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Welcome back to Vital Times, the podcast of the California Society of Anesthesiologists.

The news: CSA is launching its first Podcast Host Contest. We're looking for new voices for this show — and we're looking for it among you.

Who's eligible: Anesthesiology residents and fellows at California programs. Medical students at California medical schools with a demonstrated interest in the specialty. Any year. All subspecialty tracks.

No podcasting experience required. None. If you've never touched a microphone and you have something to say, we want to hear it.

How to enter. Send us:

1. An audio or video file, two to five minutes. Introduce yourself, or talk through a topic you care about. It doesn't need to be polished. We want to hear how you think and how you sound.
2. A written statement, 250 to 500 words. Why hosting interests you. What you'd cover. Who you'd want in the room.

Who's judging: selected members of the Communications Committee and staff. We're scoring on communication style, content knowledge, professionalism, enthusiasm, creativity, and alignment with CSA values.

Why it matters. This is more than a published episode with your name on it or a line on your CV. It's mentorship — working with us on the craft of interviewing and the discipline of talking well about hard subjects. It's visibility across CSA, and a leadership network most trainees don't see for years.

The winner is recognized in the CSA Newsletter, on our website, and at the Annual Meeting.

And if you don't win: strong entries may be featured on the CSA website. Either way, you'll have made something that's yours.

The bottom line. Sixty to ninety percent of residents already listen to podcasts monthly. Some of the people making them should be you.

Submissions open September 9th and close November 9th. Send yours to csa@csahq.org.

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Decreasing insurance reimbursements, rising costs, longer hours, lower pay, less agency over your working conditions, and increasing administrative and educational requirements. These are just a few of the issues that many anesthesiologists and physicians face. Meanwhile, governments make ill-considered rules, cut funding, prevent fair and equitable negotiations, and non-physician providers continue to fight for greater authority to practice medicine without having attended medical school. A physician and anesthesiologist shortage emboldens them to feel entitled to greater independence. New residencies are being developed to counter this shortage, but how can they successfully navigate all the obstacles they may face? How do any of us try to make our practices, working conditions, or pay structures better?

Organizations like the California Society of Anesthesiologists and others exist to support their members. They advocate, educate, collaborate, network, and elevate anesthesiologists throughout California. None of this work can be done without engaged and enthusiastic members.

Join my guests today as they explain why they got involved with the CSA and why they think it is important for all members to do so.

Dr. Newhide completed his Anesthesiology residency training at the University of Maryland Medical Center and a fellowship in Regional Anesthesia and Acute Pain Management at the University of Pittsburgh Medical Center. With a strong commitment to serving the underserved, he returned to his home state of California to help found a new residency program in Stockton, CA. He is currently serving as the Residency Program Director at St. Joseph's Medical Center, helping to develop a new generation of anesthesiologists to serve the Central Valley.

Dr. Klein is a fourth-year resident in anesthesiology at UCLA and serves as her residency program's ASA and CSA resident delegate. She will be completing her fellowship in Regional Anesthesia and Acute Pain Management at Duke University in the upcoming academic year. As a resident on a research track, she is involved in informatics and policy-related research on insurance utilization and physician payments. She plans to practice in a large academic setting so she can continue on her path as a physician-researcher while staying involved in the health policy space.

Dr. Mariam Sarwary is currently a Clinical Assistant Professor at Stanford and the Program Director for the Regional Anesthesia and Acute Pain Medicine Fellowship. She has been involved with the CSA since residency and currently sits on the organization's Board of Directors. Mariam also serves as a mentor for Stanford's Leadership Education in Advancing Diversity (LEAD) program and is a member of the GME Well-Being Committee.

Dr. Christina Menor is a board-certified anesthesiologist in private practice in Los Angeles. She specializes in ambulatory, pediatric, and obstetric anesthesiology. Dr. Menor currently serves as the President of the California Society of Anesthesiologists. She co-authored an article that describes California survey data on medical titles. She is a member of Physicians Protecting Patients and is an active advocate for physician-led care and title transparency. She has been active with the CSA since residency.

