The Danbury Medical Files

Send us Fan Mail In this podcast, I want to take a moment to thank all of the residents who are graduating this year, in 2026. I had the privilege of meeting many of you in 2023, some at the beginning of our time together and others later during your residency journey. Since then, I have watched you grow—not only as physicians, but as people. It has been remarkable to see your development, your de...

Send us Fan Mail Have you noticed that many systems and services no longer seem to work for you the way they once did? Have you noticed how social media has changed, becoming less about connecting people and more about something else entirely? These changes are described through the concept of “enshittification,” introduced by Cory Doctorow. In this episode, I apply those ideas and observations to...

Send us Fan Mail In this new episode of the Danbury medical files, I share with you one of the many adventures I had with my dad Dr. Victor Espana Pinetta MD, MPH. I am trying to describe one of the multiple vaccination campaigns that he led in my home country Guatemala. After that, I have a few thoughts about the situation of the measles cases that are piling up in the United States because of la...

Send us Fan Mail In this ad-lib podcast, I explore my first impression of my experience in teaching and using POCUS in the outpatient world. I will try to tell you how this happened, how I feel the program is going, and whether I believe it is useful.  Also, some of my experiences, feats, challenges, and hopes. Hope you like the episode.   Soon, I will have an email for you to give me feedback.  ...

Send us Fan Mail In our medical career, one of the things that we are thought since we start is importance of privacy in to keep the patience, privacy safe. We even have laws that penalize anyone who shares private information from patients. This is not true when large companies are irresponsible with the way that they treat our medical information. It is also important to have awareness of this p...

Send us Fan Mail In this episode I am discussing the effects of hospital and healthcare systems mergers.  I have tried to place a vast amount of information in a few minutes.   I hope this will be of your interest and will be good information.  Lastly, a call for action from all the physician community.  We need to participate more, sadly participating more can be risky, however, in the current ti...

Send us Fan Mail In this episode of the Danbury Medial Files, I talk about three patients where POCUS was used successfully in the outpatient clinic.  I also talk about lidocaine side effects, anxiety as a common side effect of procedures. A second case of abdominal pain and a two minutes diagnosis with POCUS. A third case in avoiding a readmission.  Hopefully you find this interesting and enterta...

Send us Fan Mail Erratum:  I called VExUS volume excess ultrasound, and is venous excess ultrasound.  Also I said the flow of the portal vein should be 20 to 30 mmHg, however is 20 to 30 cm/sec.   Happy new year!  This is the first episode of the Danbury Medical Files in the 2024.  I talked about volume status, volume status is complex and deserves at least a book chapter, however, I tried to summ...

Send us Fan Mail I stopped podcasting early this year because of personal problems. I will try to keep up the next year, however, I wanted to do a final episode in 2023.  Thank you to my residents for always bringing to my attention topics that could be of benefit.   How do we know if POCUS B lines are pulmonary edema? What are the forces that are responsible for pulmonary edema? What are the fact...

Send us Fan Mail Hey everyone.  This is a follow-up chapter from the prior one, exploring how safe it is to auscultate a patient.  Also, how useful. This time I try to make the case that it is safe and also useful.  Follow me in this POCUS journey in the second season of the Danbury Medical Files.  Below I leave some interesting articles if you feel like checking.  Picano E, Scali MC, Ciampi Q, Li...

Send us Fan Mail Inequality in healthcare is a recognized problem.  I had the privilege of interviewing Brenda Ayers, MD.  The head of a task force to decrease and eliminate inequality in NUVANCE-HEALTH.    I met Dr. Ayers as the Chief Hospitalist at Vassar Brothers Hospital in Poughkeepsie, New York.   Her work in the Nuvance Health Network (Danbury Hospital, which is my employer, is part of this...

Send us Fan Mail This time I am exploring what is written about the efficacy of lung auscultation.  I found this interesting meta-analysis and saw the difficulties that the authors went thru to find literature about lung auscultation.  Is it safe? We have auscultation for so long right now, however is it really giving results? The article used is below:  Arts, L., Lim, E.H.T., van de Ven, P.M. et...

Send us Fan Mail This is a follow-up from my prior episode; as I finished uploading and had a second look at that episode, I figured out that I was discussing the case of the patients like I was doing a small teaching, and everyone could see what I was saying.   Today I will try to describe the findings of portal hypertension that are feasible to evaluate with POCUS in the medical ward, the outpat...

Send us Fan Mail Welcome 2023!  After a vacation I want to share this new Podcast with you.  In todays episode I describe the decision making and the importance of POCUS in a couple of patients with liver disease.   Is my conviction that POCUS needs to become the rule rather than the exception in our daily lives as internists and hospitalists.   Let's get to the PODCAST number one.  Please le...

Send us Fan Mail In today´s episode, I have the three Chief Residents from Danbury Hospital, a program of Internal Medicine.  I have Dr. Azadeh, Gassemi, Dr. Uneza Khawaja and Dr. Wendy Perdomo.   We explore the topic of women in medicine and have a very good discussion about the topic, about them, their goals, and how they view the future for women in Medicine.   Women are shaping medicine and th...

Send us Fan Mail Thank you for listening to the Danbury Medical Files! During this episode, we dive into the history of the diagnosis of pleural effusion since the term "succussion" to POCUS.  We talk briefly about the invention of percussion and how physical examination and imaging fare in diagnosing pleural effusion.  We talk about POCUS and pleural effusion.  Finally, we talk about th...

Send us Fan Mail Today we don´t go to the room of the patient to greet the patients and figure out what brought them to the ED.  As hospitalists, we are probably the third or fourth person they interact with.  Check first the EMR. Assure the patient of all the work that is being performed behind the scenes.   Do not anchor or close the box.  Still, try to get as much detail as you can.   When pres...

Send us Fan Mail Mass shootings are sadly way too common in America.  So far, there are more mass shootings than days during this year.   More than 18000 people have died from a gun-inflicted injury in 2022 alone.  We have more guns than people in the country.   In 2018 the NRA "advised" the physicians to stay in their lane and not have an opinion or research about gun deaths.  Since 199...

Send us Fan Mail Hello, this is Christian Espana Schmidt MD, POCUS associate director in Danbury Hospital.  Today we explore a little bit of history of medicine, the pulsus paradoxus in cardiac tamponade with my special guest Dr.  Ferdinand Visco FACC, Dr. Visco was born in Brooklyn NY, studied medicine in Padua Italy and became a cardiologist in Nasau County Hospital, he then became faculty in Br...

Send us Fan Mail Hello again, this is the second podcast.  I am Christian Espana Schmidt MD, a hospitalist and a POCUS instructor and program developer and director.   A bit of lung point-of-care ultrasound.   COVID 19 normalized the use of Point of Care Ultrasound. Featuring: Beth West Director of the Patricia Tiejen Academy. The Patricia A. Tietjen, MD Teaching Academy was founded in 2021, with...

Send us Fan Mail Welcome to the Danbury Medical Files PODCAST.   After a conversation with one of my residents a couple of years ago, she told me we should have a PODCAST the internal medicine community.   That idea lingered for a while, and now it's time to act.   Here we talk about how I started my path in #POCUS.   We also have a guest Matt Barbery MD, he is one of the Associate Program Di...