Overheard In The Emergency Room

Your 16-Week Roadmap to Longevity: An ED Physician's 5-Pillar Playbook

Welcome to the Season 1 finale of Overheard in the Emergency Room.   There's no single ED case anchoring this episode. There are fourteen of them — every patien every story, every lesson we walked through across the season. And rather than introduce one more case and pretend it summarises a whole year of conversations, Dr Cois pulls everything into a single playbook. Five Tier 1 pillars - in the order that actually matters: 1. A primary care physician who knows you and screens you (the single most evidence-backed longevity intervention in the literature). 2. A whole-plant-predominant diet, with specific steps to build fibre and plant diversity. 3. Exercise across three buckets — resistance training, cardiorespiratory fitness, and incidental movement. 4. Sleep, treated like your Olympic sport, with four concrete steps. 5. Stress management as a clinical skill, practised when calm. Plus a free 16-week Recapture Your Health roadmap PDF at DrCois.com — no email gate, no upsell. If you've been with us since Episode 1, thank you. If you're new, this is a great place to start. 🩺 Educational content only. Not medical advice. Cronometer is referenced without anyfinancial relationship. Let's chase less bad days and more good decades together. • A primary care physician isthe single most evidence-backed longevity intervention — more powerful than anysupplement, peptide, or wearable. • Diet, exercise, sleep, and stress management are the four lifestyle pillars that compound across decades - work all four, not one. • Aim for 30–40 g of fiber daily, 30+ unique plant species weekly, and 80% of your plate as whole plant foods. • Exercise has three required buckets: resistance training, cardiorespiratory fitness (Zone 2 + intervals), and incidental movement. • Treat sleep like an Olympicsport. Anchor with wake time, not bedtime. • Stress management is a learnable clinical skill — practise it in calm moments so it is available in real ones. •  Pick one pillar this fortnight. Behaviour change fails when people try to overhaul everything at once. Educational content only. This podcast does not provide medical advice and does not establish a physician–patient relationship. If you have symptoms concerning for a medical condition, please seek care from a qualified clinician.

The Sleep Mistake Every Night-Shift Worker Is Making (ER Doc Explains)

If you work night shifts, swing shifts, or any schedule that doesn't line up with the sun, this Quick Hit is your sleep playbook. Dr Cois — emergency physician and host of Overheard in the Emergency Room — walks through the evidence-based system he uses for himself and shares with his patients. You'll learn why shift work nudges your long-term risk of diabetes, cardiovascular disease, and other chronic conditions, and exactly what to do about it. The framework: four circadian behaviours (consistent wake time, daily nervous-system regulation, meal timing, pre-shift exercise) plus three environmental levers (cool room, true darkness, noise control). Honourable mentions cover sunglasses on the drive home, alcohol, strategic napping, screen light, sleep apnea screening, and how to use wearables without letting them stress you out. For the deep dive on sleep physiology, the hormone story, and the cohort evidence, listen to Episode 4 of the main season. Key Takeaways •  Shift work raises long-term cardiometabolic and chronic disease risk — but the levers to push back are well-defined. •  Cluster your shifts into blocks rather than scattering one-off nights. •  Stop eating four hours before sleep; cut caffeine in the second half of your shift. •  Exercise hard before your shift to manufacture the morning cortisol spike your body would normally produce on a day schedule. •  Build a daily nervous-system regulation practice — the car meditation is the easiest start. •  Protect your sleep environment: cool, dark, quiet, and household-aligned. Chapter Markers Chapter timestamps are maintained on YouTube as the master version — refer to the YouTube description for a full chapter breakdown. Disclaimer Educational purposes only. This podcast does not provide medical advice and does not establish a physician-patient relationship.

Quick Hit: What Really Happens When You Go to the ER with Stomach Pain (ER Doctor Explains)

“Dr Cois, I’ve got abdominal pain. What will happen to me when I come to the ED?”  It’s one of the most common questions in my inbox — and one of the top 3 reasons people present to my Emergency Department. In this Quick Hit, I walk you through what actually happens when you come in with stomach pain: the conversation we have, the 4 diagnoses we cannot miss, and the bigger story most patients never hear. Inside this episode: •  How emergency physicians use the SOCRATES framework to find the diagnosis before any test is ordered •  The 4 can’t-miss diagnoses — cholecystitis, appendicitis, diverticulitis, and small bowel obstruction — and how each one classically presents •  Non-GI causes of abdominal pain we always consider,including kidney stones, UTIs, aortic emergencies, and mesenteric ischaemia •  Why most recurrent abdominal pain comes back toconstipation, reflux, and non-alcoholic fatty liver disease •  A practical, week-by-week plan to safely increase yourfiber from 15 g to 40 g a day •  Why a CT scan isn’t always the right answer, and how to think about radiation risk in the ER •  The bold takeaway: if we don’t find a life threat, your next step isn’t another scan — it’s your Tier 1 habits Key Takeaways •  Most abdominal pain in the ER goes home safely •  80% of your plate should be plant foods •  Increase fiber gradually — not 15 g to 40 g overnight •  PPIs are a 2–6 week tool, not a forever medication •  Establish care with a primary care provider for any recurrent abdominal symptoms Chapter Markers Chapter timestamps available on the YouTube version of this episode — use that as the master reference. Disclaimer This episode is for educational purposes only and does not constitute medical advice. If you have symptoms that concern you, please contact your physician or local emergency services. Closing Send your next Quick Hit question via the contact form at DrCois.com or DM @dr_cois on socials. Fewer bad days. More good decades.

