The Doctor's Art

One of the most mysterious and frightening entities in medicine are prion diseases — rare neurodegenerative disorders that are usually infectious in nature but involve not bacteria or viruses, but proteins. Prions are misfolded proteins that can induce normal proteins to become misfolded as well, resulting in a chain reaction that leads to irreversible brain damage and death. What makes prions alarming is that they are incurable, can incubate for decades in a person's brain without symptoms, and are usually associated with 100% mortality within months to a few years. Sonia Vallabh, PhD was a recently-married lawyer in her early career when she witnessed her mother's baffling sudden health decline and death. Her mother was ferried from hospital to hospital, yet dozens of doctors could not figure out why she was seemingly succumbing to rapidly progressive dementia at the age of 52. It wasn't until after her death that Vallabh discovered the cause was a genetic prion disease. Subsequent testing revealed that Sonia Vallabh herself had inherited the same genetic abnormality. Determined to find a solution, Vallabh and her husband Eric, a transportation engineer, decided to retrain as biomedical scientists in a race to cure her before it grew too late. The couple now leads a prion research lab at the Broad Institute at MIT and Harvard. They are also the co-founders of the nonprofit Prion Alliance. Over the course of our conversation, Vallabh opens up about what it was like to accompany her mother in her last months of life, the psychological toll of dealing with a fatal medical mystery, how she lives each day with an awareness of how ephemeral life is, what prion diseases are and what makes them so difficult to treat, what makes her optimistic about the future of her work, and more. In this episode, you’ll hear about: 3:23 - Vallabh’s early memories of her mother and the devastating experience that overcame her at 52 years old16:37 - The process of grieving the loss a parent22:32 - What prion diseases are25:35 - How Vallabh made the decision to undergo the genetic testing that confirmed she inherited a mutation thah causes prion disease 36:27 - Vallabh’s major career change to become biomedical researchers 45:50 - Where the quest for an effective therapy for prion disease currently stands 52:08 - Vallabh’s message to listeners on how to approach life View Sonia Vallabh’s TED Talk on her quest to cure prion disease. 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 2024

The second half of the 20th century saw monumental shifts in civil rights in the United States, with the end of legalized racial segregation, discrimination, and disenfranchisement affecting all spheres of life, from education to health care to housing to marriage and more. Judge David S. Tatel is a civil rights lawyer who has contributed to key advancements in voting rights, educational equality, and disability rights. Over the course of his five-decade career, he has served as Director of the National Lawyers Committee for Civil Rights Under Law, as Director of the Office for Civil Rights during the Carter administration, and as a federal judge on the D.C. Circuit, considered the second highest court in America. Judge Tatel also happens to be blind, due to a rare genetic condition called retinitis pigmentosa. In 2024, he published a book titled Vision: A Memoir of Blindness and Justice. Over the course of our conversation, Judge Tatel opens up about how he has wrestled with vision impairment in both his legal career and his personal life. He discusses what it was like to be diagnosed with an incurable, progressive, blinding disease as a teenager, how he struggled to make sense of his identity as a blind individual even as his career was taking off, his philosophy as a lawyer, how his beautiful relationship with his wife and children have helped him navigate the world, and how he met his guide dog, Vixen. Judge Tatel's legacy is one of judicial integrity, a lifelong commitment to equality, and a testament to the boundless potential of individuals living with disabilities.In this episode, you’ll hear about: 3:45 - Judge Tatel’s experience of being diagnosed with retinitis pigmentosa as a teenager 15:33 - The inspiration that led Judge Tatel to focus his legal career on civil rights22:47 - Judge Tatel’s experience of progressively losing his vision while ascending in his legal career 28:05 - Visual elements of life that Judge Tatel misses and how he now “experiences” vision33:12 - Why Judge Tatel regrets concealing the truth about his blindness early in his career 37:01 - How Judge Tatel’s blindness has influenced his civil rights work44:45 - Judge Tatel’s concerns about the future of democracy in the United States 46:27 - The ways in which getting a guide dog late in life changed Judge Tatel’s sense of freedom and his perspective on blindness 49:06 - Judge Tatel’s advice to his former self 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 2024

