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The Doctor's Art

Author: Henry Bair and Tyler Johnson

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The practice of medicine–filled with moments of joy, suffering, grace, sorrow, and hope–offers a window into the human condition. Though serving as guides and companions to patients’ illness experiences is profoundly meaningful work, the busy nature of modern medicine can blind its own practitioners to the reasons they entered it in the first place. Join oncologist Tyler Johnson and medical trainee Henry Bair as they meet with doctors, patients, leaders, educators, and others in healthcare, to explore stories on finding and nourishing meaning in medicine. This podcast is for anyone striving for a deeper connection with their medical journey. Visit TheDoctorsArt.com for more information.
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One of medicine's thorniest ethical questions concerns the lengths to which a physician should go to ameliorate suffering, including the use of medical means to hasten death. Yet, particularly for those who care for patients with, or for those who live with, serious illness, this question is all but inevitable. In this episode, Dr. Stefanie Green, the current president of the Canadian Association of Medical Assistance in Dying Assessors and Providers, shares her experiences helping patients die and how she views this branch of medicine. Dr. Green has been at the forefront of the change in legal regulation and clinical practice around medical assistance in dying (MAiD) in Canada. In her 2022 book, This is Assisted Dying, she shares the delicate, challenging, and humane moments she has witnessed while navigating this unique work.Disclaimer: This episode does not advocate for or against medical assistance in dying. Rather, it seeks to understand why a clinician may choose to perform this work. If you are experiencing suicidal thoughts or a crisis, please call or text 998 to reach the Suicide & Crisis Lifeline, available 24 hours a day, 7 days a week.In this episode, you will hear about:How Dr. Green transitioned from a career in maternity care to medical assistance in dying (MAiD) - 5:14A brief legal history of MAiD in Canada, beginning with Rodriguez v British Columbiaand including the sea change that came with Carter v. Canada - 6:39An overview of how MAiD works today in Canada - 12:14How MAiD works in the United States, specifically in California, and the role of prognosis in a patient’s eligibility for MAiD - 15:43Dr. Green’s reflections on how two decades working in maternity prepared her for MAiD - 20:45The specific process by which Dr. Green helps her patients die - 24:13The first patient encounter in which Dr. Green provided MAiD - 27:53Reflections on the frame of mind Dr. Green must adopt in order to perform this work - 35:04How Dr. Green processes the difficult emotions arising from her work - 43:22Dr. Green’s reflections on her role as a patient advocate when handling family conflicts at end of life - 47:50Advice for clinicians about connecting with patients through empathetic presence - 51:35Dr. Stefanie Green is the author of This is Assisted Dying.You can follow Dr. Stefanie Green on Twitter @DocSGreen.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023
What does it take to lead a health department with a budget of more than $50 billion, overseeing the health of nearly 20 million Americans? Here to tell us about that is Dr. Nirav R. Shah, who was the 15th New York State Commissioner of Health from 2011 to 2014. Today, Dr. Shah is a nationally recognized advocate of patient safety, health care innovation, and high-quality, low-cost care. He has variously served as Chief Operating Officer of Kaiser Permanente in Southern California, Advisor to the CDC Director, Senior Fellow of the Institute of Health Improvement, and Senior Scholar at Stanford University's Clinical Excellence Research Center. In this episode, Dr. Shah joins us to share his philosophy of healthcare leadership and how meaningful relationships anchor his work.In this episode, you will hear about:How Dr. Shah’s upbringing and the influence of Jainism steered him away from a lucrative career in finance and into medicine - 1:53Two patient stories in which seemingly simple mistakes led to moments of awakening for Dr. Shah in recognizing his purpose in medicine - 6:21A brief overview of Dr. Shah’s career path - 13:47Lessons on empathetic leadership that Dr. Shah picked up along the way - 19:21How forging strong relationships helped Dr. Shah find solutions on big issues during his time as New York State’s Health Commissioner - 21:57Dr. Shah’s current pursuits, including those focused on making a business case for supporting the unpaid caregivers of patients - 31:23Why transparency and bureaucratic structure are critical components of healthcare reform in the United States - 37:46Advice to clinicians on what makes effective leaders and collaborators, and how to find passion for meaningful projects - 41:43Dr. Shah is a trustee of the John A. Hartford Foundation, a board member of STERIS, and an advisor to GSR Ventures.You can follow Dr. Nirav R. Shah on Twitter @NiravRShah or on LinkedIn.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023
