The Doctor's Art - TopPodcast.com

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Leading Healthcare Through Relationships | Nirav R. Shah, MD, MPH Jan 24, 2023

Show notes

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 Nirav R. Shah, MD, MPH, 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 - 1:53
Two patient stories in which seemingly simple mistakes led to moments of awakening for Dr. Shah in recognizing his purpose in medicine - 6:21
A brief overview of Dr. Shah’s career path - 13:47
Lessons on empathetic leadership that Dr. Shah picked up along the way - 19:21
How forging strong relationships helped Dr. Shah find solutions on big issues during his time as New York State’s Health Commissioner - 21:57
Dr. Shah’s current pursuits, including those focused on making a business case for supporting the unpaid caregivers of patients - 31:23
Why transparency and bureaucratic structure are critical components of healthcare reform in the United States - 37:46
Advice to clinicians on what makes effective leaders and collaborators, and how to find passion for meaningful projects - 41:43

Dr. 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.

The Pain of Others | Haider Warraich, MD Jan 17, 2023

Show notes

Storytelling, pain, rage, and cultural competency are just some of the themes we will explore in this episode. Our guest, Haider Warraich, MD, 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 - 2:10
How Dr. Warraich stays connected to his patients and his work despite the intense pressure and responsibility he experiences on a daily basis - 7:03
What drew Dr. Warraich to cardiology and end-of-life care - 13:22
Dr. 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 - 17:33
A discussion of how the medical culture of Pakistan differs from the United States and how they can be shockingly similar - 22:06
How Tom Brady, the football quarterback, inspires Dr. Warraich to stay connected to the emotional core of his practice - 28:49
Why it’s important to stay in a field if you care about it, especially if you hope to change and improve it - 35:37
Dr. Warraich’s reflections on the nature of pain and how he hopes to change our cultural conversation around it - 41:38
How acute pain and chronic pain are very different processes and how we can address suffering as a subject and deeply personal experience - 45:17

You 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, andState 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.

The Power of Compassion | James Doty, MD Jan 10, 2023

Show notes

What if we could scientifically prove that compassion improves our well-being, our cognitive function, our longevity, and societal welfare? Here to explore these questions is our guest on this episode, James Doty, MD, a neurosurgeon, inventor, entrepreneur and writer. As the founding director of Stanford's Center for Compassion and Altruism Research and Education, his academic focus is the neurobiological effects of meditation, compassion, and altruistic behavior. His bestselling 2017 memoir, Into the Magic Shop, details his path from a troubled childhood to becoming an internationally-renowned surgeon and philanthropist. He has served on the board of a number of nonprofit organizations, including as former Chairman of the Dalai Lama Foundation, and is on the International Advisory Board of the Council of the Parliament of the World's Religions. In this episode, we discuss his unlikely journey to medicine and the incredible insights on compassion he has collected over the years.

In this episode, you will hear about:

Dr. Doty’s difficult childhood experiences and how the kindness of strangers pulled him to medicine - 2:10
How Dr. Doty dealt with the fish-out-of-water experiences in medical school - 11:00
A discussion of negative self-talk and how to overcome it - 17:30
How Dr. Doty went from developing a neuroscience center in impoverished Mississippi to establishing an altruism research lab at Stanford University - 20:19
A discussion of the eponymous incident of Dr. Doty’s book Into the Magic Shop and how it profoundly shifted his view on compassion - 26:06
A review of some of the exciting findings of Stanford’s Center for Compassion and Altruism Research and Education - 32:36
Reflections on how Dr. Doty practices compassion in his daily life - 38:29
A brief discussion of the power of belief and how it shapes our reality - 44:00
A discussion of how the dehumanizing bureaucracy and profiteering of the medical field is failing physicians - 49:55

Dr. James Doty is the author of the best-selling memoir Into the Magic Shop: A Neurosurgeon’s Quest to Discover the Mysteries of the Brain and the Secrets of the Heart.