Addiction is often misunderstood not just by the public, but also by clinicians. It challenges us as individuals, families, and communities. To understand addiction is to understand not only human behavior and neuroscience, but also social networks, public policies, and bioethics. Our guest on this episode, Keith Humphreys, PhD, is a psychologist who specializes in addiction and has served on the White House Commission on Drug Free Communities during the Bush administration, and as Senior Policy Advisor to the White House Office of National Drug Control Policy during the Obama administration. His research on recovery support systems like Alcoholics Anonymous and on the opioid crisis has shaped how we understand addiction recovery.Over the course of our conversation, Dr. Humphreys shares how he became interested in addiction medicine, what happens to our brains when we become addicted, the difficulty of balancing interventions with a respect for patient autonomy, why social networks can be powerful tools in addiction recovery, possible solutions to the opioid crisis, and how clinicians can better establish trust with patients facing addiction.In this episode, you’ll hear about: 2:36 - How Dr. Humphreys became interested in studying the psychology of addiction 4:34 - The neuroscience of addiction 9:15 - Whether addictive behavior is a matter of personal choice 16:27 - How clinicians can address patients who do not yet recognize their addiction as a problem21:36 - What GLP-1 inhibitors can tell us about the mechanisms of addiction 26:07 - The benefits of peer support groups (like Alcoholics Anonymous) for addiction recovery32:55 - Dr. Humphreys' work on drug policy 37:32 - The rise of the opioid crisis43:05 - Policy models to address substance abuse48:24 - How medical professionals who are struggling with addiction can seek help 51:25 - Dr. Humphreys' advice for clinicians on how to connect with patients who are struggling with addiction Dr. Keith Humphreys can be found on Twitter/X at @KeithNHumphreys.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 2024

One of the most fascinating concepts in human health is the idea of social contagion, meaning that emotions, behaviors, and health outcomes can spread through social networks, much like infectious diseases. Examples in the medical literature abound: if a person becomes obese, their friends have a significantly higher chance of becoming obese — even their friends of friends have increased odds of becoming obese. Similarly, someone who quit smoking is likely to create a ripple effect through their social networks, influencing many more people to quit smoking. Social contagion affects life and death itself — after the death of a spouse, the surviving partner's mortality risk increases, and conversely, strong social networks are protective against early death. Much of the groundwork of our understanding of the powerful health effects of social networks laid by Nicholas Christakis, MD, PhD, MPH, a physician-turned-social scientist who is the author of multiple best selling books, including Apollo's Arrow: The Profound and Enduring Impact of Coronavirus On the Way We Live (2020) in Blueprint: The Evolutionary Origins of a Good Society (2019).In this episode, Dr. Christakis shares his remarkable path to medicine and sociology, beginning from witnessing his mother's struggle through serious illness, to his foray into palliative medicine, and finally to his life's work on the social, economic and evolutionary determinants of human welfare. We discuss the mechanisms by which social contagion functions, why modern medicine does a disservice to patients by atomizing their medical problems, how the COVID-19 pandemic illustrates the effects of social networks on public health, the philosophical implications of living an interconnected life, and why human beings are wired to build good societies through our capacity for love, friendship and cooperation.In this episode, you’ll hear about 3:17 - Dr. Christakis’s path to medicine through witnessing his mother’s serious illness 15:05 - How Dr. Christakis became passionate about studying the effects of social networks 24:43 - How social networks affect an individual’s health 31:28 - The negative effects that COVID-19 restrictions had on patients and their loved ones38:58 - The central thesis of Dr. Christakis’s 2019 book Blueprint: The Evolutionary Origins of a Good Society 50:38 - Dr. Christakis’s thoughts on how to live a meaningful life  Dr. Nicholas Christakis can be found on Twitter/X at @NAChristakis.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 2024

Digital technologies have saturated our lives and there is no going back. Given this, it's worth pondering whether and how they are fundamentally reshaping our mind and our relationships. A seminal work that explores these issues is the 2010 book The Shallows: What the Internet Is Doing to Our Brains, by journalist Nicholas Carr. In it, he argues that the internet is “shallowing” our brains, meaning that as we offload cognitive tasks to digital tools, our ability to read linearly, to absorb and immerse ourselves in complex information, is reduced. But more than that, the internet curtails our emotional depth and compassion, diminishing our humanity and rendering us more computer-like, as we process information in short bursts, skim for quick answers, and operate with frenetic attention spans. In Carr’s 2014 book The Glass Cage, he discusses how the increasing automation of tasks leads to a decrease in human agency, creativity, and problem solving capability.In this episode, Carr joins us to discuss the neuroplasticity of the brain, the mechanisms by which digital technologies reduce our ability to think deeply, how the failures of electronic medical records illustrate the limitations of technology, what social media does to our relationships, the value of focused, reflective thought in a fast paced world, what we can all do to remain independent of technology, and more.In this episode, you’ll hear about: 2:42 - Carr’s path to researching and writing about the human consequences of technology5:38 - The central thesis of Carr’s 2010 book The Shallows 15:27 - Whether the cognitive impacts of digital technologies are reversible or permanent21:18 - Whether society is better or worse off due to social media and the internet25:38 - How modern technology has changed the medical profession 38:22 - Carr’s thesis for his upcoming book Superbloom45:21 - How society can address the loss of focus and empathy that has occurred as a result of social media Nicholas Carr can be found on Twitter/X at @roughtype.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 2024

