The Doctor's Art - TopPodcast.com

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A Physician-Engineer and His Patient Stories | Bryant Lin, MD, MEng Aug 30, 2022

Show notes

Technological advancements have enabled us to accomplish medical miracles through novel medical devices, algorithms, and digital tools. At the same time, the exponential entanglement of tech with healthcare has led many clinicians to feel disconnected from the human element of medicine. Here to discuss this conundrum is Bryant Lin, MD, MEng, the director of Medicine and the Muse, the medical humanities program at Stanford Medical School, and a mechanical engineer by training who focuses on medical device development. Dr. Lin also conducts research in Asian population health and is the cofounder of Stanford’s Consultative Medicine Clinic, which evaluates patients with medical mysteries. In today’s episode, Dr. Lin shares his unique perspective at the crossroads of technology and the humanities, and discusses how storytelling can be a powerful instrument to keep physicians grounded in what truly matters for their patients.

In this episode, you will hear about:

How an early interest in engineering led Dr. Lin to medicine - 1:42
A poignant letter Dr. Lin received from one of his long-term aging patients that reaffirms why his medical career is meaningful - 4:10
A discussion of how medical bureaucratization has stolen away much of the human connection that underpins fulfilling medical work - 7:39
How Medicine and the Muse, the medical humanities program at Stanford, helps clinicians connect with the meaning in medicine - 12:40
What Dr. Lin hopes to achieve through teaching medical humanities to future clinicians - 25:45
How storytelling helps healthcare providers better connect with their patients - 27:28
How Dr. Lin integrates storytelling into medical device design, and why it is imperative to not allow technology to distance physicians from their patients - 31:24

Dr. Lin manages the forthcoming digital medical humanities newsletter Panacea Health.

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.

A Doctor's Journey from the Edge of Death | Rana Awdish, MD Aug 23, 2022

Show notes

Rana Awdish, MD was on the last day of her critical care medicine training when her life changed forever. Seven months pregnant at the time, Dr. Awdish abruptly found herself in a life threatening crisis when a previously undiagnosed liver tumor suddenly ruptured. She was rushed to the ICU of her own hospital, where she came unimaginably close to death multiple times. Despite this tragic event, she survived thanks to the incredible work of her medical team. Today, Dr. Awdish is the author of the acclaimed memoir In Shock, which recounts her time as an ICU patient. She is also the Medical Director of the Pulmonary Hypertension Program at Henry Ford Hospital in Detroit, Michigan, and Medical Director of Care Experience for the Henry Ford Health System. In this episode, she shares what she has learned from her experiences about compassion, hope, and improving empathetic communication in health care.

In this episode, you will hear about:

How a family ailment inspired Dr. Awdish to pursue a medical career - 2:10
An riveting personal account of the catastrophic medical event that befell Dr. Awdish - 4:17
A discussion of the learning curve in medicine and the need to create safe spaces for physicians to admit ignorance - 12:13
The fascinating and unsettling experience of being a highly-trained physician and a critically-ill patient at the same time, and how this experience showed her the way our current medical culture disempowers patients - 15:17
Dr. Awdish’s reflections on the antagonistic environment of her prolonged hospital stay - 20:19
A discussion of hope, concept often misunderstood by physicians as running counter to realistic expectations - 27:37
The intense and unexpected role of spirituality in Dr. Awdish’s critical care experience - 32:14
Navigating the medical profession while confronting suffering and not burning out - 34:37
A discussion of Dr. Awdish’s profound essay The Shape of the Shore about the first year of the COVID-19 pandemic in Detroit - 37:36
Dr. Awdish’s advice to new physicians and students to help them stay connected to their work and to see the humanity in their patients - 44:33

Dr. Rana Awdish is the author of:

In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope, a memoir about the harrowing events discussed in this episode and the revelations she attained by going through them.

The Shape of the Shore, an essay about working in the ICU during the first months of the COVID-19 pandemic.

Dr. Johnson mentions the essay The Learning Curve by Dr. Atul Gawande.

Follow Dr. Awdish on Twitter @RanaAwdish.

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

Purpose and Justice on the Pandemic Frontlines | Thomas Fisher, MD Aug 16, 2022

Show notes

Imagine showing up for work every day for a year, knowing full well that each day you risk contracting a potentially devastating disease with unknown long-term consequences. That's exactly what Thomas Fisher, MD went through, as he documents vividly in his recent book, The Emergency: A Year of Healing and Heartbreak in a Chicago E.R., which delves into what it was like fighting COVID-19 on the frontlines in 2020. Dr. Fisher, an emergency physician at the University of Chicago Medical Center, former healthcare executive, and former White House Fellow, has dedicated his life to caring for his community, the black population of Chicago's South Side. In this episode, he recounts harrowing stories from the emergency room, gives an impassioned critique of a health care system with too little space for doctors to provide the care their patients need, and shares a renewed vision of healthcare as a foundation of social justice.