He is the senior editor of the Handbook of Compassion Science published by Oxford University.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

On Ending Well | Shoshana Ungerleider, MD Jan 03, 2023

Show notes

Too often, modern medicine focuses on life-extending interventions for those nearing the end of life at the expense of quality of life. Our guest today, Shoshana Ungerleider, MD, argues we urgently need to rethink the emphasis of end-of-life care. She's the founder of the End Well Foundation, a nonprofit that seeks to improve how doctors and patients approach issues of mortality, as well as an executive producer of the 2018 film End Game and a major funder of the 2016 film Extremis, two Academy Award-nominated short documentaries on end-of-life care. As a health communicator. Dr. Ungerleider is the host of the TED Health Podcast and has been featured as a medical expert on CNN, CBS, PBS, Fox News, and other news networks. In this episode, she discusses her journey in health care and shares her mission to transform the end of life experience of patients everywhere and make dying well a part of living well.

In this episode, you will hear about:

How Dr. Ungerleider found her way to a career in health care and how she pushed through imposter syndrome while in medical school - 2:23
Dr. Ungerleider’s formative experiences working with elderly patients in the ICU, leading her question the practices of modern medicine when dealing with seriously ill patients - 10:18
How the Covid-19 pandemic has shifted public consciousness around death and dying - 15:30
The origins of End Well, the conference and organization founded by Dr. Ungerleider and her colleagues in 2017 - 23:51
What it would look like for there to be a shift in the cultural conversation around death and dying - 30:31
A reflection on the risks of romanticizing the dying process - 36:54
The recent cancer diagnosis in Dr. Ungerleider’s family and how this has propelled her to proactively manage her own risks - 43:49
Advice for new clinicians on dealing with patient deaths - 48:49

Dr. Shoshana Ungerleider is the author of “My Dad’s Terminal Cancer Diagnosis May Have Saved My Life” for Newsweek.

You can follow Dr. Ungerleider on Twitter @ShoshUMD

In this episode, we discussed The Good Place, an award-winning sitcom series about philosophy and the afterlife.

We discussed several articles and studies about whether physicians are more likely to choose to die at home than the general public. These articles include “How Doctors Die” by Ken Murray, “Association of Occupation as a Physician With Likelihood of Dying in a Hospital” by Blecker, Johnson, Altekruse, et al. and “Patients, and Doctors, Aren’t Dying at Home” by Dr. Danielle Ofri (our guest on episode 35).

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Life Lessons from Death | Frank Ostaseski Dec 20, 2022

Show notes

"Death is not waiting for us at the end of a long road. Death is always with us, in the marrow of every passing moment. She is the secret teacher hiding in plain sight, helping us to discover what matters most."
So writes Frank Ostaseski, an internationally respected Buddhist teacher and pioneer in end-of-life care. Frank is the founder of the Zen Hospice Project in San Francisco, the first Buddhist hospice in America. Over the course of his career, Frank has accompanied over 1000 people through the dying process; these experiences have taught him lessons on how maintaining an ever-present consciousness of death can bring us closer to our most authentic selves. He describes these lessons in his bestselling 2017 book, The Five Invitations. In this episode, Frank joins us to share hard-earned wisdom from his unique life journey. Over the course of our deeply reflective and even meditative conversation, we discuss matters ranging from Japanese death poems, to Buddhist mindfulness practices, to what courage looks like in the face of death.

In this episode, you will hear about:

How the AIDS crisis led to the founding of the Zen Hospice Project - 2:16
What Frank’s work looks like on a daily basis - 3:52
Frank’s role as an ‘interpreter’ between patients and doctors - 5:57
How clinicians can develop their own rituals in the process of healing patients - 9:09
How Frank makes sense of the grief and suffering he witnesses and, despite it all, keep his spirit balanced - 13:40
How the tenets of Buddhism influenced care at the Zen Hospice Project - 25:58
How progresses in modern medicine sometimes hinders us in our acceptance of the impermanence and inevitability of death - 33:56
Lessons on love, mindfulness, and finding meaning from Frank’s stories of patients at the end of life - 38:20
The Five Invitations and what they look like in practice - 45:20

Frank Ostaseski is the author of The Five Invitations: Discovering What Death Can Teach Us About Living Fully.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Love and Mercy in the ICU | Wes Ely, MD Dec 13, 2022

Show notes

The ICU can be a traumatizing place for patients, who are frequently heavily sedated, rendered unable to speak by breathing tubes, isolated by family visit limitations, and sometimes even physically restrained. In fact, a significant proportion of patients discharged from the ICU later develop persistent cognitive impairments and physical disabilities. Over the past two decades, Wes Ely, MD has worked to improve the care of patients in the ICU, leading landmark studies resulting in the development of delirium prevention protocols that are now adopted in ICUs everywhere. Today, Dr. Ely co-directs the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center at Vanderbilt University Medical Center. In this episode, Dr. Ely joins us to share his career-long fight to reform ICU medicine and to recount poignant stories that illuminate and elevate the humanity of patients amid the chaos of the ICU — and in the process discusses themes that seldom appear in contemporary medical discourse, such as love, beauty, and mercy.