Storytelling, pain, rage, and cultural competency are just some of the themes we will explore in this episode. Our guest, Dr. Haider Warraich, grew up and went to medical school in Pakistan before completing residency at Harvard Medical School and fellowship in cardiovascular medicine at Duke University Medical Center. Today, he is an assistant professor at Harvard Medical School and the associate director of the Heart Failure Program at the VA Boston Health Care System. A prolific writer, he contributes regularly to the New York Times, Washington Post, and others. He is the author of three books on medicine for the general audience, most recently 2022’s The Song of Our Scars: The Untold Story of Pain, which examines the nature of pain not only as a physical, but also a historical and cultural experience. Over the course of our conversation, Dr. Warraich compares his medical experiences in Pakistan and in the US, discusses why he strives to incorporate palliative care into his cardiology work, and offers an impassioned critique of how modern medicine fails to address patients' suffering.In this episode, you will hear about:How Dr. Warraich went from thinking of his medical training as an “arranged marriage” to loving the career - 2:10How Dr. Warraich stays connected to his patients and his work despite the intense pressure and responsibility he experiences on a daily basis - 7:03What drew Dr. Warraich to cardiology and end-of-life care - 13:22Dr. Warraich’s reflections on the gaps in the care of patients with heart disease and how he now strives to reform the practice of cardiology - 17:33A discussion of how the medical culture of Pakistan differs from the United States and how they can be shockingly similar - 22:06How Tom Brady, the football quarterback, inspires Dr. Warraich to stay connected to the emotional core of his practice - 28:49Why it’s important to stay in a field if you care about it, especially if you hope to change and improve it - 35:37Dr. Warraich’s reflections on the nature of pain and how he hopes to change our cultural conversation around it - 41:38How acute pain and chronic pain are very different processes and how we can address suffering as a subject and deeply personal experience - 45:17You can follow Dr. Warraich on Twitter @haiderwarraich.Dr. Haider Warraich is the author of several books, including The Song of Our Scars: The Untold Story of Pain, Modern Death: How Medicine Changed the End of Life, and State of the Heart: Exploring the History, Science, and Future of Cardiac Disease.In this episode, we discuss the article “At the Edge of the Inside” by David Brooks, for the New York Times, and the book Just Mercy by Bryan Stevenson.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, and feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023
What if we could scientifically prove that compassion improves our well-being, our cognitive function, our longevity, and societal welfare? Here to explore these questions is our guest on this episode, Dr. James Doty, a neurosurgeon, inventor, entrepreneur and writer. As the founding director of Stanford's Center for Compassion and Altruism Research and Education, his academic focus is the neurobiological effects of meditation, compassion, and altruistic behavior. His bestselling 2017 memoir, Into the Magic Shop, details his path from a troubled childhood to becoming an internationally-renowned surgeon and philanthropist. He has served on the board of a number of nonprofit organizations, including as former Chairman of the Dalai Lama Foundation, and is on the International Advisory Board of the Council of the Parliament of the World's Religions. In this episode, we discuss his unlikely journey to medicine and the incredible insights on compassion he has collected over the years.In this episode, you will hear about:Dr. Doty’s difficult childhood experiences and how the kindness of strangers pulled him to medicine - 2:10How Dr. Doty dealt with the fish-out-of-water experiences in medical school - 11:00A discussion of negative self-talk and how to overcome it - 17:30How Dr. Doty went from developing a neuroscience center in impoverished Mississippi to establishing an altruism research lab at Stanford University - 20:19A discussion of the eponymous incident of Dr. Doty’s book Into the Magic Shop and how it profoundly shifted his view on compassion - 26:06A review of some of the exciting findings of Stanford’s Center for Compassion and Altruism Research and Education - 32:36Reflections on how Dr. Doty practices compassion in his daily life - 38:29A brief discussion of the power of belief and how it shapes our reality - 44:00A discussion of how the dehumanizing bureaucracy and profiteering of the medical field is failing physicians - 49:55Dr. James Doty is the author of the best-selling memoir Into the Magic Shop: A Neurosurgeon’s Quest to Discover the Mysteries of the Brain and the Secrets of the Heart.He is the senior editor of the Handbook of Compassion Science published by Oxford University.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
