Out of Patients with Matthew Zachary
Out of Patients with Matthew Zachary
Matthew Zachary is the healthcare policy love child of Jon Stewart, Howard Stern, Thomas Paine, Ralph Nader, and Jerry Seinfeld. He has 19 years of receipts to prove it. Editorially independent. Answerable to no one. What started as The Stupid Cancer Show in 2007 became Out of Patients. The first online health podcast in America, predating the medium itself. Zachary survived brain cancer at 21, built the young adult cancer movement from scratch, and spent two decades channeling patient rage into something the system never saw coming. Now he is marching into Washington. Out of Patients goes where the comfortable shows will not. Politics. Healthcare policy. Economics. Institutional accountability. Consumer protection. The forces shaping what 330 million Americans can access, afford, and survive. Battle-scarred patients. Exhausted caregivers. Rare insiders brave enough to name what is killing us. And the occasional elected official about to find out what an organized patient constituency actually looks like. This is the show that started the conversation America is still not ready to finish.
May 25, 2026

Fatal to Relentless: Kathy Giusti

Fatal to Relentless: Kathy Giusti

In December 1996, a 37 year old pharmaceutical executive sat in a Borders bookstore reading medical textbooks on the floor, trying to understand a disease she had never heard of. Multiple myeloma carried a three year prognosis. Her daughter was 18 months old. Her father had just died of cancer. Within weeks, she pushed her doctors to say the quiet part clearly. This would likely end her life before her child entered kindergarten.

Kathy Giusti refused to accept passive survival. She built a plan while the system offered fragments. She interviewed oncologists and fertility specialists at the same time. She pursued IVF to have a second child while preparing for treatment. She stayed employed to keep insurance coverage. Every decision carried financial, medical, and emotional risk.

That same urgency exposed a deeper failure. Cancer research moved slowly. Academic centers guarded data. Clinical trials lacked coordination. Patients entered a system that demanded compliance without providing clarity. Giusti responded by building the Multiple Myeloma Research Foundation, not as a support group, but as an operating engine to accelerate drug development, fund research, and force collaboration across institutions.

This episode tracks the tension between individual agency and systemic failure. Giusti describes how patients navigate diagnosis, insurance barriers, and fragmented care in real time. She explains how data, genomics, and clinical trials reshape cancer treatment while still leaving patients responsible for decisions they are not trained to make. She addresses disparities in access, the limits of early detection, and the reality that progress in oncology often depends on speed, funding, and alignment of incentives.

The conversation moves between lived experience and structural critique. It names the cost of delay, the burden placed on patients to act as their own advocate, and the tradeoffs required to push a system forward that still protects itself first.

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RELATED LINKS

Kathy Giusti

Multiple Myeloma Research Foundation

Fatal to Fearless

American Society of Hematology

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Out of Patients EP445: Fatal to Relentless: Kathy Giusti

In 1996, Kathy Giusti sat on the floor of a Borders bookstore reading Harrison’s like her life depended on it. It did. She was 37, staring at a 3 year prognosis for multiple myeloma, with an 18 month old at home and a system that offered confusion i…