In this episode, you will hear about:

How Dr. Ely discovered medicine as a calling while growing up in rural Louisiana - 2:33
How a fascination with cardiopulmonary physiology, combined with an interest in patient relationships, led Dr. Ely to critical care medicine - 4:27
A discussion of how patients in ICUs can often be “de-humanized” - 6:31
A story from early in Dr. Ely’s career that illustrates “malignant normality” — when treatment norms led to patient harm - 10:40
A discussion of physician burnout and how the dehumanization of patients contributes to it - 13:27
What Dr. Ely and his colleagues have learned through years of research about the harmful standard practices of ICU care - 18:53
An explanation of the ABCDEF treatment bundle designed by Dr. Ely and his collaborators to improve outcomes of patients in the ICU patients - 24:04
How Dr. Ely processes the guilt and shame he feels from the harm he inadvertently caused to patients early in his career - 29:37
Reflections on how eye contact, physical touch, and openness of the heart are essential to good medicine - 36:03
A discussion on how Dr. Ely’s spirituality has influenced his approach to patient care - 44:51
What it means to provide healing when patients are facing serious illness, even at the end of life - 50:45

Dr. Wes Ely is the author of Every Deep-Drawn Breath, a chronicle of his experiences caring for ICU patients.

You can find out more about his work at ICUDelirium.org

Follow Dr. Ely on Twitter @WesElyMD

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Decoding Cancer | Harold Varmus, MD Dec 06, 2022

Show notes

A pivotal development in the history of cancer research was the discovery that cancers can arise from mutations in genes already present in normal, healthy cells. Joining us in this episode is Harold Varmus, MD, who shared the Nobel Prize in Physiology or Medicine in 1989 with his colleague, J. Michael Bishop, for this discovery. Their work has enabled scientists to explore why certain cancers develop in the human body and how we can develop better cancer treatments that target these genetic mutations. In addition to his pioneering research, Dr. Varmus has served as Director of the National Institutes of Health and the National Cancer Institute, President of Memorial Sloan-Kettering Cancer Center, and Scientific Advisor to the US Government, World Health Organization, and various other foundations and academic institutions. Over the course of our conversation, Dr. Varmus describes his groundbreaking research, approach to institutional leadership, and his advocacy for the democratization of scientific knowledge through his role in the founding of PubMed Central and the Public Library of Science.

In this episode, you will hear about:

How Dr. Varmus' broad educational interests led him to pursue a medical career - 2:56
How working at the National Institutes of Health drove Dr. Varmus’s passion for research and the trailblazing path his career took - 8:48
A summary of Dr. Varmus’s research on retroviral oncogenes, which led to major advancements in cancer diagnoses and treatments - 16:35
How Dr. Varmus became involved in the politics of science after receiving a Nobel Prize - 27:13
Dr. Varmus’ mission while he was Director of the National Institutes of Health and his perspectives on the elements of effective healthcare institutional leadership - 30:28
A discussion of open access publishing, a mechanism of distributing the results of scientific research online for free - 32:37

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Life and Death in 12 Hours | Christin Thankachan, BSN, RN-BC Nov 29, 2022

Show notes

For all the crucial work physicians do in the hospital, no one spends more time with hospitalized patients than nurses. This is especially true in the intensive care unit, where nurses serve as patients’ conduits with their medical team and perhaps even with the outside world. Joining us in this episode is Christin Thankachan, an ICU nurse at Stanford Health Care who cares for the most seriously ill cancer patients in the hospital. Over the course of our stirring conversation, we ask her to reflect on how she guides patients and their families, with a comforting and compassionate hand, through life’s darkest moments. In addition, Christin shares the unique challenges she has faced as a frontline worker during the COVID-19 pandemic, and how she has maintained hope and meaning through these trying times.

