike minded whose values align
with your own and you have thesupport to continue to do the
right things because we cameinto this to heal people,
Chris (56:45):
right?
Dr Morgan (56:45):
We're here to preserve life.
And what happens in medicineoftentimes to minorities and
women's is the antithesis ofthat.
Chris (56:58):
Yeah, absolutely.
So better more, what we're goingto do is I'm gonna ask you just
a couple of questions to closethis out here.
Do you, what do you think thehealthcare system can do better
to address these disparitiesthat we talked about?
Cause we talked about it fromthe standpoint of minority
health, from the standpoint ofsocial determinants, as well as,
you know, gender inequities too.
(57:18):
What are some things that youthink the in moving forward that
we all can do, I can do,patients can do, et cetera.
Dr Morgan (57:24):
Yeah, we need to have more principal investigators of
research clinical trials who areblack.
That means that the drugcompanies and research and
pharma and biotech companiesneed to train Physicians we they
don't recruit see there's somany parts of this They don't
recruit black physicians to leadtrials.
We know the number one reasonthat a patient will enroll in a
(57:47):
clinical trial is if she or heis approached by a trusted
physician.
That's any race, any creed, anyculture.
80 percent of African Americanpatients are seen by African
Americans physicians here.
in this country for all thereasons I just named, right?
We first picked people where wecan trust them.
(58:07):
We can trust that they will notfirst do us harm, that we can
believe what they're saying.
So if 80 percent of the blackpopulation is seen by black
physicians and almost 0 percentof black physicians Our trial is
Stanley clinical trial.
And we know that the number onereason that a patient will
enroll in a clinical trials.
(58:28):
If they're approached by aphysician, you can see where I'm
going where we end up withmedications.
We don't really know if theywork for us or not.
You know, we don't really knowwhat's happening.
You know, currently there's ablood pressure medicine that I'm
looking at more carefullybecause it seems to me I
continue to hear better.
Testimony and anecdotes thatblack women, when they're taking
it, start to lose their hair.
(58:51):
Well, that's not a part of theside effects from the clinical
trial profile.
But when you look into it, Oh,they didn't really enroll black
women.
So now here we are out in realworld use.
And we're losing our hair whenwe take the medication, you talk
to your doctor about it.
What does your doctor say?
Well, it's not one of the sideeffects.
Chris (59:09):
Yep.
It's in your mouth,
Dr Morgan (59:12):
which is correct, right?
So they're treating you to thetop of evidence based medicine.
Chris (59:17):
Right.
Dr Morgan (59:17):
But if you're with a black doctor, a black doctor
will say, Hmm,
Chris (59:24):
that's a big deal.
Is
Dr Morgan (59:28):
a big deal.
And so we really need to havepeople in research.
We need to have people who areleading research, like at these
big medical centers, the chiefscientific officer, the chief
research officer.
These are positions that need tobe held by women, by people of
color.
It doesn't mean that white mencan't have them.
They can also have them, butyour team needs to have people
(59:50):
who have a 360 degree lens onyour patient population in that
hospital and not just led bygroup thing.
The chief medical officerreinforces with the chief
scientific officer saying, wereinforce it with chief research
officer and nobody has anydifferent ideas.
So they just all congratulatethemselves and never, not in a
mean way, They just didn't knowthat there was another something
(01:00:12):
else to think about becausenobody brought it to their
attention and nobody brought itto their attention because
there's nobody sitting at thetable who's in power, that they
have been powered to bring it totheir attention.
And the last thing that I'll sayis the most educated demographic
in this country is the blackwoman.
Black women have the highestlevel of education and the most
(01:00:33):
degrees in this country.
And that certainly is notrepresented in the jobs that we
hold in the places that we go inthe seats that we have.
We don't have a place that thetable work hard to get to the
middle.
And we can never get furtherthan the middle.
So listen to me, listen closelyto what I'm saying.
(01:00:53):
If you need to leave, you leaveand go get your black job and
you continue to maximize all ofyour achievements because every
place won't value you.
wherever you are.
And even though I know you say,if you leave, this is going to
happen in my patients, this, butonce you can get out and achieve
more power and moreindependence, you have the
(01:01:15):
ability to influence externally.
So don't stay for the sake ofstaying.
Many of us do that.
I get it.
But just Think about how all ofthat works because we work very
hard.
We don't have the ability topass down generational wealth.
We never are promoted in jobsthat are higher, high paying
(01:01:37):
enough.
It determines the schools thatyour children will go to, the
education they will receive, thehousing that you can provide,
the foods that you can choose,whether you can have organic or
not, it's going to impact yourlongevity.
Let me tell you something.
Number one, Factor in the UnitedStates of America for long life.
It's not good cardiac health.
(01:01:59):
It's not, you know breastcancer.
It's not, if you're a runner, along distance runner, the number
one indicator for living a longlife is how much money you make.
So, when you look at Jeff Bezos,And the heads of Microsoft, you
(01:02:19):
don't have to know any of theirmedical history, but just the
fact of their financialstanding, they're going to live
longer than you are.
