The Pulse

On this episode, we explore ADHD in adults — how to spot it, how to treat it, and how to function with it. We talk with a leading psychologist about what’s behind ADHD’s often frustrating symptoms, hear about what it’s like receiving a diagnosis late in life, and find out why people with ADHD are often very sensitive.

People with ADHD often struggle with task initiation — especially when it comes to tasks that they find boring, complicated, or aversive. Pulse reporter Liz Tung offers a day-in-the-life glimpse at what it’s like trying to start one of these tasks … and what she ended up doing instead.

We talk with psychologist Russell Ramsay, the co-founder and former co-director of the University of Pennsylvania’s Adult ADHD Treatment and Research Program, about why ADHD in adults has been neglected for so long, and the many parts of people’s lives it affects — from work, to relationships, to their own self-perception. He also discusses what's behind time blindness, why people with ADHD struggle with long deadlines but excel at short ones, and what's going on in the brain that causes these behaviors.

For a lot of adults with ADHD, finally receiving a diagnosis can be a relief — something that explains and reframes a lifetime of struggle. But it can also be destabilizing, especially when the diagnosis comes later in life. Pulse reporter Alan Yu tells the story of how one older woman’s diagnosis transformed her life, her understanding of herself, and her relationship with her daughter.

For years, psychiatrist Sasha Hamdani thought she was just sensitive — she would cry at the drop of a hat and spiral when she’d made a mistake. It wasn’t until years later that she encountered a name for what she was experiencing: Rejection Sensitivity Dysphoria, or RSD — a powerful emotional reaction, common in people with ADHD, to perceived criticism or rejection. Hamdani discusses how RSD shaped her professional life, the proposed brain mechanism behind it, and techniques for dealing with it. Her book is “Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply.”

It’s a story that’s unfolding across America, from Texas to Tennessee, Kansas to the Rust Belt — rural hospitals are struggling or closing, leaving residents, towns, and entire regions without access to important healthcare services, from cancer screenings to maternity care. For some people, it can even mean a several-hour drive to the nearest emergency room — and in life-or-death situations, those extra miles can make a big difference. 

On this episode, we explore the rural healthcare crisis, and emerging solutions aimed at increasing — or at least preserving — access to care. We visit communities in rural Pennsylvania where residents are fighting to save their hospitals. We find out how other systemic pressures, like prior authorization, are squeezing rural healthcare systems. And we hear about potential solutions, ranging from state-funded reimbursement programs, to sophisticated “hospitals on wheels” aimed at bringing healthcare to the people.

SHOW NOTES:

Reporters Nicole Leonard and Alan Yu take us on a journey to two towns in rural Pennsylvania facing similar pressures — Bradford, a once-booming oil town now in decline, and Honesdale, a former railway hub nestled in the Pocono Mountains. For years, both locales have dealt with shrinking populations and a loss of businesses. We hear about the residents’ efforts and struggles to save their hospitals.

Many states, including Pennsylvania, have been working to prevent hospital closures in rural areas through experimental initiatives aimed at shoring up their finances. The Pulse's Alan Yu explains how one such initiative — the Pennsylvania Rural Health Model — aimed to combat these financial pressures by replacing the traditional fee-for-service model with a value-based model, which shifts the focus to preventative care in exchange for fixed, predictable funding. We explore how the five-year experiment played out — and why economists say it didn’t ultimately work for some hospitals. 

We talk with Miranda Yaver, an assistant professor of health policy at the University of Pittsburgh, about another challenge squeezing rural hospitals — prior authorization. Her new book is “Coverage Denied: How Health Insurers Drive Inequality in the United States.”

In some parts of rural America, patients have to travel hours in order to access care — but what if medical care could come to them? That's the idea behind a new, federally funded program called PARADIGM, which deploys AI-enabled mobile health units to patients who don’t have access to healthcare. We talk with PARADIGM’s director, emergency medicine physician Bon Ku, about how these mobile clinics work, and  hear from reporter Grant Hill about one of the program's latest creations — MARCUS, a futuristic hospital on wheels that contains an exam room, scanning machines, and even a laboratory.

On this encore episode, we explore the world of color — from how we perceive it, to our efforts to describe and differentiate its many shades. We talk with a lexicographer about efforts to standardize synthetic colors, and how we describe them, and investigate how we know that the colors we see are the same as the ones everyone else sees.

The Pulse host Maiken Scott adds some pops of color to her all-black wardrobe with help from Jill Rafter, a color consultant with House of Colour, who breaks down seasonal palettes and how to choose your ideal hues based on your skin’s undertones.

We talk with lexicographer Kory Stamper about her deep dive into the origins of ultra-specific color definitions, and the fascinating history of how major global changes, ranging from industrialization to international warfare, led to a government effort to standardize not just the production of synthetic colors, but also how we talk about them. Stamper’s new book is “True Color: The Strange and Spectacular Quest to Define Color – from Azure to Zinc Pink.”

How do we know that the colors we see are the same as the colors other people see? Pulse reporter Liz Tung talks with University of Pennsylvania researcher David Brainardabout the science of how we perceive color, what we know — and don’t know — about our shared perceptions, and the philosophical questions this raises about the nature of subjective experience.

Pulse producer Nichole Currie talks with Cricket Matthews, who experiences  grapheme-colors synesthesia, a unique neurological trait in which letters, numbers, and words trigger specific colors in your mind.

Cereal was born as a health food — but quickly, sweet, crunchy flavor, bright colors, and fun shapes became more important than the nutritional value. That didn’t stop cereal companies from leaning into health claims, though.  From Cheerios to Frosted Flakes and Wheaties, brands made bold promises to lower cholesterol, promote weight loss, boost fiber and even help prevent cancer. These healthy messages were also paired with eye-catching designs and beloved mascots. It was all a powerful marketing formula, one that sold a dream to buyers — that indulging in sugary cereal could also be a healthy choice. But, over the years, the healthy veneer has chipped off the cereal box.

On this episode, public health nutritionist Marion Nestle and former Vice President of Nutrition at Kellogg Company Lisa Sutherland discuss their new book, “Sugar Coated: Unboxing the Hidden Forces Shaping America’s Favorite Breakfast Food.”

We all know we’re supposed to eat healthy — but what exactly does that mean? On this episode, what’s on your plate, why it matters, and how to make sense of conflicting nutrition advice. We talk with paleoanthropologist Daniel Lieberman about what human evolution can teach us about how we should eat, look at a typical teen’s sugar intake, and explore barriers to serving healthy and fresh school lunches.

We all know we’re supposed to limit our sugar intake — but tracking how much we’re actually eating can be hard, especially given how many products, ranging from pasta sauce to salad dressing, contain added sugars. We talk with recent high school grads Joe Faranda and Jay Lopez about what they discovered after tracking their sugar intake for a week.

It's a question we ask ourselves every day, multiple times a day: What should I eat? The answer has gotten increasingly complicated over the years, as our food options have ballooned, and dietary advice shifts. We talk with evolutionary biologist Daniel Lieberman about why humans are poorly adapted to decide what to eat, how our diets — and the way we think about them — have changed, and why nutrition labels don't give the full story. Lieberman’s new book is “Fed Up: What Evolution Reveals About Food, Diet, Health and Eating Well.”

Growing research on the negative health effects of ultra-processed foods has led to a call for healthier school lunches — but what does that really mean, and what would it require? Reporter Megan Myscofski visits a California school district that provides nutritious, locally sourced meals that are mostly made from scratch  — and finds out why similar efforts are out of reach for many districts.