First used in the context of Vietnam war veterans, the term "moral injury" refers to the psychosocial, behavioral, and spiritual distress that comes from perpetuating or witnessing events that contradict deeply held moral beliefs. In recent years, moral injury has increasingly been used to describe one of the main challenges clinicians face in modern medicine — the challenge of knowing what care patients need but being unable to provide it due to constraints beyond the clinicians control, such as limited time or misaligned financial structures. Even more than emotional exhaustion and detachment, moral injury leads to profound shame and guilt. One of the leading voices addressing moral injury among health care workers is Dr. Wendy Dean, a psychiatrist who has written widely on the issue, most recently in her book, If I Betray These Words: Moral Injury in Medicine and Why it's so Hard for Clinicians to Put Patients First. In this episode, Dr. Dean shares her own winding journey from orthopedic surgery to general surgery and finally to psychiatry, discusses where moral injury comes from and what it looks like, and explores what clinicians can do to address it.In this episode, you will hear about:Dr. Dean’s early explorations in medicine - 2:35How Dr. Dean’s desire to become a surgeon was deterred by gender discrimination - 5:12What led Dr. Dean to psychiatry, and then eventually out of clinical medicine entirely - 13:22A discussion of what moral injury is and why Dr. Dean began to study it - 18:03Examples of how moral injuries occur in the day-to-day of medical practice - 24:19How physicians and hospital administrators can address moral injury, citing as an example the court case of Raymond Brovont M.D. vs EmCare Holdings Inc - 38:57Dr. Dean’s advice for how navigate and push back against seemingly insurmountable bureaucracy - 42:22Moral Injury in Healthcare, the non-profit Dr. Dean founded - 47:39What setting personal and professional boundaries looks like in medicine - 53:04Dr. Dean’s advice to students and clinicians about fighting burnout - 57:37In this episode, we discuss Achilles in Vietnam: Combat Trauma and the Undoing of Character by Jonathan Shay, MD, PhD, and The Business of Health Care is Built on the Exploitation of Doctors and Nurses by Danielle Ofri, MD, PhD.Dr. Wendy Dean is the cohost of the Moral Matters podcast.You can follow Dr. Dean on Twitter @WDeanMD.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

When COVID-19 rapidly emerged, the World Health Organization (WHO) was thrust into an unprecedented challenge. The global pandemic response was in disarray; health care resources were limited and inequitably distributed; and misinformation burgeoned. At the center of this maelstrom was Dr. Soumya Swaminathan, who served as the WHO’s first Chief Scientist, from 2019 until 2022. Dr. Swaminathan not only spearheaded efforts to disseminate the latest scientific findings about the coronavirus and vaccine development, but also became one of the major public faces of the WHO. In this episode, we discuss Dr. Swaminathan's formative years becoming a pediatrician in India, specializing in treating children with tuberculosis and HIV, as well as the challenges she faced as a leader at the WHO in a time of eroding public trust.In this episode, you will hear about:Dr. Swaminathan’s experiences training to become a doctor in India - 2:05How Dr. Swaminathan discovered the balance between her interests in clinical medicine and research - 6:00Dr. Swaminathan’s reflections on the challenges of caring for children with tuberculosis and HIV - 9:38A discussion of global research funding disparity - 14:08How Dr. Swaminathan joined the WHO and eventually came to fill such a critical leadership role there - 19:04Dr. Swaminathan’s recollections of the arrival of COVID-19 from her perspective as the WHO’s first Chief Scientist - 21:28Lessons learned in health communication from the pandemic - 27:46The experience of being a lightning rod for online harassment and misinformation - 35:07Dr. Swaminathan’s advice to new clinicians who are considering pursuing a career in global health - 39:25You can follow Dr. Swaminathan on Twitter @DoctorSoumya.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