In this episode, you will hear about:

What motivated Dr. Fisher to write his book, The Emergency, a riveting first-hand account of the first year of the COVID-19 pandemic - 2:09
The uncertainty and terror physicians faced at very beginning of the pandemic - 5:29
An intimate picture of how emergency physicians approached the first COVID-19 patients - 9:45
How an upbringing in Chicago’s South Side propelled Dr. Fisher into a career in healthcare, and how the reality of inequitable systems has shaped his medical practice - 13:10
A discussion of the concept of “heroism” in the context of frontline healthcare workers - 20:35
How Dr. Fisher used letters addressed to patients as a narrative device in his book to explore social injustices that affect individual health - 30:50
Dr. Fisher’s reflections on maintaining a connection to the meaning of his work despite the seemingly insurmountable systemic challenges that he recognizes - 35:57
Practical advice for clinicians on making space for patient care within a rushed healthcare environment - 42:28

Dr. Fisher is the author of The Emergency: A Year of Healing and Heartbreak in a Chicago E.R.

Follow Dr. Fisher on Twitter @TFisherMD.

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

Stewarding the Vulnerable Moments | Audrey Shafer, MD Aug 09, 2022

Show notes

What is it like to comfort patients in the moments before they surrender consciousness to undergo surgery? What can the humanities teach us about being present for a patient when they are at their most vulnerable? As an anesthesiologist and founding director of Medicine and the Muse, Stanford Medicine’s health humanities program, Audrey Shafer, MD has spent her career pondering and addressing these questions. In this episode, Dr. Shafer discusses how her exploits in the humanities have shaped her career in medicine, gives us an intimate and vivid picture of the vital work anesthesiologists do, and shares what her recent personal experiences with cancer have taught her about what it means to truly care for patients.

In this episode, you will hear about:

How growing up in an artistic household initially pushed Dr. Shafer away from the arts and toward a medical career - 1:51
Why Dr. Shafer chose to become an anesthesiologist - 5:51
Dr. Shafer’s discovery of the medical humanities and how she would later create the first program of its type at Stanford Medicine - 8:57
A discussion of what the medical humanities are and a defense of its value - 12:00
Reflections on the profound privilege of being an anesthesiologist and a medical educator - 17:45
A behind-the-scenes look at an anesthesiologist’s work - 25:02
Dr. Shafer’s recent cancer diagnosis and her treatment journey - 34:29
Advice for clinicians and medical students about seeing patients’ illnesses within the greater context of their lives - 41:15

Follow Dr. Shafer on Twitter @AudreyShafer.

You can peruse the Literature Arts & Medicine magazine here.

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

Lessons from a Lifelong Patient Turned Oncologist | Eric Winer, MD Aug 02, 2022

Show notes

Born with hemophilia in a time before effective therapies existed and having experienced treatment complications including hepatitis C and HIV, Eric Winer, MD spent much of his childhood and young adulthood in and out of the hospital. Today, he is the Director of Yale Cancer Center and President of the American Society of Clinical Oncology (ASCO), the largest organization of clinicians caring for cancer patients. An internationally renowned expert in breast cancer, his research has immensely impacted how breast cancer is now treated. In this episode, Dr. Winer shares his path to oncology and his insights from being a lifelong patient on stigma, compassion, and empathy.

In this episode, you will hear about:

How growing up with hemophilia led Dr. Winer to the field of medicine - 1:50
The patient that cemented Dr. Winer’s dedication to oncology as his life’s work - 7:55
Dr. Winer’s reflections on how his experiences as a patient shape his work as a doctor - 12:52
Facing the reality of caring for patients with terminal illness - 18:21
How Dr. Winer grounds the care he provides in the humanism of each patient - 23:49
Dr. Winer’s mission and vision as president of the American Society of Clinical Oncology - 25:49
How leading by example is critical to cultivating a strong, respectful, and collaborative institutional culture - 31:02
Dr. Winer’s advice to medical students and new clinicians on maintaining a connection to meaningful work - 33:12