Too often, modern medicine focuses on life-extending interventions for those nearing the end of life at the expense of quality of life. Our guest today, Dr. Shoshana Ungerleider, argues we urgently need to rethink the emphasis of end-of-life care. She's the founder of the End Well Foundation, a nonprofit that seeks to improve how doctors and patients approach issues of mortality, as well as an executive producer of the 2018 film End Game and a major funder of the 2016 film Extremis, two Academy Award-nominated short documentaries on end-of-life care. As a health communicator. Dr. Ungerleider is the host of the TED Health Podcast and has been featured as a medical expert on CNN, CBS, PBS, Fox News, and other news networks. In this episode, she discusses her journey in health care and shares her mission to transform the end of life experience of patients everywhere and make dying well a part of living well.In this episode, you will hear about:How Dr. Ungerleider found her way to a career in health care and how she pushed through imposter syndrome while in medical school - 2:23Dr. Ungerleider’s formative experiences working with elderly patients in the ICU, leading her question the practices of modern medicine when dealing with seriously ill patients - 10:18How the Covid-19 pandemic has shifted public consciousness around death and dying - 15:30The origins of End Well, the conference and organization founded by Dr. Ungerleider and her colleagues in 2017 - 23:51What it would look like for there to be a shift in the cultural conversation around death and dying - 30:31A reflection on the risks of romanticizing the dying process - 36:54The recent cancer diagnosis in Dr. Ungerleider’s family and how this has propelled her to proactively manage her own risks - 43:49Advice for new clinicians on dealing with patient deaths - 48:49Dr. Shoshana Ungerleider is the author of “My Dad’s Terminal Cancer Diagnosis May Have Saved My Life” for Newsweek.You can follow Dr. Ungerleider on Twitter @ShoshUMDIn this episode, we discussed The Good Place, an award-winning sitcom series about philosophy and the afterlife.We discussed several articles and studies about whether physicians are more likely to choose to die at home than the general public. These articles include “How Doctors Die” by Ken Murray, “Association of Occupation as a Physician With Likelihood of Dying in a Hospital” by Blecker, Johnson, Altekruse, et al. and “Patients, and Doctors, Aren’t Dying at Home” by Dr. Danielle Ofri (our guest on episode 35).Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
"Death is not waiting for us at the end of a long road. Death is always with us, in the marrow of every passing moment. She is the secret teacher hiding in plain sight, helping us to discover what matters most."   So writes Frank Ostaseski, an internationally respected Buddhist teacher and pioneer in end-of-life care. Frank is the founder of the Zen Hospice Project in San Francisco, the first Buddhist hospice in America. Over the course of his career, Frank has accompanied over 1000 people through the dying process; these experiences have taught him lessons on how maintaining an ever-present consciousness of death can bring us closer to our most authentic selves. He describes these lessons in his bestselling 2017 book, The Five Invitations. In this episode, Frank joins us to share hard-earned wisdom from his unique life journey. Over the course of our deeply reflective and even meditative conversation, we discuss matters ranging from Japanese death poems, to Buddhist mindfulness practices, to what courage looks like in the face of death.In this episode, you will hear about:How the AIDS crisis led to the founding of the Zen Hospice Project - 2:16What Frank’s work looks like on a daily basis - 3:52Frank’s role as an ‘interpreter’ between patients and doctors - 5:57How clinicians can develop their own rituals in the process of healing patients - 9:09How Frank makes sense of the grief and suffering he witnesses and, despite it all, keep his spirit balanced - 13:40How the tenets of Buddhism influenced care at the Zen Hospice Project - 25:58How progresses in modern medicine sometimes hinders us in our acceptance of the impermanence and inevitability of death - 33:56Lessons on love, mindfulness, and finding meaning from Frank’s stories of patients at the end of life - 38:20The Five Invitations and what they look like in practice - 45:20Frank Ostaseski is the author of The Five Invitations: Discovering What Death Can Teach Us About Living Fully.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
The ICU can be a traumatizing place for patients, who are frequently heavily sedated, rendered unable to speak by breathing tubes, isolated by family visit limitations, and sometimes even physically restrained. In fact, a significant proportion of patients discharged from the ICU later develop persistent cognitive impairments and physical disabilities. Over the past two decades, Dr. Wes Ely has worked to improve the care of patients in the ICU, leading landmark studies resulting in the development of delirium prevention protocols that are now adopted in ICUs everywhere. Today, Dr. Ely co-directs the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center at Vanderbilt University Medical Center. In this episode, Dr. Ely joins us to share his career-long fight to reform ICU medicine and to recount poignant stories that illuminate and elevate the humanity of patients amid the chaos of the ICU — and in the process