Medicine is filled with stories that illustrate the most beautiful, devastating, hopeful, and consequential moments of life. But how do we capture these moments and transform them into everlasting lessons that guide us on our search for meaning? That's where the art of storytelling comes in. Our guest on this episode is Anna Reisman, MD, director of the Program for Humanities in Medicine at the Yale School of Medicine. Dr. Reisman is not only a physician-writer whose essays have appeared in The Atlantic, The New York Times, and other major outlets. She has also dedicated her career to helping clinicians better reflect and write about their experiences. Over the course of our conversation, we discuss how Dr. Reisman went from being an English major in college to working as a physician, her own experiences with burnout and what helped her overcome it, her approach to creative nonfiction writing, concrete ways that writing sharpens the mind of the physician, and more.In this episode, you’ll hear about: 2:00 - Dr. Reisman’s path from English major to physician 3:45 - The scope of Dr. Reisman’s current work 8:22 - How Dr. Reisman became involved in medical humanities and how she created a writer workshop at Yale Medicine14:19 - How writing and the medical profession goes hand in hand 22:49 - The VA Writes reflective writing group 27:56 - Teaching observational skills to medical students in today’s technology-forward landscape30:25 - How to approach the writing process if you are new to writing 45:57 - What Dr. Reisman wishes she would have known at the beginning of her career Dr. Anna Reisman can be found on Twitter/X at @annareisman. A list of Dr. Reisman’s essays can be found on MuckRack. 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 2024

During the first year of the COVID-19 pandemic, the phrase “Healthcare Heroes” echoed through hospital walls and city streets. For many people, this felt like an overdue acknowledgment of the difficult and important work that healthcare professionals carried out during the most devastating healthcare crisis the world had seen in a century. But this phrase can also be problematic, romanticizing the sacrifices of individual clinicians without addressing the systemic failures that put them at risk, overlooking the mental health struggles they experienced, and undermining healthcare environments that encourage reflection about respect and duty. Our guest on this episode is Dhaval Desai, MD, a hospitalist at Emory Healthcare in Georgia and the author of the book Burning Out on the Covid Front Lines: A Doctor's Memoir of Fatherhood, Race, and Perseverance in the Pandemic (2023), in which he details his personal narrative as a healthcare leader and frontline physician fighting to hold his hospital together. Over the course of our conversation, Dr. Desai shares why he decided to train in both internal medicine and pediatrics, how his experiences caring for his ailing father revealed the flaws of our healthcare systems, the nerve-wracking first few months of the COVID-19 pandemic, his own struggles as a leader, healer, father, and husband during a time of deep uncertainty, how we can all better connect with patients through even a few moments of shared humanity amid our busy days, and more.In this episode, you’ll hear about: 2:36 - Dr. Desai’s path to medicine5:05 - How a Med-Peds residency differs from other medical residency tracks 8:06 - How Dr. Desai’s personal experiences have shaped his approach to patient advocacy 11:53 - Dr. Desai’s personal and professional life leading up to the COVID-19 pandemic18:46 - Dr. Desai’s opinion on why it is important for leaders to be able to express emotion 24:53 - How Dr. Desai used his leadership role to help his staff navigate the emotional turmoil of the pandemic experience 28:32 - Moments when Dr. Desai suffered heavily from burnout34:47 - Stories of the isolating effects of COVID-19 in the ER 39:53 - Our society’s support of healthcare workers46:19 - Advice for young clinicians on ensuring humanity stays central to their work Dr. Dhaval Desai can be found on Instagram at @doctordesaimd and on X/Twitter @DrDesaiMDx.In this episode, we discussed the New York Times article “I Couldn’t Do Anything: The Virus and an E.R. Doctor’s Suicide” 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 2024

Precision medicine — the approach to health care that involves tailoring medical interventions to an individual's genetic makeup, environment and lifestyle — promises to deliver the right treatment to the right person at the right time. From preventing diseases decades before they appear, to specially designed cocktails of cancer drugs, to genetic modification of rare diseases, many of these applications sound straight out of science fiction. At the forefront of precision medicine and medical genomics is Euan Ashley, MBChB, DPhill, Chair of Medicine at Stanford University Medical Center. A cardiologist and intensive care physician by training, Dr. Ashley has pioneered the use of genetic sequencing to identify risk factors for heart disease and new treatments for rare diseases. He is also the author of The Genome Odyssey: Medical Mysteries and the Incredible Quest to Solve Them (2021).Over the course of our conversation, we discuss his path from growing up in a small Scottish town to now working at the cutting edge of medicine, the excitement and fulfillment he experiences as a clinician in the cardiac intensive care unit, remarkable patient stories of healing and resilience, the future of precision medicine, why he is optimistic about the development of artificial intelligence, and more.In this episode, you’ll hear about: 2:24 - Dr. Ashley’s path to medicine and to cardiology 7:19 - What life is like working in the CCU21:34 - How the Undiagnosed Diseases Network was founded and what it does33:22 - An overview of precision medicine38:09 - The impact that genetic testing and genomic medicine is having on modern medicine and where it could go from here 45:00 - Dr. Ashley’s thoughts on how AI will change the field of medicine 51:40 - Making access to medical advancements in AI and genomics more equitable 1:04:39 - Dr. Ashley’s advice for healthcare professionals in training Dr. Euan Ashley can be found on Twitter/X at @euanashley. 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 2024