Navigating the unforgiving hours and ethical challenges of medical training while holding onto humanism; the medical and cultural history of the human heart; the moving journey of a doctor as he wrestles with his duties as a son and caregiver for a father with dementia. These are just some of the diverse subject matters our guest in this episode, Dr. Sandeep Jauhar, has written about. Dr. Jauhar is the director of the Heart Failure Program at Long Island Jewish Medical Center and a multiple-time bestselling author whose writings have also appeared in the New York Times, Wall Street Journal, and other publications. In the first half of our conversation, Dr. Jauhar shares his journey in medicine and struggles with burnout; while in the second half, we discuss his poignant experiences caring for his father, the subject of his most recent book, My Father's Brain: Life in the Shadow of Alzheimer's. In this episode, you will hear about:How Dr. Jauhar’s immigrant parents influenced his choice to pursue a career in medicine - 2:02Dr. Jauhar’s reflections on the role of indecisiveness in shaping his path to cardiology - 4:49A discussion of a doctor’s struggle against a corporate medical system that inflicts moral injury on physicians - 12:51Dr. Jauhar’s advice to physicians on ameliorating moral injury - 18:54Reflections on how Alzheimer’s disease affects the patient’s family, and an overview of Dr. Jauhar’s recent book My Father’s Brain - 25:10A discussion of therapeutic deception, also known as validation therapy, in which caregivers and loved ones are encouraged to “play along” with the distorted reality of a patient with dementia - 36:43The conflicts between Dr. Jauhar and his siblings concerning end-of-life care for his father - 43:18How the medical system needs to changed so that more support is given to dementia patients and their families - 49:05Dr. Sandeep Jauhar is the author of several best-selling nonfiction books: Intern: A Doctor’s Initiation, Doctored: The Disillusionment of an American Doctor, Heart, A History, and My Father's Brain: Life in the Shadow of Alzheimer'sDr. Jauhar also responds to medical students and residents on his blog Advice on Your First Year.You can follow Dr. Jauhar on Twitter @SJauhar.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

Since 1938, the Harvard Study of Adult Development has followed the lives of hundreds, and eventually thousands, of American adults, with the goal of discovering what enables people to live healthier, more meaningful lives. Joining us in this episode is Dr. Robert Waldinger, professor of psychiatry at Harvard Medical School and the current director of the study. He is the author of the book The Good Life: Lessons from the World's Longest Scientific Study of Happiness. Over the course of our conversation, we explore the origins and evolution of the study, what adult development actually means, whether happiness is a choice, how social media shapes our relationships, Dr. Waldinger's interests in Zen Buddhism, and the key to leading a fulfilling life.In this episode, you will hear about:What drew Dr. Waldinger to the field of psychiatry - 1:53Dr. Waldinger’s reflections on the work and daily practice of a psychiatrist - 3:31An overview of the Harvard Study of Adult Development, the longest running scientific study on happiness - 6:54The medical and psychosocial concepts of “adult development” - 9:49The most important and surprising findings of the Study of Adult Development - 16:20Why relationships are critical to health and happiness - 23:07How social media distorts reality and why it can be quite harmful to mental health - 29:37Whether happiness is a choice - 34:48The impact of Zen Buddhism on Dr. Waldinger’s life and work - 43:55Dr. Waldinger’s advice to clinicians on leading fulfilling careers - 50:02In this episode, we discuss the book Wherever You Go, There You Are, by Jon Kabat-Zinn.Dr. Robert Waldinger is the author of The Good Life.You can view Dr. Waldinger’s acclaimed TED Talk What Makes a Good Life.You can follow Dr. Waldinger on Twitter @RobertWaldinger.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

When we hear about people with cancer, the stories often end when the treatments end—either the battle has been won and the cancer cured, or in more tragic circumstances, the cancer takes the patient's life. But for patients who survive, that's not where the story ends. Cancer has fundamentally transformed their lives. How are they to make sense of the existentially threatening experience they have gone through? That's where cancer survivorship comes in. Joining us in this episode is Dr. Tara Sanft, director of the survivorship clinic at Yale Cancer Center, where she helps patients thrive after cancer. Dr. Sanft is also a breast oncologist and the Chief Patient Experience Officer at Smilow Cancer Hospital. In this episode, we discuss the importance of cancer survivorship, how Dr. Sanft navigates the emotional challenges of her work, and what all clinicians can do to better support patients through difficult times.In this episode, you will hear about:How the death of a family member influenced Dr. Sanft’s decision to go into medicine - 2:04Why Dr. Sanft’s decided to focus on palliative care - 6:02Reflections on how communication and building relationships are key to palliative care - 14:20A discussion of cultivating sacred moments in medicine - 19:53The purpose of a cancer survivorship clinic - 26:02A discussion of the most challenging aspects of Dr. Sanft’s practice - 33:35How Dr. Sanft shoulders the emotional toll of her work - 36:30Dr. Sanft’s duties as the Chief Patient Experience Officer at her hospital - 40:25How to create culture change in medicine - 43:17Dr. Sanft’s advice to clinicians on how to better foster self-compassion and create effective healthcare teams - 48:18You can follow Tara Sanft on Twitter @TaraSanftMD.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