discusses themes that seldom appear in contemporary medical discourse, such as love, beauty, and mercy.In this episode, you will hear about:How Dr. Ely discovered medicine as a calling while growing up in rural Louisiana - 2:33How a fascination with cardiopulmonary physiology, combined with an interest in patient relationships, led Dr. Ely to critical care medicine - 4:27A discussion of how patients in ICUs can often be “de-humanized” - 6:31A story from early in Dr. Ely’s career that illustrates “malignant normality” — when treatment norms led to patient harm - 10:40A discussion of physician burnout and how the dehumanization of patients contributes to it - 13:27What Dr. Ely and his colleagues have learned through years of research about the harmful standard practices of ICU care - 18:53An explanation of the ABCDEF treatment bundle designed by Dr. Ely and his collaborators to improve outcomes of patients in the ICU patients - 24:04How Dr. Ely processes the guilt and shame he feels from the harm he inadvertently caused to patients early in his career - 29:37Reflections on how eye contact, physical touch, and openness of the heart are essential to good medicine - 36:03A discussion on how Dr. Ely’s spirituality has influenced his approach to patient care - 44:51What it means to provide healing when patients are facing serious illness, even at the end of life - 50:45Dr. Wes Ely is the author of Every Deep-Drawn Breath, a chronicle of his experiences caring for ICU patients.You can find out more about his work at ICUDelirium.orgFollow Dr. Ely on Twitter @WesElyMDVisit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
A pivotal development in the history of cancer research was the discovery that cancers can arise from mutations in genes already present in normal, healthy cells. Joining us in this episode is Dr. Harold Varmus, who shared the Nobel Prize in Physiology or Medicine in 1989 with his colleague, J. Michael Bishop, for this discovery. Their work has enabled scientists to explore why certain cancers develop in the human body and how we can develop better cancer treatments that target these genetic mutations. In addition to his pioneering research, Dr. Varmus has served as Director of the National Institutes of Health and the National Cancer Institute, President of Memorial Sloan-Kettering Cancer Center, and Scientific Advisor to the US Government, World Health Organization, and various other foundations and academic institutions. Over the course of our conversation, Dr. Varmus describes his groundbreaking research, approach to institutional leadership, and his advocacy for the democratization of scientific knowledge through his role in the founding of PubMed Central and the Public Library of Science.In this episode, you will hear about:How Dr. Varmus' broad educational interests led him to pursue a medical career - 2:56How working at the National Institutes of Health drove Dr. Varmus’s passion for research and the trailblazing path his career took - 8:48A summary of Dr. Varmus’s research on retroviral oncogenes, which led to major advancements in cancer diagnoses and treatments - 16:35How Dr. Varmus became involved in the politics of science after receiving a Nobel Prize -  27:13Dr. Varmus’ mission while he was Director of the National Institutes of Health and his perspectives on the elements of effective healthcare institutional leadership - 30:28A discussion of open access publishing, a mechanism of distributing the results of scientific research online for free - 32:37Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
For all the crucial work physicians do in the hospital, no one spends more time with hospitalized patients than nurses. This is especially true in the intensive care unit, where nurses serve as patients’ conduits with their medical team and perhaps even with the outside world. Joining us in this episode is Christin Thankachan, an ICU nurse at Stanford Health Care who cares for the most seriously ill cancer patients in the hospital. Over the course of our stirring conversation, we ask her to reflect on how she guides patients and their families, with a comforting and compassionate hand, through life’s darkest moments. In addition, Christin shares the unique challenges she has faced as a frontline worker during the COVID-19 pandemic, and how she has maintained hope and meaning through these trying times.In this episode, you will hear about:How Hurricane Sandy pushed Christin towards a career in nursing - 2:06The differences between a nurse’s responsibilities in an intensive care unit and a medical/surgical unit - 5:13What a typical day is like for an ICU nurse - 7:26How Christin finds the physical, emotional, and psychological stamina to care for some of the sickest patients in the hospital - 10:22The kinds of relationships Christin forms with her patients and how she strives to elevate the human connection - 13:49The importance Christin places on recognizing the fullness of the humanity within each patient - 21:16The power of hope for patients facing serious illnesses - 31:50What it was like to serve as a frontline worker in the early days of the COVID-19 pandemic - 36:38Advice on how to stay connected to the most meaningful aspects of a healthcare profession, even in the darkest times - 40:47Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