Quick Hit: What Actually Happens When You Walk into the ER with Chest Pain

Welcome to the very first Quick Hit — a brand new bonus series from Overheard in the Emergency Room where Dr Cois tackles the questions you’ve been sending in. Short. Focused. Practical. Today: “What actually happens when I walk into the Emergency Department with chest pain?” Dr Cois walks you through the full chest pain workup — why we move so fast, what door-to balloon time means, the three body systems behind every differential (heart, lungs, GI), which tests get ordered and when, and the diagnoses your ED doctor is quietly thinking about even when they don’t mention them. Plus the most important takeaway: when to come in, and what to do after. This is a clinical overview, not a deep evidence dive — but if you’ve ever sat in an ED waiting room wondering what was actually happening, this is the inside view. For the companion blog post and free resources, visit DrCois.com.  Key takeaways: ●     Chest pain gets immediate attention becausecardiovascular disease is the #1 killer in high-income countries ●     Door-to-balloon time is the metric that drives EDurgency around chest pain ●     Three main body systems frame every workup: heart,lungs, GI tract ●     ECG, troponin, chest X-ray, and bedside echo are theworkhorses; CT angiogram is risk-stratified ●     “Musculoskeletal” and “gastritis” are essentiallydiagnoses of exclusion — follow up with your PCP ●     If chest pain is new, severe, or doesn’t fit a patternyou recognise: come in Educational content only. Not medical advice. If you are experiencing chest pain, seek emergency care immediately.

The Ultimate Supplement Guide: What the Evidence Actually Says (Creatine, BPC-157, NMN & More)

The global wellness industry is a 6.8-trillion-dollar business — more than four times the size of global pharma — and it runs on supplements. But how much of it actually has evidence behind it? In Episode 14 of Overheard in the Emergency Room, Dr Adrian Cois — a board-certified Emergency Physician — walks through the published systematic reviews and meta-analyses for the nine most common supplements of 2026. Which ones have genuine evidence? Which ones are selling you a story? And how should you make decisions in a regulatory environment where, under DSHEA, supplements do not have to be proven safe or effective before they hit the shelf? The episode is anchored by two clinical stories: a coworker asking whether any supplement will stop her from getting sick, and an older man on Social Security spending his limited income on a herbal product while eating free meals at a senior centre. In between, Dr Cois breaks down creatine, vitamin D, omega-3, magnesium, and multivitamins — the five with reasonable evidence — and then takes apart NMN, berberine, collagen, and "detox" supplements — four with very thin evidence and very large marketing budgets. The episode also takes on the February 2026 FDA peptide reclassification, explains why BPC-157's evidence base is 35 rat studies and one uncontrolled case series, and closes with a blinded randomised-trial comparison between the Pfizer-BioNTech mRNA COVID vaccine trial and the retatrutide phase 2 obesity trial — revealing why influencers who dismissed the first while promoting the second are holding incoherent evidentiary standards. •  Supplements are Tier 2 by definition. They cannotsubstitute for diet, movement, sleep, stress management, and a primary carephysician. •  Five supplements with reasonable evidence in specificpopulations: creatine (resistance training), vitamin D (deficiency, older adults, prediabetes, pregnancy), omega-3 (specific cardiovascular contexts), magnesium (blood pressure, migraines), multivitamins (older adults with imperfect diets). •  Four with large marketing and small evidence: NMN, berberine (outside metabolic syndrome), collagen, and "detox" protocols. •  The BPC-157 evidence base is 35 preclinical animal studies and one uncontrolled case series in 12 humans. Reclassification by the FDA in 2026 restored access; it did not validate evidence. •  The three-question cabinet audit: Is there a medical reason? Can I name the evidence? What could this money do elsewhere? Note: Final timestamps to be filled in after recording. Use the YouTube chapter block above as the master, then synchronise to Spotify. Companion blog post with full references, evidence tables, and clinician-facing notes at drcois.com. Educational content only. Not medical advice. Always consult your own physician before starting, stopping, or modifying any supplement or medication regimen.