In the Judeo-Christian tradition, the Sabbath is a day of rest during the week. Our guest in this episode, Judith Shulevitz, is a journalist and literary critic who has thought deeply about what the secular world can learn about meaningful rest from the practice of the Sabbath. In her book The Sabbath World: Glimpses of a Different Order of Time, she explores how, despite our culture of workaholism, we can still discover the restorative joy of rest, reflection, and family. Shulevitz is also a regular contributor to the New York Times and the Atlantic, and is the chief science writer of the New Republic. Over the course of our conversation, we discuss the origins of the Sabbath, the ideals this tradition can bring back for the individual and community, and how clinicians can create space for purposeful rest amid their busy lives.In this episode, you will hear about:What drew Shulevitz towards re-engaging with her Jewish faith as an adult - 2:50What observing the Sabbath looks like in a traditional Jewish household - 5:20An exploration of the idea of a “secular Sabbath” and what it could mean for the modern world - 10:33The relentless culture of medical residency training and the factors contributing to it - 13:00How medical training affects physicians’ sense of community - 36:37Shulevitz’ advice to those with very busy schedules on how to make space for purposeful rest in their lives - 38:52Reflections on the need for physicians to process the extremes of emotion and suffering they encounter - 47:36Why it is critical to be present in the real world during times of rest - 50:45Judith Shulevitz is the author of The Sabbath World: Glimpses of a Different Order of Time.You can follow Judith Shulevitz on Twitter @JudithShulevitz.Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

We are joined in this episode by Dr. Eric Reinhart, an anthropologist, psychoanalyst, and psychiatry resident at Northwestern University Feinberg School of Medicine. While Dr. Reinhart is the first resident-in-training we've had on this program, his path has been far from straightforward. Prior to residency, Dr. Reinhart conducted ethnographic work in Chicago's South Side, India, South Africa, and migrant communities in Southern Europe. Through this research, he addresses the multifaceted effects of poverty and social inequities on community health. In this conversation, we discuss how he applies his anthropology training to create culturally sensitive systemic changes and how healthcare providers can play a more active role in engaging with their communities.In this episode, you will hear about:How having a deaf brother led Dr. Reinhart to medicine - 1:54Dr. Reinhart’s observations of the disconnect between the ideals he heard in medical school and the reality of how profit-driven hospitals operate - 5:59Why Dr. Reinhart pursued a study in anthropology to learn how to address contemporary social ills - 12:46How a case study of drug-resistant tuberculosis in Russian prisons informed Dr. Reinhart’s evaluation of pandemics - 19:37What drew Dr. Reinhart to psychoanalysis and psychiatry, and how he applies them to his field studies - 26:41A discussion of the power structures inherent to medico-social field work and how to properly determine what a community needs - 32:04Advice on how doctors and medical trainees can become empowered to help change the systems they work in - 41:21How Dr. Reinhart hopes to apply his experiences to improve community-based care - 48:42You can follow Dr. Eric Reinhart on Twitter @_Eric_Reinhart.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

