Summary4 min read

Becker’s Healthcare Podcast – Episode Summary

Guest: Dr. Michael J. Welsh, Professor of Internal Medicine–Pulmonary, Critical Care, and Occupational Medicine, University of Iowa
Patient Guest: Grace Lichett, University of Iowa Health Care
Host: Mariah Muhammad
Date: October 12, 2025
Main Theme:
A candid conversation connecting the physician and patient perspective on the treatment of cystic fibrosis (CF), highlighting advances in care, lived patient experience, and medical insights from decades of research and clinical practice.

Episode Overview

This episode delves into the journey of cystic fibrosis treatment, exploring both the clinical and personal dimensions. Dr. Michael J. Welsh offers an expert’s perspective on CF’s impact and the evolution of therapies, while patient Grace Lichett shares her lived experience growing up with the condition. The episode underscores the transformation in CF outcomes thanks to therapeutic breakthroughs and emphasizes the enduring dedication behind CF research and care.

Key Discussion Points and Insights

1. What Is Cystic Fibrosis? (00:41)

Dr. Welsh explains cystic fibrosis as a genetic, autosomal recessive disease and the “most common severe life threatening disease in Caucasians, particularly of northern European ancestry.”
The disease affects multiple organs, historically impacting the pancreas (resulting in early nutritional challenges) and, crucially, the lungs.
Notable Disease Complications:
- Persistent lung infections, particularly by Pseudomonas aeruginosa and Staph aureus.
Treatments before recent advances:
- Enzyme replacement for pancreatic function
- Antibiotics
- Physical therapies (“pounding on people's backs”) and mist/saline to assist with mucus clearance

“But, but for a long time the lung disease is the major cause of suffering for people with cystic fibrosis.”
— Dr. Welsh, [00:55]

The landscape changed profoundly after the discovery of the CF gene, which Dr. Welsh cites as a "turning point."

2. Childhood Experience with CF: Grace’s Story (02:47)

Grace was diagnosed as a baby in 2004 and recalls never being without therapies.
Therapeutic Regimen:
- Started nebulizer treatments at a young age
- Used the CF “vest” treatment (an inflatable vest that provides chest physiotherapy to break up mucus)
Pre-Modulator Therapy Era:
- Suffered recurrent lung infections, specifically pseudomonas, at multiple points: 14 months old, fifth grade, eighth grade.
- Describes herself as "lucky" that these infections didn’t cause major lung damage.

“I was born during a very fortunate time where I didn't have to live without these specific therapies like that.”
— Grace, [03:08]

Post-Modulator Therapy:
- The introduction of “modulators” caused her lung function to “skyrocket”
- Enabled her to thrive as a long-distance runner and pursue her passions.

“…It really helped me out to pursue that passion, something that I was already actively pursuing, but now could comfortably continue to do so with a little bit of strength support.”
— Grace, [04:16]

3. Dr. Welsh’s Motivation and Commitment to CF Research (04:50)

Dr. Welsh recounts his first encounter with a young CF patient as a junior medical student, vividly recalling her visible struggle to breathe and the limitations placed on her life.
The memory of this patient’s suffering and the prognosis left a deep, lasting impact on his career trajectory.

“I met a young girl…she was struggling to breathe. I could see her using her accessory muscles, speaking in short sentences, just obviously having difficulty breathing, frequently coughing, a really harsh cough…and I learned how short her life would be. That made a, made an indelible impression.”
— Dr. Welsh, [05:01]

Notable Quotes & Memorable Moments

| Timestamp | Speaker | Quote | |-----------|--------------|-------------------------------------------------------------------------------------------------| | 00:55 | Dr. Welsh | “But for a long time the lung disease is the major cause of suffering for people with CF.” | | 03:08 | Grace | “I was born during a very fortunate time where I didn't have to live without these therapies…” | | 04:16 | Grace | “…My lung function skyrocketed, which was such a blessing…It really helped me to pursue running.”| | 05:01 | Dr. Welsh | “I met a young girl…she was struggling to breathe…That made an indelible impression.” |

Important Segments & Timestamps

[00:41] – Dr. Welsh’s comprehensive explanation of CF and its historical treatment milestones
[02:47] – Grace’s candid recounting of growing up with CF and the pre-modulator therapy experience
[04:32] – Grace’s transformation after modulator therapy and its impact on her health and lifestyle
[04:50] – Dr. Welsh’s origin story: the patient experience that drove his lifelong dedication to CF research

