The Host Response: A FirstcallID Podcast

When physicians retire, we often focus on how they leave practice. Less attention is paid to the physician who inherits their patients. In this episode of The Host Response , Dr. Paul Bunce reflects on the experience of assuming care from retiring colleagues and mentors. Patients aren't simply transferred from one chart to another. Many have spent years, even decades, building trust with a physici...

Are superficial wound swabs really useless? In this episode of The Host Response , Dr. Paul Bunce challenges the conventional wisdom around superficial wound cultures and explains when a swab from purulent drainage might actually provide a useful clinical clue. The key is knowing when to ignore the junk that grows, and when a culture might help guide therapy in a patient who isn't improving.

A sexual history is about much more than deciding which STI tests to order. In this episode of The Host Response , Dr. Paul Bunce explores why taking a thoughtful, nonjudgmental sexual history remains an important part of infectious diseases care. Beyond guiding testing, these conversations can uncover opportunities for prevention and open the door to discussions about relationships, consent, subs...

Sometimes the hardest part of medicine isn’t knowing what to do, it’s recognizing when you need to do it now. In this episode, Paul Bunce explores the clinical “window of opportunity”: that period when the diagnosis is still uncertain, but the opportunity to make a meaningful difference is beginning to close. Small delays in investigations, procedures, consultations, or treatment can accumulate, p...

What happens when a patient is clearly sick, but every specialist says, “It's not my disease”? In this episode of The Host Response, Dr. Paul Bunce explores diagnostic uncertainty, specialist “not me” opinions, and the danger of becoming too certain when a patient doesn’t fit a familiar pattern. How do we distinguish “unlikely” from “impossible”? How do we communicate uncertainty to patients h...

What is fever, exactly? In this episode of The Host Response , Dr. Paul Bunce explores one of the most common (and often misunderstood) clinical findings in medicine. What distinguishes fever from hyperthermia? Is "feeling feverish" the same as having a fever? Why do fevers come and go? And why is fever best understood as a host response rather than a diagnosis? Through practical clinica...

For many younger clinicians, HIV is now a well-managed chronic disease. But for many patients, it carries memories of a very different era. In this episode of The Host Response , Dr. Paul Bunce reflects on how his understanding of HIV evolved; from childhood memories shaped by television and the media, to caring for people living with HIV whose stories transformed his perspective. Along the way, h...

How do we decide who the "great" physicians really are? In this reflective episode of The Host Response , Dr. Paul Bunce explores how reputation changes with perspective. From keynote speakers and internationally recognized experts to the quiet clinicians who keep healthcare systems functioning, visibility and excellence are not always the same thing. Drawing on experiences from Infectio...

In this installment, co-host Brooke Fraser returns as we discuss educational resources that have shaped our learning, including This Podcast Will Kill You, Febrile's infographic library, and a particularly memorable recent episode of Breakpoints. From the literature, we review a multi-centre study examining ophthalmologic screening in candidemia and discuss the recent randomized trial of vanco...

When a patient develops an infection without an obvious source, someone will eventually suggest a familiar explanation: translocation . In this episode of The Host Response, we explore the biology behind bacterial translocation, why the concept is often invoked in Infectious Diseases, and how a plausible mechanism can sometimes become a substitute for finding the real source. Using cases of E. col...

Discharge from hospital is often treated as a conclusion, but in practice, it frequently marks the start of a less clearly defined phase of care. In this episode of The Host Response , we explore the concept of “holding the bag” in infectious diseases and internal medicine: what happens when responsibility for follow-up is not clearly assigned after discharge. We discuss common real-world scenario...

In this fourth instalment of Bundles, Dr. Paul Bunce is joined again by Dr. Brooke Fraser to cover a mix of Infectious Diseases insights, useful resources, and ideas from beyond medicine that shape how we think and practice. In this episode: 🧠 Teaching tools The Gorgas Course - Case of the Week - A practical, case-based tropical medicine resource from the Gorgas Course A visual, diagnostic reason...

In this episode of The Host Response, Dr. Paul Bunce explores a deceptively simple problem in infectious diseases: the clinical story you’re given isn’t always the story you need. From “CSF was clear” to “ALL of the hardware is out,” small assumptions, missing details, and imprecise language can quietly shape major management decisions. In a field where treatment depends heavily on context, verify...

