Dr. Dean Mitchell sits down with Dr. Kenneth Liegner, an internist and critical care physician who has treated thousands of chronic Lyme patients since the early days of the disease's recognition. Dr. Liegner trained in anatomic pathology, internal medicine, and surgical critical care before opening a general practice in Westchester County, where he found himself in the middle of one of the most contested debates in modern medicine.

The conversation traces how Dr. Liegner came to understand that Lyme disease could follow a relapsing, persistent course, and why that conclusion put him at odds with mainstream infectious disease guidelines. He discusses the IDSA's 2000 and 2006 guidelines, the role of insurance industry interests in shaping treatment coverage, and what it meant professionally to keep treating patients during an era he describes as dangerous for practitioners. He also shares a 1991 case in which spirochetes were cultured from a patient's spinal fluid after prior intravenous antibiotic treatment, later published in the science press.

Dr. Mitchell and Dr. Liegner cover the complexity of tick-borne coinfections including Babesiosis, Ehrlichiosis, Anaplasmosis, and Bartonella; the limitations of standard serological testing and the Dearborn criteria; and the challenge of biofilm as a barrier to antibiotic effectiveness. Dr. Liegner also explains his current approach to prophylactic treatment following a tick attachment, including his use of minocycline and Malarone, and his reasoning for that protocol given what he has seen over decades of practice.

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Dr. Dean Mitchell sits down with Dr. Lawrence Lustig, Howard W. Smith Professor and Chair of Otolaryngology Head and Neck Surgery at Columbia University, to discuss a gene therapy called Otofarmaní that has recently received FDA approval for a rare genetic form of deafness caused by mutations in the otoferlin gene. Dr. Lustig, one of the lead investigators in the clinical trial, explains how the therapy works, why this particular form of deafness made it a viable candidate, and what the results looked like across their first 12 patients.

The conversation covers the decades of foundational science that made this possible, from early genetics research in the 1980s and 90s to the dual-vector delivery technique that solved the problem of the otoferlin gene being too large for a single viral vector. Dr. Lustig walks through how the inner ear functions, why otoferlin-related deafness preserves inner ear structures long enough to allow intervention, and how hearing recovery typically unfolds over weeks to months in treated children. The discussion also addresses the significant variability in outcomes across patients and why that variability is still not fully understood.

Dr. Mitchell and Dr. Lustig compare gene therapy to cochlear implantation, examining the practical differences in sound quality, hardware management, and the speech and language development windows that make early intervention critical regardless of which approach is used. They also address hearing screening practices, the limits of otoacoustic emissions testing in otoferlin-related cases, and what might be on the horizon for more common forms of hearing loss, including age-related degeneration and noise-induced damage.

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Email: care@mitchellmedicalgroup.com

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For decades, hormone replacement therapy carried a stigma rooted in a flawed study that left millions of women suffering through menopause without support. Dr. Dean Mitchell sits down with Dr. Gillian Goddard, endocrinologist and author of The Hormone Loop, to untangle the science and set the record straight.

They cover why the Women's Health Initiative study has been widely misinterpreted, what actually happens hormonally during perimenopause and menopause, and why the timing of when a woman starts HRT matters more than most doctors discuss. Dr. Goddard explains the difference between synthetic and bioidentical hormones, why transdermal estrogen is preferred over oral, and what the research actually says about breast cancer risk.

The conversation also addresses testosterone for women, the limitations of black cohosh and soy supplements, how to monitor treatment, and why more women should be consulting an endocrinologist rather than relying solely on their gynecologist.

Contact Dr. Mitchell:

Email: care@mitchellmedicalgroup.com

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Order your copy of Dr. Mitchell’s latest book, Conquering Candida, here.

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