The wellness industry saturates our cultural consciousness, with juice cleanses, organic skincare, and spa retreats flooding our social media feeds. But what does this plethora of dazzling — and often-expensive — lifestyle products all amount to? Not much, argues Dr. Pooja Lakshmin, a psychiatrist who specializes in women's mental health and clinical assistant professor at George Washington University School of Medicine. As she writes, "our understanding of self-care and wellness is incomplete at best and manipulative at worst. We cannot meditate our way out of a 40 hour workweek without childcare. These wellness products keep us looking outward, comparing ourselves with others or striving for perfection." She details her ideas for achieving true wellness in her recently released book, Real Self-Care: A Transformative Program for Redefining Wellness. In this episode, Dr. Lakshmin joins us to discuss how she overcame her own struggles working in medicine and details practical strategies for real self-care, which, in her words, "isn't a thing to do or buy, but a way to be." In this episode, you will hear about:How Dr. Lakshmin’s rocky initial foray into medicine led her a career in psychiatry - 2:15Dr. Lakshmin’s disillusionment with medicine, her two years away from the profession, and what she learned from immersing herself in the wellness industry - 5:34Reflections on the state of the wellness industry - 10:42An overview of Dr. Lakshmin’s book Real Self-Care and what real self-care looks like - 15:52A deeper dive into the first principle of real self-care: boundary setting - 18:47A discussion of how the American healthcare system often exploits doctors and nurses - 24:25The second principle of real self-care: self-compassion - 32:08The third principle of real self-care: knowing your values - 38:44The fourth principle of real self-care: empower oneself to create change - 45:09Dr. Lakshmin’s advice on getting control of your self-care journey - 50:43In this episode, we discussed the essay The Business of Healthcare Depends on Exploiting Doctors and Nurses by Dr. Danielle Ofri, published in the New York Times.We also discussed Dr. Lakshmin’s article How Society Turned its Back on Mothers, published in the New York Times.Dr. Pooja Lakshmin is the founder and CEO of GEMMA, a women’s mental healthcare education community focused on impact and equity.You can follow Dr. Pooja Lakshmin on Twitter @PoojaLakshmin.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

Approximately 1 in 700 babies in the United States are born with Down Syndrome. Yet, despite how common this condition is for people, we don’t often have the chance to hear their stories. In this episode, we are joined by Dashiell Meier, a young aspiring filmmaker and disability advocate who has Down Syndrome. Over the course of our conversation, we have the wonderful opportunity to explore how Dashiell sees the world as he reflects upon the stereotypes that society holds against people with disabilities, discusses what makes his favorite doctors stand out, shares his passion for storytelling, and offers advice to clinicians on how to better connect with patients who have disabilities.In this episode, you will hear about:How Dashiell currently helps Stanford medical students learn to communicate with patients with disabilities - 1:47Dashiell’s academic interests and career aspirations in the entertainment world - 3:22Dashiell’s interactions with doctors and what makes his favorites stand out - 5:22A discussion of the stereotypes that people with Down Syndrome face - 7:42What Dashiell wishes people knew about Down Syndrome - 11:00The movement for people with disabilities that Dashiell is spearheading, and what he hopes to achieve through it - 19:10Advice on building good relationships with people who have disabilities - 27:00The projects Dashiell intends to create as a filmmaker - 32:04How to develop greater empathy for people with disabilities - 34:46Advice to new clinicians and trainees on how best to interact with patients with disabilities - 37:10You can follow Dashiell’s film and video projects on his YouTube channel. You can also follow him on Twitter @DashiellMeier.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

From Tanzania to India, from Tibet to Antarctica, Dr. Jonathan Reisman, our guest in this episode, has practiced medicine in truly diverse regions of the world. Dr. Reisman's talents and passions are unparalleled in their variety; he is, among many things, an emergency physician, naturalist, food writer, travel writer, and wilderness survival expert. He is the author of The Unseen Body, an exploration of the human anatomy through all of its miraculous, mundane, bizarre, and surprising parts, presented through the eyes of a lifelong adventurer. Over the course of our conversation, Dr. Reisman shares his experiences traveling through the most remote areas of the world, what his voyages have taught him about health and illness, the impact of emerging digital technologies on the doctor-patient relationship, and much more.In this episode, you will hear about:How a love of the natural world led young Dr. Reisman to travel abroad and ultimately to the medical profession - 2:04Dr. Reisman’s early adventures studying sociology in the Russian Far East - 5:30The parallels between exploring the natural world and the human body - 9:26The puzzle-solving aspects of medicine and the impact of emerging technologies and artificial intelligence - 12:18Dr. Reisman’s reflects on his time practicing medicine in India, Tanzania, Nepal, and Antarctica, and the importance of the physical exam in these settings - 21:15The strengths and limitations of the physical exam, especially as they relate to the clinician-patient relationship - 31:53How artificial intelligence will complement human physicians in the future - 36:38What Dr. Reisman believes is critical to the future of medical education - 46:12Dr. Reisman’s advice to young clinicians on how to keep their curiosity alive - 55:10Dr. Jonathan Reisman is the author of The Unseen Body: A Doctor’s Journey Through the Hidden Wonders of the Human Anatomy.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