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Dr. Beth Duggan, Vice Chair of faculty development at UAB, and Dr. Daryl Oakes, Stanford Associate Dean of Post Graduate Medical Education, speak on ways anesthesiologists can escape being pigeonholed to instead craft a fulfilling and sustainable career.

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When Congress celebrated July 4 by enacting House Resolution 1 (known as H.R. 1 or the “One Big Beautiful Bill Act”), experts warned of massive impacts on Medicaid programs nationwide and the more than 70 million people who rely on them.

H.R. 1 cut nearly $1 trillion from Medicaid, the largest funding reduction in the program’s 60-year history. The nonpartisan Congressional Budget Office estimates that by 2034, as many as 10 million individuals nationwide will become uninsured as numerous new eligibility rules are imposed in Medicaid and ACA programs.

The Medicaid program, known as Medi-Cal in California, covers more than half of the state’s children, 2.2 million seniors and people with disabilities, 1 in 5 working Californians, and millions of other people with low incomes. H.R. 1 is expected to cut $30 billion a year in federal funding from Medi-Cal, reducing overall access to care and possibly pushing some safety net providers into dire straits, according to the California Budget and Policy Center. Up to 3.4 million state residents could lose coverage, the center said. As the uninsured population rises, more medical bills will go unpaid, cutting revenue for California’s health care safety net.

Join my guests today who will explain the impact this will have on rural healthcare in California and the effect on anesthesiology services.

Charley Yan is a fourth-year medical student at UC Davis with a background in Medicaid policy. Before medical school, he helped drive California’s Medicaid expansion efforts and has since analyzed coverage and safety-net policies across multiple states.

Mary Morales is an anesthesiologist at Stanford. She is the current vice chair of the CSA Justice, Equity, Diversity, and Inclusion committee (JEDI).

Naileshni Singh (pronounced Na-Lesh-Knee Sing) is a pain interventionalist with a background in Anesthesiology from the University of California, Davis. She is the current chair of the California Society of Anesthesiologist's Justice, Equity, Diversity, and Inclusion committee (JEDI).

Resources:

https://csahq.org/2025/09/02/federal-funding-cuts-threaten-rural-californias-health-anesthesia-care/

https://www.chcf.org/resource/how-massive-federal-cuts-will-create-unprecedented-challenges-medi-cal-patients-providers/

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Dr. Ludwig Lin (@LudwigLin) of CSA’s Vital Times Podcast catches up with one of the Match 2026 viral stars - Shay Taylor Allen (@Shayy.Taylor), a MS4 at Howard University School of Medicine, whose clip of herself jumping up and down in celebration when she matched to her first choice of Yale Anesthesiology Residency. As the first episode in a CSA Vital Times podcast arc about job crafting within Anesthesiology, Drs. Lin and Taylor Allen talk about her journey through life and medicine, and the important mentors, allies and champions who helped her innate resilience in clarifying and achieving her goals. #Jobcrafting #ShayTaylorAllen

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Welcome to another episode of Vital Times.

In January 2026 the American Society of Anesthesiologists (ASA) and the Society for Pediatric Anesthesia (SPA) issued an updated joint communication regarding severe neurologic complications, including stroke and death, in healthy young adult (oldest reported so far is 36) and pediatric patients of Venezuelan ancestry following routine general anesthesia. There have been about 36 known or suspected cases worldwide although that number seems to be regularly increasing. The majority of cases have occurred in South American countries, with six reported in in the United States and eight in Europe. Genetic testing on a subset of the patients found a genetic mutation in mitochondrial DNA, known as the ND4 mutation. (for an interview with the physician and mother listen here https://www.instagram.com/reel/DUb4tYGjfdM/?utm_source=ig_web_copy_link .

In July 2025, anecdotal communications from South American anesthesiology societies described cases of patients having severe complications from general anesthesia. Despite incomplete and emerging clinical and scientific information, ASA and SPA felt the severity of the cases warrant an expert opinion communication to inform anesthesiologists and their patients.