Joseph Sakran, MD, MPH was a teenager in a small town in Virginia when, in 1994, his life took a dramatic turn. At the age of 17, he was out with his friends after a high school football game when a nearby gunfight broke out and he was struck by a stray bullet in the throat. The bullet, tearing through his windpipe and a carotid artery, brought him to the razor edge of death before he was saved by trauma surgeons. Thirty years later, Dr. Sakran is now a trauma surgeon who serves as Director of Emergency General Surgery at the Johns Hopkins Hospital in Baltimore and a vocal advocate of reducing firearm injury through public health initiatives at the state and national levels. Following the 2018 comment by the National Rifle Association that doctors should “stay in their lane” with regard to gun violence prevention, Dr. Sakran started the #ThisIsOurLane movement, mobilizing thousands of health care professionals to advocate for gun violence as a public health crisis. Over the course of our conversation, Dr. Sakran shares his harrowing experience of being shot and what it was like to be confronted with imminent death, how his perspectives on and priorities in life changed after the incident, what goes on in his mind when he operates on victims of gun violence, how he connects with his patients over shared experiences of trauma, how all clinicians can be more empathetic with their patients, and why advocacy is integral to the work of a physician. In this episode, you’ll hear about: 2:46 - How a personal tragedy set Dr. Sakran on the path to becoming a trauma surgeon 9:51 - How Dr. Sakran’s perspective on life was altered by his personal experience with gun violence13:11 - How Dr. Sakran’s experiences informs his approach to speaking with patients and their loved ones during traumatic situations 19:09 - The importance of showing empathy to build rapport with patients and families23:51 - What it is like to tend to victims of violence 29:26 - Addressing the public health crisis of gun violence in America 37:41 - How clinicians can become more involved in advocacy45:32 - Dr. Sakran’s advice to future clinicians Dr. Joseph Sakran can be found on Twitter/X at @josephsakran.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 2024

To the best of our knowledge, humans appear to be unique among animals in our awareness of mortality — at least in our capacity for existential reflection about death in an abstract, cultural, and symbolic sense. With this capacity comes profound psychological experiences, from our search for meaning, to our struggle with grief, to a yearning for the spiritual. Our guest on this episode is Dr. Rachel Clarke, a palliative care physician based in the United Kingdom who entered medicine after an initial career in journalism. As she would discover, her love for language and storytelling has turned out to be one of the most important ways she helps patients heal in some of the most devastating moments of their lives. As a writer. Dr. Clarke is the author of multiple best selling books, including Dear Life: A Doctor's Story of Love and Loss (2020), Your Life in My Hands: A Junior Doctor's Story (2017), and Breathtaking (2021), which was adapted into a TV series of the same name. Her writing, imbued with both grace and grit, invites readers to confront difficult truths about mortality, suffering, and the inequities of the healthcare system, while also offering a vision of medicine that is as deeply human as it is healing. Over the course of our conversation, we discuss her journey to medicine by way of journalism, her reflections on the moral imperatives that drive her work, the power of storytelling in comforting patients, why suffering is inextricably connected to love, and more. In this episode, you’ll hear about:3:12 - Why Dr. Clarke switched careers from journalism to palliative care9:46 - The challenge modern doctors and patients face when it comes to thinking about mortality 15:09 - Supporting a patient’s psychological suffering through conversation 20:31 - Grappling with what Dr. Clarke calls the “essential paradox of being a human being” — our awareness of mortality33:41 - The experience of watching a person die and the reverence we hold for the bodies of the dead 43:05 - The doctor’s dual responsibilities of navigating both science and human emotionsDr. Rachel Clarke is the author of four books, including most recently, The Story of a Heart (2024). Dr. Clarke can be found on Twitter/X at @doctor_oxford.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 2024