That's how America works.
Chris (01:02:31):
Yeah, absolutely.
Dr.
Morgan, you know, I, Iappreciate you coming out and
talking to us.
I hope to have you on again,more so just, just for my own
edification.
I feel like I've been healedfrom this conversation, but
definitely thank you so much forour listeners.
Absolutely.
Please be sure to check outstairwell chronicles Dr.
(01:02:53):
Morgan.
Again, I'll post your your app'cause I definitely want to get
that out to our listeners too.
Yeah.
The Hello,
Dr Morgan (01:02:59):
hello Heart app and hypertension.
We are here to really solve thatproblem and to stand in the gap
especially for women's health,especially women in menopause.
We didn't even talk about thattoday and how your risk of heart
disease increases.
But get a chance.
Look at the Hello Heart app.
And follow HelloHeart and youcan follow me as well at Dr.
Jane Morgan, D R J A Y N E M O RG A N.
(01:03:23):
Submit a question.
I might, I might put it on mystairwell chronicle, answer the
question for you.
Chris (01:03:28):
Absolutely.
Absolutely.
Well, thank you so much, Dr.
Morgan.
We'll, we'll, we'll be sure totalk about it next time.
Thank you very much.
All
Dr Morgan (01:03:33):
right.
Chris (01:03:34):
Bye.
All
So that's it.
I want to thank Dr.
Jane Morgan for coming out andspeaking with us.
I hope she comes out again andspeaks further because there's
much more we need to get into.
Um, and I know I speak for a lotof folks out there to say that a
lot of what she had to offer.
Was very eyeopening was verymuch what a lot of folks needed
(01:03:55):
to hear.
Especially younger doctors inthe beginning of their career,
folks that are just now cominginto knowing they have diabetes
or high blood pressure, etcetera.
And how we can utilize themedications that we take.
And some of the actions that wedo in our day to day choices in
terms of exercise, in terms offoods that we choose.
(01:04:17):
If we have the choice to do so.
That may affect our health inthe long run.
Please feel free to check outher.
Feature content, which is thestairwell Chronicles.
You can check that out onInstagram.
On Tik TOK on X.
Now the former Twitter.
So feel free to check that out.
Also check out her app as well.
(01:04:37):
I will place a link to her appfor everyone out there.
Because I think that it's reallygood at terms of increasing our
awareness.
And our health and keeping us ontop of everything.
That app is called.
Hello, heart.
And again, I'll place a link toHello Heart that you all can get
that on your devices.
(01:04:59):
This is a first episode ofseason two.
This is your warning thingsabout to get real to season.
We're going to continue to bringyou content of this same ilk.
I want to make sure that we getto the core of some of the
issues.
And to be honest with you, theonly way to do that is to talk
about these issues.
It's not to skirt around them.
(01:05:20):
And we're going to continue todo that in the next several
episodes, just because we can'tkeep doing the same thing over
and over again, we have to comeup with.
Some meaningful resolutions tosome of the issues that we're
seeing over and over and overagain.
Here in the state of Wisconsin.
Next month will be our nextepisode.
(01:05:42):
And because we have.
Some pretty monumental electionscoming up.
What we're going to do is we'regoing to bring you some topics
that are going to affect yourhealth in the state of
Wisconsin.
And so we'll have some veryspecial guests that are going to
be coming on to talk a littlebit more about some of the
public health issues and some ofthe public health legislation
(01:06:03):
that is affecting the health ofWisconsinites throughout the
state.
So.
Feel free to reach out to me ifyou have any other questions.
About this episode or aboutother episodes as you've been
doing in the past, and we'relooking forward to presenting
that information.
As an aside.
What we'll be doing also is wewill be.
(01:06:24):
Putting information out therefor anyone who wants to donate
To a great cause for the braintumor foundation..
There is a nurse that I workwith.
Her name is Chelsea.
I'll put her information outthere too, but she.
Is, you know, one of these.
Superheroes amongst us that Runsmarathons.
(01:06:45):
And so, you know, my.
Support goes out to her.
She'll be running for the braintumor foundation.
And essentially what this is, isa group of runners who come out
and they will dedicate, theirrun to increasing awareness of
brain tumors, as well as tryingto garner support for research
(01:07:08):
garner funds for research, etcetera.
And so.
Brain tumors and cancers arethings that affect.
Pretty much anyone that, youknow, if you're not affected
yourself personally, having.
Had a friend of mine in college.
My good friend, Rashaun Black orBeau as we call them.
(01:07:28):
Hu.
Was a teammate of mine incollege.
Unfortunately died secondary to.
Glioblastoma multiforme I wantto make sure that we do all that
we can to support brain tumor.
Research and make sure that wedo all we can to support folks
who are doing things in thecommunity in order to eradicate,
you know, this, disease process.
(01:07:49):
So.
Feel free to support her link.
I'll put that out there as muchas we can.
As always, thank you so much forjoining us.
we're looking forward to seeingyou.
In the next couple of weeks andas always take care of
yourselves, take care of eachother.
And if you need me.
Come and see me.
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