Detailed family histories of patients who were recently affected revealed that all were of Venezuelan heritage and several had family members who also had adverse outcomes after an otherwise uneventful anesthetic. Four anesthesiologists at the leading edge of this newly discovered condition joined the show today to explain how it was discovered, what is known and what we can do about it.

Dr. Jim Fehr is the past President of the Society for Pediatric Anesthesia, and the Division chief of Pediatric Anesthesia at Stanford Lucile Packard Children’s Hospital. He is one of the coauthors of the joint statement, a member of the Society for PEdiatri Anesthesia’s Wake Up Safe initiative and very involved with Patient Safety.

Dr. Veronica Zoghbi is a Venezuelan pediatric anesthesiologist and Director of Pediatric Regional Anesthesia at the University of Miami in Miami, Florida. South Florida and Miami have one of the highest concentrations of people from Venezuela in the USA. She and our other 2 guests are members of VAPOR (Venezuelan Anesthesiologist Perioperative Risk Reduction)

Dr. Claudia Bruguera Torres is a pediatric anesthesiologist from Venezuela and Assistant Professor at Cincinnati Children's Hospital.

Dr. Luis Rodriguez is a Venezuelan Pediatric Anesthesiologist from Miami FL, and currently serves as the Vice President for the Florida Society of Anesthesiologists

Finally, if complications occur in patients with the ND4 mutation, anesthesiologists should report the case to their institutions’ patient safety organization and the Anesthesia Incident Reporting System of the Anesthesia Quality Institute.

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This episode of Vital Times features a conversation with clinician-scientists Dr. Jamie Sleigh and Dr. Elizabeth Whitlock, whose work focuses on delirium and perioperative brain health. They explore the emerging role of intraoperative processed EEG monitoring and its potential to improve postoperative neurological outcomes. This discussion highlights the evolving tools and evidence-based strategies anesthesiologists use to deliver safe, high-quality care and optimize patient outcomes across the perioperative continuum.

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Today’s episode features a truly special conversation with Dr. Diana Ramos, California Surgeon General, and Dr. Calvin Johnson, Professor of Anesthesiology—both dedicated advocates for improving maternal health.

Dr. Ramos is a distinguished public health leader who earned her medical degree from the Keck School of Medicine at USC and completed her OB-GYN training at the LA County–USC Medical Center. She also holds a Master of Public Health from UCLA and an MBA from the UC Irvine Paul Merage School of Business. Dr. Ramos has received numerous honors, including the Latino Spirit Award for Achievement in Public Service (2024) and the Public Health Leadership Award (2025) from All Children Thrive. She is deeply passionate about reducing maternal morbidity and mortality in California and across the nation, as well as improving health outcomes for children.

Dr. Johnson is a Professor of Anesthesiology at Cedars-Sinai Medical School in Los Angeles. He is triple board-certified in Anesthesiology, Pediatric Anesthesiology, and Pain Medicine. He is an active member of the California Society of Anesthesiologists and serves on the California Pregnancy-Associated Review Committee.

Maternal mortality remains a critical issue, with an incidence of 33 per 100,000 births in the United States and 15 per 100,000 in California. What are the most common causes of maternal mortality? How many of these deaths are preventable? What factors increase the risk of morbidity and mortality, and how have anesthesiologists played a role in reducing these risks?

In this episode, Drs. Ramos and Johnson discuss why maternal mortality persists, current incidence rates, and what can be done to address this urgent issue. They also explore Adverse Childhood Experiences (ACEs) and their impact on children’s immediate and long-term health. Together, they emphasize the critical importance of collaboration across multiple specialties—including public health, nursing, community medicine, and preconception and prenatal care—to improve outcomes for mothers and children.

Selected Resources:

https://osg.ca.gov/

https://osg.ca.gov/aces-in-youth/

https://osg.ca.gov/prema/