Modern medicine has long considered many neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease to be immutably linked to the fate of certain unlucky individuals through yet-poorly understood genetic mechanisms. But increasingly, we are seeing evidence that some of our lifestyle choices, including our diet, physical activity, and relationships, may play a significant role in the development of, or protection against, these diseases. Our guest on this episode, David Perlmutter, MD, is a neurologist and writer whose immensely popular books, including Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar — Your Brain’s Silent Killers (2013), discuss why diets low in refined carbohydrates and high in fats, in addition to foods that nurture a healthy gut microbiome, may prevent cognitive decline. Over the course of our conversation, we discuss Dr. Perlmutter's path from conventional neurology to moving towards a more functional and holistic approach to treating brain disorders, the importance of metabolic health in maintaining our cognitive capacities, how Dr. Perlmutter responds to critics of his non-conventional medical advice, why nutrition science is riddled with messy and conflicting findings and how we can better navigate through it all, what clinicians can do to better help their patients live well, and more. Note: Some of Dr. Perlmutter’s ideas and recommendations have been the subject of debate and controversy within the medical community. While we believe in fostering open dialog and exploring diverse perspectives, the views expressed in this episode are those of Dr. Perlmutter and do not necessarily reflect the views or endorsements of this podcast. We encourage listeners to critically evaluate the information presented and work with qualified healthcare professionals when making any changes to their health and wellness routines.In this episode, you’ll hear about: 3:11 - Dr. Perlmutter’s transition from conventional neurology to what he calls “preventative” neurology8:43 - Dr. Perlmutter’s views on what constitutes a “disease” and the role of the doctor. 19:08 - Emerging science on the importance of metabolic health on brain health 25:17 - How scientific studies on preventative health can be (and have been) designed 34:56 - Why Dr. Perlmutter prioritizes health markers (such as HbA1c) over specific dietary recommendations when working with patients42:21 - Dr. Perlmutter’s views on GLP-1 antagonists such as Ozempic and Mounjaro50:36 - How Dr. Perlmutter has dealt with critics of his workDr. David Perlmutter is the author of eight books. Dr. Perlmutter can be found on Twitter/X at @davidperlmutter. 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 2024

What makes a life worth living? This question has animated great thinkers and faith traditions for millennia. Interestingly enough, in our time of rapid globalization, technological advancement, and material abundance, we often seem more unmoored from our conception of the self and its relation to the world than ever before.Our guest on this episode, Miroslav Volf, has spent his life wrestling with this question of questions and helping others to do the same. Volf is a professor of theology at Yale Divinity School and founding director of the Yale Center for Faith and Culture, and his work explores the intersections of faith, identity, and public life. He is the author of more than 10 books, including the bestselling Life Worth Living: A Guide to What Matters Most (2023), based on one of the most popular courses at Yale University, which he co-teaches. The book, an inquiry into the nature of human flourishing, invites readers to consider wisdom drawn from various religious, philosophical, and literary traditions. He challenges the often superficial metrics of happiness promoted by modern society, urging readers to reflect deeply on the kind of life they want to lead — one that is not just pleasurable or successful by conventional standards, but that is positively shaped by adversity, contemplation, and interconnectedness.In our conversation, we discuss how growing up as the son of a Pentecostal minister in Former Yugoslavia influenced Volf's relationship with Christian theology, why faith is a “comfortably difficult” thing, why “finding your authentic self” is a problematic concept in modern culture, how social media, divisive political currents, and the relentless drive for productivity distract us from what matters most, and the nobility in pursuing a richer, more intentioned, and just life.In this episode, you’ll hear about:3:12 - What Volf’s work as a systematic theologian entails, and key childhood experiences that shaped his relationship with faith12:18 - The philosophical basis for the Yale class that inspired the book Life Worth Living 20:23 - Why Volf uses Smokey Bear as a representation of the pursuit of a meaningful life26:53 - Shifting the focus of life from personal desires toward the quest to live by “truth”40:38 - The inherent challenge in shifting focus away from “I, Me, and Mine”45:49 - How the search for a meaningful life relates to the experiences of a medical professional51:42 - Advice for how to add philosophical practices to a busy modern lifeMiroslav Volf is the author of 17 books, including Life Worth Living (2023)Past episodes discussed in this episode:Episode 95: Shaping a Soul, Building a Self | William DeresiewiczEpisode 21: Pain, Pleasure, and Finding Balance | Anna Lembke, MDVisit www.TheDoctorsArt.com for 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 anyone working in health care who would love to explore meaning in medicine with us on the show, send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2024

Most people shudder at the idea of an infectious disease outbreak — patients stricken with a mysterious illness, hospitals overflowing, and cities going into lockdown. But for Syra Madad, DHSc, MSc , MCP, rushing into such a scenario, donned in a hazmat suit, to control the chaos has been a dream since childhood. Today, she is an epidemiologist, biosecurity advisor, and a pathogen preparedness expert who serves as Senior Director of the System-Wide Special Pathogens Program at New York City Health and Hospitals, which operates the municipal health care system of New York City. Over the course of our conversation, Dr. Madad shares what excites her about the work of infectious disease control, why she believes we have emerged from the Covid-19 pandemic worse prepared for the next pandemic, how scientists and doctors can better communicate with the public in the absence of clear data, the importance of utilizing trusted messengers in the community to fully deploy the power of public health, and more. In this episode, you’ll hear about: 2:09 - How a movie led Dr. Madad to become an infectious disease preparedness expert6:54 - An overview of Biosafety levels (BSL)  9:30 - Moments in Dr. Madad’s career when disease containment went well and moments when it did not. 12:27 - How Dr. Madad mentally and emotionally manages the heavy weight of often-lethal infectious diseases18:05 - Dr. Madad’s opinion on how COVID-19 policies were handled 24:02 - Dr. Madad’s personal thoughts on the potential origins of COVID-19 26:55 - What concerns Dr. Madad most about future pandemics and how we can make positive steps toward recovering trust in science35:40 - Dr. Madad’s advice for those considering a career in public health or infectious diseases Dr. Syra Madad appears in the Netflix special Pandemic: How to Prevent an Outbreak.Dr. Syra Madad can be found on Twitter/X at @syramadad.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 2024