For all the deeply rewarding moments medicine offers, it is also a profession often intensely challenging on both systemic and personal levels. Our guest in this episode is Dr. Caroline Elton, an occupational psychologist who has devoted her career to counseling doctors and medical trainees in the National Health Service and various medical schools in the UK. She is the author of Also Human: The Inner Lives of Doctors, which discusses the physical, mental, and emotional toll of medical training and practice. Among other issues, she writes about how doctors deal with guilt and shame, gender and racial discrimination in health care training, the erosion of the clinician-patient relationship in modern medicine, and how clinicians can build emotional resilience. Over the course of our conversation, Dr. Elton shares what led her to this work, exposes the many shortcomings in how doctors are trained today, and explores how we can create a more humane path forward.In this episode, you will hear about:What led Dr. Elton to her unique work in counseling physicians - 2:04Reflections on both the compassion and the callousness Dr. Elton witnessed as she observed physicians (her patients) in their working environments - 10:01A review of medical training in the UK versus the US - 15:16A discussion of Also Human: The Inner Lives of Doctors and the concept of moral injury - 19:51The kinds of patients Dr. Elton sees in her present work - 25:00How institutional cultures can come to valorize toxic, brutal expectations placed on physicians - 27:03How Dr. Elton’s managed her first patient, a doctor who was planning on quitting medicine just weeks after beginning her postgraduate training - 32:49A discussion of how sexism and other forms of bigotry factors into burnout - 38:20Why the screening process for selecting future doctors should be improved - 43:37How a trainee can prepare themselves for the psychological demands of a medical career - 48:00Advice to administrators and executives of how best to serve the psychological demands of their medical workforce - 50:34Dr. Caroline Elton is the author of Also Human: The Inner Lives of Doctors.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

The American Medical Association (AMA) is the largest professional association of physicians in the United States, comprising more than 270,000 clinicians across all medical specialties. It is involved in all aspects of American medicine, from establishing standards of care, to reforming medical education, to lobbying for health care policies. Our guest in this episode is Dr. Jack Resneck Jr., chair of the department of dermatology at the University of California San Francisco and the current president of the AMA. In this conversation, we explore Dr. Resneck's personal journey in medicine, how the AMA is addressing physician burnout, how the AMA is coming to terms with its own history with race relations, how digital health is transforming medicine, how health care reimbursement rates are determined, and how doctors can play a more active role in advocating for their own work.In this episode, you will hear about:Dr. Resneck’s early years as a self-described ‘policy nerd’ and growing up in a physician family - 2:10How Dr. Resneck first became involved with the AMA - 6:01A brief review of the history and mission of the AMA - 8:23A discussion of the epidemic of burnout and how the AMA is addressing it - 12:45A survey of the AMA’s current policy priorities - 23:42A conversation around the incentive discrepancies around primary care medicine and how the AMA’s Relative Value Update Committee (RUC) is addressing this - 29:26How artificial intelligence and other new technologies are shaping the future of medicine, and why physicians must take an active role in their development - 36:25Reflections on the history of the AMA’s race relations and what the modern medical establishment must do to remedy health discrepancies, including The AMA’s Strategic Plan to Embed Racial Justice and Advance Health Equity - 47:15Dr. Resneck’s optimistic view of the future of the profession - 55:08In this episode we discussed several reports and articles, including:The Flexner Report, a 1910 survey of the medical profession that was used to standardize medical education.How Being a Doctor Became the Most Miserable Profession by Daniela Drake.The Lorna Breen Health Care Provider Protection Act, a recently-passed legislation aimed at helping physicians.Follow Dr. Resneck on Twitter @JackResneckMD.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