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

Pain, Pleasure, and Finding the Balance | Anna Lembke, MD Jul 26, 2022

Show notes

Our modern world grants us unprecedented access to high-reward, high-dopamine stimuli—not just drugs, but also food, news, shopping, sex, gaming, social media, gambling, and more. But psychiatrist Anna Lembke, MD argues that this society-wide overindulgence in pleasure threatens to lead us to deeper pain. Dr. Lembke is the director of the Addiction Medicine Service at Stanford Medicine and is the author of two bestselling books, Dopamine Nation and Drug Dealer, MD. As one of the first doctors to sound the alarm on the opioid epidemic in America, she's an expert on the issue and has advised policymakers at the highest levels of government. In this episode, Dr. Lembke describes her work treating all kinds of addiction, discusses her deep concern with the overconsumption of pleasure in our culture, and shares what we can all do to renew meaning and connectedness in our lives through balancing pain and pleasure.

In this episode, you will hear about:

What first drew Dr. Lembke to a medical career and how she initially discovered psychiatry - 2:13
Why Dr. Lembke dedicates herself to addiction medicine, and how her philosophy can help others find meaningful work - 9:16
The historical shift, with the advent of the opioid epidemic, to understanding addiction as a medical condition instead of a moral or personal failing - 12:53
Reframing addiction as a medical diagnosis and approaching patients facing addictive disorders with compassion - 17:58
How flaws in contemporary medical practice and misaligned incentives for doctors contributed to the opioid crisis - 24:15
A discussion of Dr. Lemke’s book Dopamine Nation, including how easy access to pleasure causes addictagenic responses in nearly every aspect of our lives - 29:32
How humans can reconnect with meaning despite living in a culture that often substitutes meaning with cheap pleasure - 34:15
Dr. Lembke’s advice to all clinicians for how to better connect with patients - 45:20

Tyler refers to the essay “I Used to be a Human Being” by Andrew Sullivan.

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

Ethical Dilemmas in the Hospital | David Magnus, PhD Jul 19, 2022

Show notes

What happens when miscommunication between a doctor and patient leads to intractable conflict? What happens when a patient requests an intervention a doctor does not feel ethically comfortable with? In the toughest of situations, doctors turn to the clinical ethicist for help. David Magnus, PhD, an internationally regarded leader in clinical ethics, is the director of the Stanford University Center for Biomedical Ethics, co-founder and editor-in-chief of the American Journal of Bioethics, and former president of the Association of Bioethics Program Directors. In this episode, Dr. Magnus shares lessons learned from the most ethically ambiguous scenarios he has managed, the importance of ethical thinking skills for all clinicians, and the difficulties inherent in clinician-patient communication.

In this episode, you will hear about:

What it’s like to be a clinical ethicist, handling the tough ethical questions doctors call on them to resolve - 5:05
How an ethicist determines what is “right” in a given circumstance - 9:10
How Dr. Magnus’ deals with patients who refuse to accept his recommendations for care - 11:33
Dr. Magnus’s journey from professor of philosophy to leading thinker on medical ethics - 14:00
How the intense specialization of modern medicine may be contributing to clinician burnout - 23:31
How misinterpretation of language can be a major barrier to good health care - 32:25
Why clinicians use “hedge language” and “shield attributions” and how they can dramatically alter a patient’s understanding of their situation - 40:46
Dr. Magnus’s advice to new clinicians on cultivating skills in ethical thinking and responsible patient communication - 50:45

Learn more about the American Society for Bioethics and Humanities here.

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

Transforming the Culture of Medicine | Robert Pearl, MD Jul 12, 2022

Show notes

As former CEO of the Permanente Medical Group, Robert Pearl, MD was responsible for the work of 50,000 healthcare workers and the medical care of 5 million Americans through Kaiser Permanente hospitals across the country. A leading expert on healthcare management and strategy, Dr. Pearl is the author of two bestselling books, “Mistreated: Why We Think We’re Getting Good Healthcare–And Why We’re Usually Wrong” and “Uncaring: How the Culture of Medicine Kills Doctors and Patients,” a regular contributor to Forbes, and the host of several popular medical podcasts. He is a board-certified plastic and reconstructive surgeon, clinical professor at Stanford Medicine, and lecturer at the Stanford Graduate School of Business. In this episode, Dr. Pearl shares his thoughts on why American healthcare is failing not only patients but also physicians, and what we can do to address inherent problems in the culture of medicine.