For many physicians, having serious illness conversations with patients — talking about a dire prognosis or the futility of curative treatments — is one of the most daunting aspects of patient care. But to palliative care physician Shunichi Nakagawa, MD, these conversations are fundamentally about communicating the honest truth in an elegant, considerate, and humane way. Dr. Nakagawa, the director of the Inpatient Palliative Care Service at Columbia University Medical Center, joins us in this episode to discuss both his unique personal journey, as well as his insightful approach to figuring out what really matters to patients during critical moments in their lives. He shares what it was like completing his surgical training in Japan, than coming to the United States with the hope of becoming a liver transplant surgeon, before having those hopes dashed when he found out he was ineligible to work as a surgeon in the US due to his hepatitis carrier status, and finally discovering his true calling in geriatrics and palliative care. We also discuss cultural challenges in thinking about the end of life, why it is so difficult for physicians to communicate with their patients about serious illness, how clinicians ought to approach shared decision making, and why, when done well, this can be one of the most meaningful and rewarding parts of doctoring.In this episode, you’ll hear about: 2:34 - How Dr. Nakagawa entered a career in medicine in Japan5:33 - Dr. Nakagawa’s unique journey through medical training, from surgery to palliative care  16:25 - The three-stage process that Dr. Nakagawa follows when communicating challenging medical information to patients28:10 - Delivering medical advice in a succinct way when speaking to patients and their family members 36:14 - Lessons on what works and what doesn’t work in sensitive patient communication Dr. Shunichi Nakagawa can be found on Twitter/X at @snakagawa_md. 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 2024

When Impossible Foods released its first product, the Impossible Burger, in 2016, it was met with equal parts curiosity, skepticism, and excitement. This plant-based “meat that bleeds” was seen as a novelty item. Today, Impossible Foods’ expanded line of offerings, from sausages to chicken nuggets to Italian meatballs, can be found in most American grocery stores at a price that rivals traditional meats. The founder of Impossible Foods is Pat Brown, MD, PhD, a physician and molecular biologist who, after seeing the detrimental impact of animal farming on deforestation, water pollution, and greenhouse gas emissions, made it his ambitious mission to create a sustainable food system by reducing our reliance on animal agriculture. He set out to develop plant-based alternatives to meat that not only matched, but surpassed the taste and nutritional value of traditional meats, harnessing biochemistry to recreate the sensory experience and culinary qualities of meat at a molecular level. In this episode, Dr. Brown joins us to share his early career path from clinical pediatrics to biochemistry research, along the way inventing the DNA microarray, now an essential laboratory tool used to measure the expression levels of thousands of genes. He then discusses the origins of Impossible Foods, the scientific breakthroughs that have propelled its success, and how he hopes to inspire a cultural shift towards more sustainable eating habits and ensure a healthier planet for future generations.In this episode, you’ll hear about: 2:41 - How Dr. Brown was initially drawn to a career in medicine 7:54 - Why Dr. Brown chose to transition from clinical work to biomedical research 14:05 - How Dr. Brown’s drive to tackle the biggest problems of humanity led to the creation of Impossible Foods24:19 - The scientific approach that Impossible Foods takes in creating its products30:17 - Whether plant-based meats are too highly processed38:40 - Dr. Brown’s vision for the future of food 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 2024