Matters of faith and spirituality are seldom openly discussed in medicine. But for our guest in this episode, pediatric palliative care doctor Dr. Elisha Waldman, these issues are a daily fixture of his work. Dr. Waldman is former associate chief of the Division of Pediatric Palliative Care at Ann and Robert H. Lurie Children's Hospital of Chicago and former medical director of pediatric palliative care at Columbia University Irving Medical Center. He is the author of the memoir This Narrow Space, in which he describes his seven years working as a pediatric oncologist at Hadassah Hospital in Jerusalem, Israel, while grappling with the ethical and political complexities that came with treating his Muslim, Jewish, and Christian patients. Over the course of our conversation, Dr. Waldman discusses his formative religious upbringing, delves deep into what it means to be present with patients in moments of suffering and existential anguish, and examines what his experiences have taught him about the enigmas of life, death, faith, and identity.In this episode, you will hear about:How Dr. Waldman’s early interest in religious studies influenced his pursuit of a career caring for children with cancer - 2:12Dr. Waldman’s religious upbringing as the son of a conservative Jewish rabbi - 7:00A discussion of spiritual care in medicine and what it means to be a “spiritual generalist” versus a “spiritual specialist” - 13:49Reflections on what brought Dr. Waldman to Jerusalem and what it was like to practice medicine in such a diverse and politically complex city - 23:01How Dr. Waldman finds the emotional fortitude to continue giving care and comfort to children who are seriously ill - 26:11A discussion of powerful and beautiful moments in accompanying patients through suffering - 33:40How pain differs from suffering and what physicians can do once they recognize that difference - 48:13Dr. Waldman’s advice to young clinicians on being present and curious with patients - 57:25Dr. Elisha Waldman is the author of This Narrow Space: A Pediatric Oncologist, His Muslim, Jewish, and Christian Patients, and a Hospital in Jerusalem.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

The National Academy of Medicine (NAM) is an independent organization that provides expert evidence-based guidance on issues of health, biomedical science, and health policy. Election to the NAM is considered one of the highest honors in the fields of health and medicine, recognizing individuals who have shown exceptional professional achievement and commitment to service. In this episode, we are joined by Dr. Victor Dzau, who has been president of the NAM since 2014. He previously served as President of the Duke University Health System, Chairman of Medicine at Brigham and Women's Hospital of Harvard Medical School, and Chairman of Medicine at Stanford Health Care. As a leading scholar in cardiovascular medicine, his pioneering research laid the foundation for the development of blood pressure medications widely used today. Over the course of our conversation, Dr. Dzau discusses his challenging upbringing as a refugee of the Chinese Civil War, describes his dedication to health equity and global health; explores the work of the NAM, and passionately shares why clinicians should be more involved in public discourse.In this episode, you will hear about:How growing up as a refugee of the Chinese Civil War shaped Dr. Dzau’s path and practice as a physician - 2:27How Dr. Dzau’s became a physician-scientist - 7:06The circumstances that led Dr. Dzau to take on issues of global health - 11:03Reflections on how Dr. Dzau stays in touch with the deeper meaning of medicine - 13:05A discussion of the values Dr. Dzau holds in his various roles - 17:41The difficulties Dr. Dzau faced during his education and career and how he recovered from burnout - 20:04A description of the purpose and mission of the National Academy of Medicine - 28:36How new members are elected to the NAM - 32:26A survey of the current issues the NAM focuses on and how Dr. Dzau thinks about the political dimensions of his work - 36:25The need for medical professionals to better communicate scientific facts with the broader public - 41:25Advice to early-career clinicians on leadership - 45:32Dr. Dzau delivered the Boston University Class of 2020 Commencement Speech, in which he discussed his own experience of burnout.You can follow Dr. Dzau on Twitter @VictorDzau.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