In this episode, you will hear about:

Dr. Pearl’s journey to a career in plastic surgery - 2:13
Grappling with complications that arise during surgery - 9:40
Dr. Pearl’s transition from surgeon to CEO of the Permanente Medical Group - 12:49
The mission that Dr. Pearl brought to his role as CEO and how he implemented that mission - 17:21
How Dr. Pearl paved a path for increasing both the quality of care and physician satisfaction, while keeping costs low, and why so often these goals seem at odds with each other - 20:32
The toxic culture of denial in medicine and why it is killing doctors and patients - 27:45
How status and compensation disparity contributes to physician burnout, and what to do about it - 35:47
Dr. Pearl’s administrative strategy that led Kaiser Permanente to much success during his tenure as CEO - 43:08
Dr. Pearl’s advice to physicians on how to stay connected and empowered in their careers - 46:38

Dr. Robert Pearl is:

Author of two books: Mistreated: Why We Think We’re Getting Good Healthcare - And Why We’re Usually Wrong; and Uncaring: How the Culture of Medicine Kills Doctors & Patients, with all proceeds going to Doctors Without Borders
A frequent contributor to Forbes Magazine
The host of two podcasts: Fixing Healthcare and Coronavirus: The Truth

Find more information at RobertPearlMD.com or follow Dr. Pearl on Twitter @RobertPearlMD

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

The Doctor as Detective | Lisa Sanders, MD Jul 05, 2022

Show notes

As the real-life inspiration for and medical consultant to the popular TV show "House, M.D.," journalist-turned-physician Lisa Sanders, MD has played quite the role in elevating the prestige and drama of medical diagnosis. For the past 20 years, Dr. Sanders has written a column in the New York Times titled "Diagnosis," in which she discusses bizarre and fascinating medical cases. In 2019, this column was turned into a Netflix documentary series of the same name. She has garnered much acclaim for presenting the process of diagnosis as a detective story, rather than the rote recall of a set of facts and figures. Dr. Sanders joins us in this episode to speak about her remarkable career path, her work, and how storytelling contributes to patient healing.

In this episode, you will hear about:

Dr. Sanders’ career prior to medicine as a TV journalist and how it influenced her path as a physician - 1:59
Dr. Sanders’ revelation about diagnosis as detective work and how she developed her passion for it - 4:59
Being part of the handful of “weirdos” that Yale Medical School admits every year, and combating imposter syndrome - 7:14
Dr. Sanders’ reflections on the how money-making impacts physician burnout and how the burden of choice in medical career paths may lead to a sense of disconnect - 12:39
Medical diagnosis itself as a kind of healing, allowing patients to contextualize their circumstances within their personal narratives - 18:05
Dr. Sanders’ best-practices on communicating with patients - 29:03
The methodology of solving and describing medical mysteries - 32:10
Challenges and opportunities in eliciting and listening to patient stories - 42:16
Dr. Sanders’ hope that the human dimension of medicine does not get displaced by the technical dimension, and why storytelling is integral to patient healing - 46:41

Dr. Lisa Sanders is the author of several books, including

Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis (2009), and

Diagnosis: Solving the Most Baffling Medical Mysteries (2019)

She writes a column for the New York Times called Diagnosis, which can be found archived here

Follow Dr. Sanders on Twitter @LisaSandersmd

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

Art, Drama, and a Terminal Illness | Ellen Dunphy Jun 28, 2022

Show notes

When actress and playwright Ellen Dunphy — then a robustly-healthy 33-year old — first met co-host Dr. Tyler Johnson in early 2020, they were filming an educational video teaching doctors how to discuss terminal illnesses with patients. Six months later, in a twist of fate, upon receiving a terminal diagnosis of gastric cancer, Ellen learned that Dr. Johnson would be her oncologist — for real this time. In this poignant episode, Ellen candidly shares her experiences from the moment she received her diagnosis to how she has subsequently grappled with grief, and discusses how this has fueled the creation of a play about her cancer journey. This is a rare occasion of conversation and reflection between a dying patient and her doctor on what matters most in medicine.

We note with sadness that Ellen passed away peacefully on July 4, 2022, surrounded by people who loved her.

In this episode, you will hear about:

The circumstances that first brought Ellen and Dr. Johnson together - 1:38
Ellen and Tyler’s second meeting, under drastically different yet parallel circumstances - 5:03
What it was like for both Ellen and Dr. Johnson at the moment her diagnosis was delivered - 7:24
What was surprising to Ellen about going through cancer treatment - 13:24
Ellen’s advice to medical professionals in light of her own treatment journey - 16:40
Ellen’s reflections on the process of writing her play about receiving a terminal cancer diagnosis - 21:12
The meaning of medicine, as seen by Ellen - 27:45
Ellen’s advice to all patients on the importance of advocating for oneself - 29:00

Ellen’s one-woman play “Imaginary Endings” about facing her cancer diagnosis can be viewed on YouTube.

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

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