Few would dispute that vision is just about our most important sense. From a neurophysiological perspective, more than half of the human brain is dedicated to processing vision. But beyond that, it also enables us to meaningfully interact with the world and the people around us, and allows us to engage in many of the activities that bring us joy in life. Joining us in this episode is Dr. Michael Marmor, Professor Emeritus and former chair of ophthalmology at Stanford University School of Medicine. In addition to his significant contributions to our understanding of diseases of the retina, Dr. Marmor is a patron of the arts who has published several books on vision and visual art. Over the course of our conversation, we discuss the fascinating inner workings of eyesight, how art appreciation can help create better doctors, and how Dr. Marmor accompanies patients facing vision loss.In this episode, you will hear about:How a desire to “wear multiple hats” — researcher, surgeon, educator — led Dr. Marmor to ophthalmology - 2:04A brief exploration of the sense of sight - 4:01Dr. Marmor’s research on the retina and why he believes a thorough understanding of how diseases work is critical for physicians caring for patients - 8:07Why helping a patient understand their condition provides comfort, even with serious illnesses - 11:53Dr. Marmor’s passion for the fine arts and how his expertise in vision complemented this passion - 18:23What art appreciation can do for physicians and how it gives us new ways of thinking and seeing - 23:52How medical curricula can be improved to integrate the arts and humanities, and the importance of an emphasis on breadth in addition to technical depth - 33:06Why an appreciation for all kinds of art keeps us in touch with culture -  46:29Dr. Marmor is the author of several books on art, including The Eye of the Artist (1996), Degas Through His Own Eyes: Visual Disability and the Late Style of Degas (2006), and The Artist’s Eyes (2009).Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
When it comes to medical humanitarianism, there is no bigger name than Médecins Sans Frontières (MSF), also known in English as Doctors Without Borders. MSF is renowned for its work in regions affected by armed conflict, endemic diseases, and natural disasters. In this episode, we are joined by Dr. Christos Christou, a Greek surgeon who has served as the international president of MSF since 2019. As a field doctor, he has worked in South Sudan, Iraq, Cameroon, and various other conflict zones. Over the course of our conversation, Dr. Christou takes us into the trenches of his medical work in caring for some of the most vulnerable people in the world, shares how he finds meaning and hope amid the depths of human suffering, and discusses the challenges to global health today.In this episode, you will hear about:How the values of his self-described “rustic” childhood led Dr. Christou into medicine - 2:28How Dr. Christou’s time in university shaped his life philosophy - 3:27The history and mission of Médecins Sans Frontières/Doctors Without Borders - 5:59What it is like to practice medicine in regions affected by armed conflict and natural disasters - 8:13Dr. Christou’s journey in MSF, from when he first heard of it to how he became its leader - 10:42Lessons learned on finding meaning in medicine in some of the most resource-limited settings - 13:41Dr. Christou’s stories of inspiring hope in patients even during incredibly challenging times - 16:19A discussion of the dangers faced by clinicians who work with MSF - 19:54The significance of bearing witness to suffering in giving a voice to vulnerable patients - 23:11A discussion of the major threats to global health today: climate change, epidemics, and war - 26:25Advice for new clinicians who wish to tackle issues in global health - 30:00Follow Dr. Christos on Twitter @DrChristou.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
While digital technologies now permeate nearly every aspect of our lives, their application to improve medicine remains limited. Still, recent advances in artificial intelligence, telecommunications, and other technologies hold enormous potential to transform how healthcare is delivered. At the forefront of exploring this potential is Dr. Justin Norden, a physician and investor at the venture capital firm GSR Ventures, where he focuses on investments in digital health companies. With a background in computer science, Dr. Norden previously worked on the healthcare team at Apple and helped launch the Center for Digital Health at Stanford University. He joins us in conversation to discuss how he discovered investing and entrepreneurship as a way to tackle problems in medicine, clarify misconceptions about digital health and venture capital, and explore how technologies are shaping the future of medicine.In this episode, you will hear about:A brief introduction to venture capital - 1:48How Dr. Norden’s experiences during medical training led him explore entrepreneurship and healthcare investing - 3:22How Dr. Norden’s passion for computer science influenced his medical education - 7:30What it was like to leave a clinical career - 10:18The past and current state of technological advancement in medicine - 20:28Co-host Dr. Johnson’s concerns over the ways technology has, at times, impeded the delivery of health care - 28:38Dr. Norden’s vision for the ideal balance between humanism and technology in medicine - 34:31How Dr. Norden considers the reconciliation between the profit motive of companies and the preservation of what makes medicine meaningful - 38:28How Dr. Norden decides which digital health companies to invest in - 44:57Advice to young clinicians who are curious about healthcare innovation - 50:09Follow Dr. Norden on Twitter @JustinNordenMD.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