While this podcast has largely featured clinicians sharing the joy they have found in medicine, in this episode—breaking with tradition—we speak with a physician left disenchanted by her experiences working in medicine. Our guest is Dr. Arghavan Salles, a minimally-invasive and bariatric surgeon who conducts research on gender equity and implicit bias in medicine. At Stanford Hospital, she advises initiatives to promote physician well-being and diversity. During the COVID-19 pandemic, her frontline experiences were featured in Newsweek, NBC, CBS, and other press outlets. Over the course of our conversation, Dr. Salles shares fiercely honest accounts about the difficulties she has faced as an immigrant, minority, and woman in medicine. Her stories are by turns saddening, shocking, and amusing, but ultimately invoke us to reflect on the part we can all play to create a more just and inclusive path for current and future physicians.In this episode, you will hear about:Dr. Salles’  path to medicine and her regrets along the way - 2:11The social pressures within medicine to overlook the downsides and hardships of a medical career - 7:11Why Dr. Salles chose surgery as a specialty - 11:02How, upon accepting her first academic position , Dr. Salles found herself in an environment that did not adequately support her surgical practice and her research - 14:12The systemic and cultural factors that led to the lack of support Dr. Salles faced - 23:03Dr. Salles’ research on gender equity in medicine - 29:57A discussion of the challenges of life as an academic physician - 32:13How Dr. Salles made the decision to put herself over her career and leave her academic position - 36:47Why it can sometimes seem that hospitals are exploiting physicians - 41:12Advice on how institutions can better promote diversity, equity, and inclusion in their culture - 47:32Learn more about Dr. Salles’ work on her website and follow her on Twitter @Arghavan_Salles.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

In the first half of 2020, New York City quickly became the American epicenter of the COVID-19 pandemic, with over 200,000 cases reported in the first few months. The city came to a standstill as thousands of people died alone in hospitals and bodies piled up in freezer trucks that could not transport them away fast enough. In August 2020, amid this cataclysm, Dr. Dave Chokshi assumed position as New York City's Health Commissioner and began the arduous task of repairing a broken city and restoring public trust among its residents. Prior to this work, Dr. Chokshi led the NYC Health and Hospitals Corporation and was a White House Fellow at the US Department of Veterans Affairs. In this episode, Dr. Chokshi joins us to share the core values that drive his public health work and how he navigated the challenges of leading New York City through COVID-19.In this episode, you will hear about:How Dr. Chokshi, early in his life, came to understand the association between health and opportunity - 3:52A discussion of how privilege impacts the opportunities available to individuals and how this recognition affects Dr. Chokshi’s medical work - 7:40How Hurricane Katrina revealed to Dr. Chokshi the flaws in our existing health systems - 15:48Dr. Chokshi’s involvement with Universities Allied for Essential Medicine - 19:34An account of Dr. Chokshi’s tenure as New York City Health Commissioner during the height of the COVID-19 pandemic - 24:31Dr. Chokshi’s principles of effective leadership - 32:31Reflections on the first wave of the COVID-19 pandemic and how indebted society is to nurses and hospital house staff - 37:15Dr. Chokshi’s personal philosophy on maintaining a balanced sense of humility - 53:48Five lessons for medical trainees and clinicians on staying connected to what makes medicine meaningful - 57:38Dr. Chokshi briefly discussed his early work with the Committed Communities Development Trust in Mumbai, India.You can follow Dr. Dave Chokshi on Twitter @DaveChokshi.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

In 2015, New York Times journalist John Leland set out to follow the lives of six people over the age of 85. What John learned shattered his preconceived notions about aging, loneliness, and loss. The resulting 2018 book, Happiness is a Choice You Make, became an international bestseller and delved into how these older individuals found wisdom and joy in the later stages of life. In this episode, John joins us to discuss the transformational exploration he undertook and lessons on living well he has discovered from this journey. In this episode, you will hear about:How a college music reviewer came to write for The New York Times - 1:41How John’s exploration of aging began when he was initially—reluctantly—assigned to write a series of articles on old age and retirement - 5:04Reflections on how John’s expectations of aging — including loss, sadness, loneliness — were transformed over the course of this writing project - 9:01How John discovers his interview subjects - 11:38 A discussion of John’s book, Happiness is a Choice You Make, and the lessons he learned from his subjects -14:44Advice to young clinicians on finding moments of happiness in their careers - 26:19John’s surprising realization that elders are not “depressed all the time” - 33:53A discussion of John’s recent article, in which he was documents the last days of Shatzi Weisberger, a nurse and prominent death educator - 36:53Reflections on how John’s relationships with older adults have changed his perception of death - 40:07Advice to clinicians on how they can better help older patients connect with what makes their lives meaningful - 45:03John Leland is the author of the book Happiness is a Choice You Make: Lessons from a Year Among the Oldest Old.He is also a staff writer at the New York Times. In this episode we discussed his articles How Loneliness is Damaging Our Health, and She Preached About Death Without Fear. Could She Practice it?You can follow John Leland on Twitter @JohnLeland.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

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 Columbia and 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