Alex Smith

San Francisco

Co-founder: GeriPal Podcast, ePrognosis | Work: Professor UCSF palliative & geriatrics | Exec Editor JAGS | Personal: father, cyclist, backpacker, Warriors fan

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Articles

Lucid Episodes: Andrea Gilmore-Bykovskyi & Andrew Peterson

1 week ago | geripal.org | Alex Smith

Have any of you watched the movie “The Notebook”? At the end, one of the characters, who has dementia, experiences an episode of lucidity.
Music as Medicine: Jenny Chen, Tyler Jorgensen, & Theresa Allison

2 weeks ago | geripal.org | Alex Smith

As you know, dear listeners, I love music. We start each podcast with a song in part to shift the frame, taking people out of their academic selves and into a more informal conversation. Well, today’s guests love music at least as much if not more than me, and they each make a strong case for music as medicine. Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Look for Jenny to potentially appear on the show America’s Got Talent (no lie).
I wish I didn’t have an itch up my spine

3 weeks ago | thecentraltrend.com | Alex Smith

Categories: May 16, 2025 This column started just as so many did—with a blank screen, a blinking cursor, and the lack of motivation to shuffle through my feelings in search of the ones I want to write down. I find a strange comfort in the fact that, for four years, that has not changed. No matter what, I’ve had this doc, this cursor, and a strong lack of motivation. But I can’t find comfort in the fact that this is the last time.
Nudges for Prognosis and Comfort Care in the ICU: Kate Courtright, Scott Halpern, & Jaspal Singh

3 weeks ago | geripal.org | Alex Smith

Our main focus today was on nudging critical care clinicians to consider a more palliative approach to care. Our guests are all trained in critical care: Kate Courtright, Scott Halpern, and Jaspal Singh. Kate and Scott have additional training in palliative medicine. To start, we review:What is a nudge? Also called behavioral interventions, heuristics, and cognitive biases.
Psilocybin in Serious Illness: James Downar, Ali John Zarrabi and Margaret Ross

1 month ago | geripal.org | Alex Smith

We’ve covered psychedelics on the podcast before—first in 2019 with Ira Byock, where we explored their potential role in medicine, and then again in 2023 with Stacy Fischer, Brian Anderson, and Theora Cimino, focusing on the reasons to approach psychedelic use in patients with caution. In today’s episode, we’re taking a closer look at the current state of the science around one specific psychedelic: psilocybin.
HIV, Aging, and Palliative Care: Peter Selwyn and Meredith Greene

1 month ago | geripal.org | Alex Smith

Peter Selwyn, one of today’s guests, has been caring for people living with HIV for over 40 years. In that time, care of people with HIV has changed dramatically. Initially, there was no treatment, then treatments with marginal efficacy, complex schedules, and a tremendous burden of side effects and drug-drug interactions. The average age at death was in the 30s. Now, more people in the US die with HIV rather than from HIV.
Potentially Unsafe Low-evidence Treatments: Adam Marks, Laura Taylor, & Jill Schneiderhan

1 month ago | geripal.org | Alex Smith

More and more people are, “doing their own research.” Self-identified experts and influencers on podcasts (podcasts!) and social media endorse treatments that are potentially harmful and have little to no evidence of benefit, or have only been studied in animals. An increasing number of federal leaders have a track record of endorsing such products. We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently.
Loss of DEI Hurts Everyone: Farah Stockman, Ali Thomas, Ken Covinsky

1 month ago | geripal.org | Alex Smith

I read Farah Stockman’s article in the NYT on why attacks on DEI will cost us all, and thought, “Yes, and ‘everyone’ includes harm to our healthcare workforce, our patients, and their families.”So we’re delighted that Farah Stockman, pulitzer prize winning journalist, author of American Made: What Happens to People When Work Disappears, and editorial board member at the New York TImes joins us to set the bigger picture for this discussion.
RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest

2 months ago | geripal.org | Alex Smith

Early in my research career, I was fascinated by the (then) frontier area of palliative care in the emergency department. I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? This is not why I went into emergency medicine. I went into emergency medicine to act.
GeriPal Takeover! Nancy Lundeberg and Annie Medina-Walpole

2 months ago | geripal.org | Alex Smith

Whelp, goodbye folks! Eric and I have been DOGE’d. In a somewhat delayed April Fools, Nancy Lundeberg and Annie Medina-Walpole have taken over podcast host duties this week. Their purpose is to interview me, Eric, and Ken Covinsky about your final AGS literature review plenary session taking place at the Annual Meeting in Chicago this May (for those attending, our session is the plenary the morning of May 10).