Tone and Language

Dr. Welsh: Reflective, didactic, empathetic–communicates the science and human impact with clarity and compassion
Grace: Personal, open, grateful–shares firsthand challenges and triumphs, capturing the patient’s voice and perspective

Summary

This episode bridges the scientific and personal aspects of cystic fibrosis, featuring deep insights from Dr. Welsh’s prospected decades in the field and Grace Lichett’s resilience as a patient. The discussion highlights transformative advancements—particularly gene discovery and modulator therapies—and reminds listeners of the dedication and hope that drive progress in rare disease management. Dr. Welsh’s career-long commitment is rooted in early, powerful patient encounters, while Grace’s story offers inspiring evidence of what new therapies can achieve for patients’ quality of life.

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Transcript6 lines

[00:01]
A
Welcome everyone to the Beckers Healthcare Podcast series. I'm Mariah Muhammad, writer and moderator with Becker's Healthcare. I'm thrilled to have with me today Dr. Michael J. Welch, professor of Internal medicine at the University of Iowa, and Grace Lichett, a patient at University of Iowa Health Care. Thank you both for speaking with me today and welcome to the podcast. We're very excited to have you join us. Today we'll be discussing a fascinating story about the treatment of cystic fibrosis between doctor and patient. To get us started, Dr. Welsh, I'll get started with you. First, for those who are not familiar with this, can you explain what cystic fibrosis is and how it affects patients lives?
[00:42]
B
So cystic fibrosis is a genetic disease. It's inherited in autosomal recessive fashion. It's the most common severe life threatening disease in Caucasians, particularly of northern European ancestry. It affects multiple different organs, it affects the pancreas. Destruction of the pancreas and intestinal problems used to be the major early claim on babies born with cystic fibrosis. Then physicians and scientists developed pig pancreas enzymes and that helped with nutrition. But, but for a long time the lung disease is the major cause of suffering for people with cystic fibrosis. And there the problem was infections that were really recalcitrant to treatment, infections with many different organs. Pseudomonas aeruginosa is a common, widely recognized organism as well as Staph aureus. And that treatments had progressed for cystic fibrosis and those consisted of antibiotics, consisted of attempts to dislodge the mucus with mists and saline administration and pounding on people's backs. And that's where the situation was prior to the recent developments. Recent developments beginning a long time ago, but accelerating and as a turning point with the discovery of the CF gene.
[02:32]
A
Wonderful. Thank you so much for giving us that background. Grace, going to you, you were diagnosed with CF as a baby. What were some of the biggest challenges you faced growing up with the disease? Before the therapies were available.
[02:47]
C
When I was born, it was about, it was 2004 and so I don't ever remember not having the therapies because as soon as I was actually old enough to know what was happening around me, I was doing two nebulizers a day and I didn't have a vest yet because I wasn't old enough. It straps to you like a vest that you'd normally wear, except for it inflates with air and it shakes you very violently to try to break up that mucus so that way you can cough it up. So once I reached that age, I, I had a vest readily available. I was born during a very fortunate time where I didn't have to live without these specific therapies like that. However, these modulator therapies, before those were available, I got sick quite often. I. I remember having pseudomonas three times in my life right when I was first diagnosed at 14 months old, or. Yeah, right when I was diagnosed at 14 months old, once in fifth grade and then once again in eighth grade. I was lucky enough that these didn't severely damage my lungs, but it was a consistent enough issue that I was at risk to become chronic with it. But it was only a couple years after my last diagnosis with pseudomonas that these modulators came out. My lung function skyrocketed, which was such a blessing because I am a long distance runner. And so it really helped me out to pursue that passion, something that I was already actively pursuing, but now could comfortably continue to do so with a little bit of strength support.
[04:33]
A
Yeah, yeah, absolutely. Well, that's, that's very good to hear. And Dr. Welsh, you've been studying CF for more than 40 years. What drew you to this disease early in your career and also what kept you focused on it for so long?
[04:50]
B
So my first exposure to cystic fibrosis was when I was a medical student, junior medical student here at the University of Iowa. And at that time I was in the pediatric clinic and I met a young girl, probably 7 or 8 years old, and she was struggling to breathe. I could see her using her accessory muscles, speaking in short sentences, just obviously having difficulty breathing, frequently coughing, a really harsh cough. And I learned about all the things she couldn't do, and I learned how short her life would be. That made a, made an indelible impression.