In this episode, you will hear about:

How Hurricane Sandy pushed Christin towards a career in nursing - 2:06
The differences between a nurse’s responsibilities in an intensive care unit and a medical/surgical unit - 5:13
What a typical day is like for an ICU nurse - 7:26
How Christin finds the physical, emotional, and psychological stamina to care for some of the sickest patients in the hospital - 10:22
The kinds of relationships Christin forms with her patients and how she strives to elevate the human connection - 13:49
The importance Christin places on recognizing the fullness of the humanity within each patient - 21:16
The power of hope for patients facing serious illnesses - 31:50
What it was like to serve as a frontline worker in the early days of the COVID-19 pandemic - 36:38
Advice on how to stay connected to the most meaningful aspects of a healthcare profession, even in the darkest times - 40:47

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

On Vision and the Arts | Michael Marmor, MD Nov 22, 2022

Show notes

Few would dispute that vision is just about our most important sense. From a neurophysiological perspective, more than half of the human brain is dedicated to processing vision. But beyond that, it also enables us to meaningfully interact with the world and the people around us, and allows us to engage in many of the activities that bring us joy in life. Joining us in this episode is Michael Marmor, MD, Professor Emeritus and former chair of ophthalmology at Stanford University School of Medicine. In addition to his significant contributions to our understanding of diseases of the retina, Dr. Marmor is a patron of the arts who has published several books on vision and visual art. Over the course of our conversation, we discuss the fascinating inner workings of eyesight, how art appreciation can help create better doctors, and how Dr. Marmor accompanies patients facing vision loss.

In this episode, you will hear about:

How a desire to “wear multiple hats” — researcher, surgeon, educator — led Dr. Marmor to ophthalmology - 2:04
A brief exploration of the sense of sight - 4:01
Dr. Marmor’s research on the retina and why he believes a thorough understanding of how diseases work is critical for physicians caring for patients - 8:07
Why helping a patient understand their condition provides comfort, even with serious illnesses - 11:53
Dr. Marmor’s passion for the fine arts and how his expertise in vision complemented this passion - 18:23
What art appreciation can do for physicians and how it gives us new ways of thinking and seeing - 23:52
How medical curricula can be improved to integrate the arts and humanities, and the importance of an emphasis on breadth in addition to technical depth - 33:06
Why an appreciation for all kinds of art keeps us in touch with culture - 46:29

Dr. Marmor is the author of several books on art, including The Eye of the Artist (1996), Degas Through His Own Eyes: Visual Disability and the Late Style of Degas (2006), and The Artist’s Eyes (2009).

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

Confronting Inhumanity Through Medicine | Christos Christou, MD Nov 15, 2022

Show notes

When it comes to medical humanitarianism, there is no bigger name than Médecins Sans Frontières (MSF), also known in English as Doctors Without Borders. MSF is renowned for its work in regions affected by armed conflict, endemic diseases, and natural disasters. In this episode, we are joined by Cristos Christou, MD, a Greek surgeon who has served as the international president of MSF since 2019. As a field doctor, he has worked in South Sudan, Iraq, Cameroon, and various other conflict zones. Over the course of our conversation, Dr. Christou takes us into the trenches of his medical work in caring for some of the most vulnerable people in the world, shares how he finds meaning and hope amid the depths of human suffering, and discusses the challenges to global health today.

In this episode, you will hear about:

How the values of his self-described “rustic” childhood led Dr. Christou into medicine - 2:28
How Dr. Christou’s time in university shaped his life philosophy - 3:27
The history and mission of Médecins Sans Frontières/Doctors Without Borders - 5:59
What it is like to practice medicine in regions affected by armed conflict and natural disasters - 8:13
Dr. Christou’s journey in MSF, from when he first heard of it to how he became its leader - 10:42
Lessons learned on finding meaning in medicine in some of the most resource-limited settings - 13:41
Dr. Christou’s stories of inspiring hope in patients even during incredibly challenging times - 16:19
A discussion of the dangers faced by clinicians who work with MSF - 19:54
The significance of bearing witness to suffering in giving a voice to vulnerable patients - 23:11
A discussion of the major threats to global health today: climate change, epidemics, and war - 26:25
Advice for new clinicians who wish to tackle issues in global health - 30:00

Follow Dr. Christos on Twitter @DrChristou.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

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