As one of the most prolific and acclaimed physician writers today, Dr. Danielle Ofri is the author of seven books on the intricacies of modern medical practice and the doctor-patient relationship. Her other writings have appeared in The New York Times, The Atlantic, The New Yorker, in addition to various leading medical journals. She is also the co-founder and editor-in-chief of the Bellevue Literary Review, a literary journal that publishes works focusing on the human body, illness, and health. In her writings, Dr. Ofri uses vivid narratives to shed light on the highs and lows of being a doctor. In this episode, she joins us to share her path to medicine, how doctors can mitigate the moral injury they experience in their work, and how storytelling can comfort us in times of suffering.In this episode, you will hear about:How Dr. Ofri was initially drawn to internal medicine through the patient stories she encountered - 1:54A discussion of the tension between the business and art of medicine - 6:07Dr. Ofri’s advice on how clinicians can combat the moral corrosion that broken medical systems can induce - 11:29How Dr. Ofri’s medical residency during the AIDS epidemic led to her passion for writing - 16:33Dr. Ofri’s writing process - 23:30A discussion of the moral philosophy of medicine and why doctors do what they do - 27:09Dr. Ofri reflections on how her writing has impacted her clinical practice - 31:47The wisdom that physicians who encounter suffering every day can share with a world experiencing collective grief from the COVID-19 pandemic - 34:38A discussion of the emotional toll on clinicians of delivering bad news and confronting grief, and an exploration of guilt and shame - 42:25Dr. Ofri’s advice to clinicians on how to stay connected to meaning in medicine - 48:44Dr. Danielle Ofri is the author of the following books on being a doctor:Singular Intimacies: Becoming a Doctor at BellevueWhat Doctors Feel: How Emotions Affect the Practice of MedicineWhen We Do Harm: A Doctor Confronts Medical ErrorWhat Patients Say, What Doctors HearMedicine in TranslationIntensive Care: A Doctor’s JourneyIncidental FindingsFollow Dr. Ofri on Twitter @DanielleOfri.This episode included an excerpt from Jacqueline du Pré and Daniel Barenboim’s performance of the Cello Sonata No. 2 in F major, Op. 99 by Johannes Brahms, recorded live in West Berlin in 1968.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
In 1969, Elisabeth Kübler-Ross identified the five stages of dying in her book On Death and Dying. Her work has radically transformed the way we think and talk about grief and loss, giving us a shared vocabulary and understanding of a previously murky, yet universal, human experience. Towards the end of her life, Kübler-Ross worked closely with David Kessler, with whom she co-authored several books and formally adapted the stages of dying into the stages of grief. Today, David is the world’s foremost expert on grief and has taught health care workers, counselors, and first responders on facing death and loss. His writings and his website Grief.com have reached millions of people. In this episode, David joins us to share his personal experiences with loss and what his decades of helping those on the edge of death have taught him about finding meaning amid suffering, and happiness after tragedy.In this episode, you will hear about:Thanatology — the study of death and dying — and what drew David to this field - 2:10Kessler’s friendship with Elisabeth Kübler-Ross, the psychiatrist best known for developing the five stages of dying - 6:06How physicians are often ill-equipped to face death and how hey might better engage with dying patients - 11:22David’s advice to physicians on finding meaning amid loss and tragedy - 19:05A review of the five stages of dying/grief - 28:58On Meaning, the sixth stage of grief that David developed - 33:38How the pandemic saw a renewed interest in grief management, and how his interview with the Harvard Business Review entitled “The Discomfort You Are Feeling is Grief” went viral - 38:04How David manages the overwhelming sadness he sometimes experiences in his line of work - 43:54David’s advice to physicians on comforting grieving patients - 48:31David Kessler is the author of several books, including The Needs of the Dying and Finding Meaning: The Sixth Stage of Grief, as well as Life Lessons and On Grief and Grieving with Elisabeth Kübler-Ross, who is herself the noted author of On Death and Dying.Follow David Kessler on Twitter @IamDavidKessler.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you know anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion or send an email to info@thedoctorsart.com.