Many people regard dementia as a fate worse than death, in large part because it strikes at the essence of our humanity — our memories, identity, and relationships with others. Unlike diseases that primarily afflict the body, dementia erodes the mind, leading to a gradual fragmentation and loss of self and autonomy. The burden of this disease on caregivers also cannot be understated. Not only does dementia require comprehensive, long term care that addresses the afflicted individual’s cognitive, behavioral, and physical issues; witnessing a loved one's slow and irreversible decline often exerts an immense emotional toll on the caregiver. Additionally, the pervasive stigma and isolation associated with dementia can leave caregivers feeling unsupported and alone. Our guest on this episode is Dasha Kiper, a clinical psychologist who works with caregivers to people with dementia. She's the author of Travelers to Unimaginable Lands: Stories of Dementia, The Caregiver, and the Human Brain (2023). The book explores the complex relationship between caregivers and dementia patients, which are frequently rife with heartbreak, guilt, frustration, helplessness and shame. Over the course of our conversation, Dasha shares her transformative personal experiences working as a caregiver, why caregivers deserve more empathy and understanding, ethical dilemmas over medical interventions and patient autonomy, navigating the distorted reality in the mind of a dementia patient, coping strategies for caregivers and healthcare professionals, and more. In this episode, you’ll hear about: 3:13 - How Dasha “stumbled” into working as a live-in caregiver for a dementia patient while still in school4:44 - How serving as a caregiver for a dementia patient shaped Dasha’s views of neurological illness10:23 - Managing the “loss of shared reality” that often occurs between the caregiver and the dementia patient23:45 - The added emotional toll that dementia can take on family members32:46 - What human dignity means in the context of dementia care      36:55 - Fostering self-compassion as a clinician or caregiver by connecting with community 49:16 - Dasha’s advice for finding community support if you are a family caregiver Dasha Kiper is the author of Travelers to Unimaginable Lands: Stories of Dementia The Caregiver and the Human Brain (2023).Past episodes and works discussed in this episode: Episode 62: Navigating my Father’s Alzheimer’s as a Doctor | Sandeep Jauhar, MDMy Father’s Brain: Life in the Shadow of Alzheimer’s by Sandeep Jauhar, MDVisit 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 2024

There once was a time when indoor smoking was allowed in workplaces all across the United States, when trans fats were ubiquitous, and when fast food restaurants didn't have to post calorie information on their menus. That wasn't so long ago, and it's in large part thanks to the pioneering efforts of Tom Frieden, MD, MPH, Health Commissioner of New York City from 2002 to 2009, that these changes were made. Dr. Frieden’s city-wide initiatives during this time included steps to reduce tobacco use (by banning indoor smoking, increasing tobacco taxes, and aggressive anti-tobacco ads), to ban trans fats and mandate proper nutrition labeling in restaurants, and to rapidly expand screening for diabetes and HIV. All of these efforts have since been adopted nationwide and have gained practically universal acceptance by the public. Prior to this, Dr. Frieden spearheaded tuberculosis control measures in New York City and India, drastically slashing rates of multidrug resistant tuberculosis. He was also director of the Centers for Disease Control and Prevention, during which time he led the CDC's response against the H1N1 influenza pandemic, the Ebola outbreak in West Africa, and the Zika virus epidemic. Most recently, he leads Resolve to Save Lives, an initiative aiming to prevent cardiovascular disease primarily through advocacy of lifestyle interventions. Over the course of our conversation, Dr. Frieden shares his personal path to a career in infectious disease and public health, lessons learned from his work on tuberculosis control, striking the balance between curbing personal liberties and protecting community health, key insights into effective public health communication particularly when dealing with incomplete information or data, the evolution of the political and partisan nature of health policy, why preventing heart disease is so critical, and more.In this episode, you’ll hear about: 3:00 - How a conversation with his father drew Dr. Frieden to a career in public health5:40 - Dr. Frieden’s early work tackling tuberculous as a “management problem”9:05 - Balancing individual rights with the health of the public17:55 - The formula Dr. Frieden has used to choose which particular public health issues to focus on 28:08 - Strategies for effective health communication with the public33:08 - The mission of Dr. Frieden's organization Resolve to Save Lives39:16 - Dr. Frieden’s thoughts on how to navigate public health communications in the light of changing scientific knowledge45:50 - The important lessons that Dr. Frieden learned from his patients about public health during his time as a clinician Dr. Tom Frieden is the President and CEO of Resolve to Save Lives. Dr. Frieden can be found on Twitter/X at @DrTomFrieden. People and Work discussed in this episode: Dr. Karel Styblo Dr. Nancy Messenior’s February 2020 COVID addressVisit 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.Copyright The Doctor’s Art Podcast 2024

It is well documented that descendants of Holocaust survivors exhibit greater levels of anxiety, depression, and vulnerability. The trauma of domestic violence can ripple through generations, with maladaptive coping mechanisms and emotional instability perpetuating subsequent cycles of trauma and dysfunction. The brutal history of slavery in the United States is seen today in the form of persistent economic disparities and ongoing social injustices, affecting mental and physical health across generations. All of this, in various forms, is intergenerational trauma. Extending beyond the individual, the emotional and psychological wounds of this type of trauma embeds itself within the family lineage through behavioral patterns, emotional responses, and even biological alterations. Our guest on this episode is Mariel Buqué, PhD, a health psychologist who specializes in helping individuals experiencing intergenerational trauma. Her book Break the Cycle: A Guide to Healing Intergenerational Trauma (2024) reveals the invisible threads that link the past and present and highlights the necessity for healing not just individuals, but entire family systems and communities. Over the course of our conversation, Dr. Buqué shares how she draws on her experiences as an Afro-Latina immigrant from the Dominican Republic in her work, how a health psychologist connects with patients, how intergenerational traumas happen and their devastating effects on individuals, families, friends, and community members, and more. In this episode you’ll hear about: 2:00 - What drew Dr. Buqué to the field of psychology5:19 - What health psychology is8:40 - What occurs in a course of treatment with a psychologist 18:30 - An overview of intergenerational trauma28:00 - The far-reaching effects of intergenerational trauma in society and how psychology can help unload the burden 35:50 - Breaking the cycle of intergenerational trauma 40:30 - The role of stigma in access to mental health care 45:10 - Dr. Buqué‘s approach to building trust with patients 48:28 - How all clinicians can better empathize and connect with their patients through trauma-informed careDr. Mariel Buqué is the author of Break the Cycle: A Guide to Healing Intergenerational Trauma (2024).Dr. Buqué can be found on Instagram at @dr.marielbuque.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 2024