When should you say everything you’re thinking...and when should you hold back? In this episode of The Host Response, Dr. Paul Bunce explores a subtle but important aspect of clinical reasoning in infectious diseases: timing. Consultants often carry multiple working diagnoses, contingencies, and “next steps” in mind, but not all of these need to be voiced immediately. Knowing what to share, when t...

How do you choose the “right” antibiotic once cultures are finalized? In this episode of The Host Response , Dr. Paul Bunce walks through one of the most deceptively complex steps in infectious diseases: selecting definitive (or “destination”) antibiotic therapy. While it may feel like the easy part of the case, this decision involves balancing multiple competing factors and not just picking the n...

In this episode of The Host Response, Dr Paul Bunce reflectson the lasting influence of Mark Crislip, known to many as the Puswhisperer, and his infectious diseases podcasts Persiflager’s Infectious Diseases Puscast and Gobbet o’ Pus. From 2007 to 2021, the Puscast offered a biweekly review ofthe infectious diseases literature, combining sharp critical appraisal with practical clinical insight. Fo...

In this episode of The Host Response, Dr. Paul Bunce explores a deceptively simple but powerful skill in medicine: using the insights of your colleagues when facing challenging cases. Drawing on a real life blastomycosis case and strategies for spotting blind spots in your own reasoning, Paul shows how mentally asking “WWJD?” what would your experienced peers do can guide decisions, clarify uncert...

In infectious diseases, reading the radiology report is not enough. In this episode, Dr. Paul Bunce explains why looking at imaging yourself is a core part of a thoughtful ID consultation. From abscesses that sound impressive on paper but are not actually drainable, to pleural effusions, pneumonias, postoperative collections, and liver abscesses, this episode explores how reviewing the images chan...

Dr. Paul Bunce and Dr. Brooke Fraser (newly minted Adult IDspecialist), bring you the third episode in our “Bundles” series with fourquick-hitting topics blending infectious diseases and beyond. Resources & Highlights: Sunnybrook Antimicrobial Stewardship AppA practical, user-friendly tool for antibiotic guidance, dosing, and special situations like pregnancy. Online TST/IGRA Interpreter (TSTi...

Why do some patients worsen after starting the right antibiotics? In this episode, Dr. Paul Bunce breaks down the post antibiotic inflammatory crash, why it happens, how to recognize it, and how to manage deterioration without reflexively broadening therapy. A must listen for trainees facing the unnerving moment when treatment appears to make things worse.

In this episode of The Host Response , infectious diseases physician Paul Bunce reflects on how clinical judgment, priorities, and perspective evolve over time in practice. Drawing on advice he shared early in his career (and revisiting it a decade later) this episode contrasts three tips for new ID doctors then with three updated lessons now , highlighting what has changed and what has stayed the...

In this episode of The Host Response , Infectious Diseases specialist Paul Bunce flips the usual conversation about “favourite ID consults” on its head. Instead of rare pathogens and diagnostic fireworks, this episode focuses on the consults many ID clinicians quietly dread and why they may be some of the most meaningful work we do. Topics include: Recurrent urinary tract infections and lower urin...

The Bundle 2.0 is here. In this episode of The Host Response , Dr. Paul Bunce and returning guest Dr. Brooke Fraser take another rapid-fire tour through what’s catching their attention across infectious diseases and adjacent domains: teaching tools worth knowing, papers that may shift practice, ideas from outside ID that still matter, and the small-but-important clinical pearls that surface in eve...

This episode explores the infectious diseases approach to rashes, skin lesions, and cutaneous manifestations of systemic illness. We review key diagnostic clues, high-yield dermatologic findings in infectious diseases, and life-threatening rash presentations clinicians must recognize early. Topics include erythema nodosum, Sweet syndrome, nodular lymphangitis, pyoderma gangrenosum, disseminated vi...

In this episode of The Host Response , Dr. Paul Bunce (Infectious Diseases specialist and clinician teacher) reflects on his complicated relationship with academic writing. From a fellowship project that refused to die to his mother’s psychic prediction that he’d one day be “published,” this episode explores what makes a medical paper worth writing. He shares his personal criteria for taking on a...