Advances in modern medicine mean a greater proportion of people today than ever before will live well into old age. Despite the seemingly encouraging trend, geriatrician Dr. Louise Aronson argues that we have made old age into a disease, a condition to be dreaded, denigrated, neglected, and denied. Dr. Aronson has made it her life's work to help us reimagine the rich possibilities of human longevity and of later life. Her bestselling book, Elderhood, was a finalist for the 2020 Pulitzer Prize for general nonfiction. In this episode, Dr. Aronson explains what makes geriatrics a meaningful career for her, discusses the faults in our society’s conception of elderhood, and shares her humane and hopeful vision for the future of aging.In this episode, you will hear about:An overview of what geriatrics entails - 1:47The need to recognize elderhood as distinct a life stage - 4:42Dr. Aronson’s reflections on what drew her into caring for older patients - 6:15The ways goals of care change in elderhood - 8:24Dr. Aronson’s approach to caring for her patients holistically - 13:27How physicians can change the “losers and winners” paradigm in healthcare - 17:34A discussion of structural and cultural ageism and the insidious ways it harms our society - 23:03How American culture and medicine elevates patient autonomy and how this can sometimes be harmful to older patients - 30:59A discussion of Dr. Aronson’s writing and what motivated her to become an author - 38:49How Dr. Aronson experienced and overcame burnout - 42:57Advice to new clinicians on how to connect with patients and create a more meaningful career path - 46:08Dr. Aronson is the author of the nonfiction book Elderhood and the short story collection A History of the Present Illness, as well as several essays and articles on ageism and aging and a blog.Follow Dr. Louise Arondson on Twitter @LouiseAronson, Instagram @LouiseAronsonSF, and LinkedIn.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
On June 28, 2022, we released an episode featuring Ellen Dunphy, a 35-year old patient with a terminal diagnosis of gastric cancer who had been under the care of co-host Dr. Tyler Johnson. Ellen passed away a week later. Accompanying every step on her cancer journey was her husband, Andy Clinnin. In this episode, Andy joins us to share his experiences as Ellen’s caregiver and primary source of emotional support. Over the course of our conversation, we explore Andy and Ellen’s relationship from its beginnings all the way to her final days and after. Andy’s reflections on these challenging moments, perhaps paradoxically, has much to teach us about what it looks like to courageously make the most of life, however much of it remains. In this episode, you will hear about:A synopsis of how Ellen came to be in Dr. Johnson’s care - 1:03How Andy and Ellen met, and their relationship leading up to her diagnosis - 6:44Andy’s perspective on Ellen’s diagnosis - 10:15What it was like for Andy to learn about Ellen’s diagnosis and how he adjusted to being her caregiver - 16:26Andy’s reflections on the experience of having Dr. Johnson as Ellen’s oncologist - 21:39How Andy helped Ellen think through her priorities at the end-of-life - 27:15How being with his partner until the end has changed the way Andy sees life - 35:46How California’s End of Life Treatment Act allowed Ellen to control how her life story ended - 43:14Andy’s advice for other caregivers on how to best take care of themselves so they may best provide care to their loved ones - 51:33 Ellen Dunphy’s one-woman play “Imaginary Endings” about facing her cancer diagnosis can be viewed on YouTube.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
What should we do about the fact that a person's health is affected in large part by social factors beyond the confines of the hospital? For a long time, traditional health care institutions have been inadequate in answering this question. Joining us in this episode is Dr. Toyin Ajayi, co-founder and chief executive officer of Cityblock Health, a tech-driven health care provider for communities with complex health and social needs. With a focus on Medicaid and lower income Medicare beneficiaries, Cityblock Health has been widely recognized as an exemplar of a sustainable model of care delivery for marginalized populations. We are pleased to be joined by Dr. Ajayi to discuss Cityblock Health as well as her clinical work, which centers on patients with chronic complex and end-of-life needs.In this episode, you will hear about:Dr. Ajayi’s personal journey from growing up in Kenya to leading Cityblock Health - 1:57Why Dr. Ajayi chose to focus her career on patients with complex and chronic health needs - 4:11The social determinants of health and its impact on a patient’s ability to seek appropriate medical care - 5:21Dr. Ajayi’s story of a chronically-ill patient who appeared ‘difficult’ but in truth was suffering from social inequities that limited his access to health care - 10:35A discussion of Cityblock Health, the value-based healthcare provider that Dr. Ajayi co-founded to provide care to the Medicaid patient population - 18:07The stigmas around Medicaid patients and why Dr. Ajayi sees opportunities instead of barriers  - 22:02An in-depth exploration of the services Cityblock Health provides - 27:00The challenges of the fee-for-service model of American healthcare, and how Cityblock seeks to address them - 32:36Dr. Ajayi’s advice to medical practitioners on how to build trust and rapport with their patients - 37:50The future of Cityblock Health and the health equity movement - 40:05Follow Dr. Toyin Ajayi on Twitter @ToyinAjayiDoc and Cityblock Health @CityblockHealthVisit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