The Genocide Against the Tutsi, occurring in Rwanda between April-July 1994, was a devastating episode of mass violence in which nearly 1 million people were killed over a period of 100 days. Fueled by longstanding ethnic tensions, political power struggles, and a deep seated history of discrimination, the genocide saw members of the Tutsi ethnic group slaughtered indiscriminately by extremists of the Hutu ethnic group. Growing up amid this chaos, Christian Ntizimira, MD witnessed some of humanity's most horrific atrocities. Instead of turning away, however, he chose to enter medicine, a profession that would allow him to address the immense suffering he saw. Today, Dr. Ntizimira is a palliative care physician and the founder and executive director of the African Center for Research on End of Life Care. In this episode, Dr. Ntizimira joins us to share his personal experiences with the Rwandan Genocide, his journey to palliative medicine after initially exploring a career in surgery, what palliative care means to him, what it looks like to honor the dignity of a patient, how he advocates better access to palliative care and chronic illness care, and his unique approach to medicine rooted in “ubuntu,” a philosophy emphasizing the universal bond that connects all humanity that is best summarized by the phrase “I am because you are.”In this episode, you’ll hear about: 2:45 - How Dr. Ntizimira’s experience as a young person during the Rwandan Genocide inspired him to become a physician, and how he eventually found himself drawn to palliative care  14:25 - Dr. Ntizimira’s distinction between “treating the disease” and “treating the person”20:22 - How Dr. Ntizimira teaches doctors to fully conceptualize patients as people instead of focusing only on their medical ailments 25:50 - The heart of palliative care that transcends cultures30:54 - The importance of presence in palliative care38:27 - What “reconciliation” means in Dr. Ntizimira’s approach to palliative care 47:17 - “Ubuntu,” an African philosophy emphasizing a shared connection among humans, and how it can revolutionize how we care for patients    Dr. Christian Ntizimira is the author of The Safari Concept: An African Framework for End of Life Care.Dr. Christian Ntizimira can be found on Twitter/X at @ntizimira.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 2024

Death and grief are much more “hidden” from society today than they once were. The medicalization of dying means that death now occurs more frequently in hospitals and care facilities than at homes. The secularization of society means that traditional religious or communal rituals surrounding death and mourning have diminished. The fast pace and optimistic lens of consumer culture means less contemplation of aging, mortality, and grief. But Mikołaj Sławkowski-Rode, PhD, a professor of philosophy at the University of Warsaw and research fellow at Oxford University, argues that experiences of mourning and grief are crucial to the human condition. They allow us to foster empathy and connect with others’ suffering. They encourage us to reflect on how we value life, relationships, and the responsibilities we have towards others, both living and deceased. They revitalize communal rituals and practices, creating a sense of shared humanity.Professor Sławkowski-Rode has written widely on the philosophical and ethical dimensions of mourning, grief, and memory, and his works have appeared in The New York Times as well as various academic publications. Over the course of our conversation, we discuss the nature of grief as a multifaceted emotional response, extending beyond a psychological state and reaching into existential realms; the role of memory in the grieving process; why love and grief are fundamentally inseparable; how the atomization of modern society affects our ability to mourn; and more. In this episode, you’ll hear about: 3:20 - The focus of Sławkowski-Rode’s current work and what his day looks like as a philosopher8:10 - The value of philosophy in society 12:42 - How Sławkowski-Rode became inspired to study grief14:57 - Why grief has become more “hidden” in society over the past century23:49 - How the “cult of individuality” leads our society to ignore aging and death 33:45 - How Sławkowski-Rode defines “human flourishing”36:31 - How the atomization of modern society affects our ability to mourn  50:00 - Practical advices for clinicians on how to navigate grief and mourning for themselves and their patients Mikołaj Sławkowski-Rode is the author of the New York Times op ed It’s OK to Never ‘Get Over’ Your Grief and numerous academic publications.Dr. Sławkowski-Rode can be found on Twitter/X at @MikolajRode.Works and past episodes discussed:The Hours of Our Death by Philipe AriesEpisode 21: Pain, Pleasure and Finding the Balance | Anna Lembke, MDVisit 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 2024