The Human Genome Project was a 13 year long international effort to map and sequence all of the genes in the human genome. Leading this ambitious endeavor was Dr. Francis Collins, who was also Director of the National Institutes of Health from 2009 to 2021. His work has had a far-reaching impact on our understanding of diseases and the development of new therapies. In addition to being one of the foremost physician scientists of our time, Dr. Collins is also well known for his bold defense of his Christian faith and for his steadfast promotion of dialogue between science and religion. His book, The Language of God, was an international bestseller. In this episode, Dr. Collins joins us to share his remarkable path in medicine, the origins and evolution of his faith, and his perspectives on the moral mission of medicine.In this episode, you will hear about:A close personal look at Dr. Collins’ career, leading to his directorship of the Human Genome Project - 1:56The mission and implications of the Human Genome Project - 10:02The cultural upheaval that has occurred during Dr. Collins’ lifetime and the way popular culture tends to pit science and faith against each other - 15:25The origin of BioLogos and its mission to foster a community that strives to harmonize science and Christian faith - 24:47A brief discussion of Intelligent Design, a movement that aims to prove the existence of God through science, and how it differs from BioLogos - 28:26Dr. Collins’ reflections on the reconciliation between his faith in God and the human suffering he has witnessed throughout his career - 32:42Advice on finding meaning and fulfillment in both life and work, and how community can help combat burnout - 40:38Dr. Francis Collins is the author of The Language of God  and the founder Biologos.org.Dr. Collins references The Problem of Pain by C.S. Lewisas being particularly enlightening to his personal worldviewDr. Collins was recently interviewed by Science.org about his time leading the National Institutes of HealthVisit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
With around 63 million beneficiaries, Medicare is the single largest provider of health insurance in the United States, serving Americans aged 65 or older, as well as some younger patients who have certain disabilities. Directing this massive program is Dr. Meena Seshamani, an otolaryngologist and former Vice President of Clinical Care Transformation at MedStar Health, a large health care organization primarily operating in the Baltimore-Washington metropolitan area. There, she led initiatives in palliative care, geriatrics, and community health. She has also served as Director of the Office of Health Reform at the US Department of Health and Human Services. In this episode, Dr. Seshamani discusses her path from surgeon to health policy leader, what draws her to caring for older adults, and her vision for a better, more sustainable health care of the future.In this episode, you will hear about:Dr. Seshamani’s enthusiasm for medicine at a young age and the diverse career trajectory that followed - 2:08A discussion of Dr. Seshamani’s past leadership roles, including those at the Office of Health Reform under the Obama administration and at MedStar Health - 6:27Balancing the need for clinicians to work collaboratively and the inclination of physicians to value autonomy - 10:20An explanation of Medicare’s role in the US healthcare ecosystem - 14:51What draws Dr. Seshamani to focus on the care of older adults - 17:39The crisis of burnout in the medical profession and Dr. Seshamani’s vision for how this can be addressed - 21:00The fee-for-service mechanism of healthcare reimbursement, accountable care relationships, and the value of preventative care - 25:33The pay disparity between specialists and primary care physicians, and the role Medicare can play - 30:40How the growing population of aging Americans impacts the future sustainability of the Medicare program - 38:41How Medicare is reforming its allocation of resources to promote health equity - 42:02Dr. Seshamani’s advice to students and clinicians on engaging in meaningful work as they advance in their careers - 48:24In this episode, we discuss the speech “Cowboys and Pit Crews” by Atul Gawande, published in the New Yorker.You can follow Dr. Seshamani on Twitter @DrMeenaSeshVisit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
Pediatric neurosurgeons manage some of the most complex diseases in children, operating on the delicate and precious organ that makes us essentially human. Dr. Jay Wellons is Chief of the Division of Pediatric Neurosurgery at Vanderbilt University Medical Center and the author of All That Moves Us, a memoir that offers an intimate and gripping account of the triumphs, terrors, joys, and pathos he encounters on a daily basis. In this episode, Dr. Wellons joins us to discuss his path to neurosurgery by way of English literature and family medicine, his faith as an anchor amidst his challenging work, and reflections on what the human dramas involving the most vulnerable children he has cared for has taught him about resilience, courage, and grace under pressure.In this episode, you will hear about:A discussion of the range of procedures pediatric neurosurgeons perform - 1:58How a fascination with neuroanatomy drew Dr. Wellons into neurosurgery, and how his literary studies have impacted his patient care - 3:58The origin of Dr. Wellons’ book All That Moves Us and his experiences with a personal health crisis - 8:59What it is like to operate on one of the most intricate and delicate parts of the human body - 18:00How Dr. Wellons deals with the weight of unsuccessful procedures, and how he carries on - 27:51Forming relationships with the families of very young and often very ill patients - 31:12A discussion of spiritual faith and its place in the life of a surgeon who sees so much tragedy - 35:27Dr. Wellons’ advice to students, trainees, and clinicians on how to stay connected and hopeful in the face of seemingly insurmountable challenges - 40:52Dr. Wellons is the author of a book All That Moves Us: A Pediatric Neurosurgeon, His Young Patients, and Their Stories of Grace and Resilience, as well as the article “How the Summer Camp Doctor Earned His Stripes ” for Garden & Gun magazine.You can follow Dr. Jay Wellons on Twitter @JayWellons5Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2022
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