The Doctor's Art - TopPodcast.com

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A Doctor for the People | Ricardo Nuila, MD Jan 23, 2024

Show notes

Ben Taub Hospital, located in the heart of Houston, Texas, is the city's largest hospital for those who cannot afford medical care. Texas, in turn, is the US state with the country's largest uninsured population. Amid chaotic emergency rooms and busy hospital wards serving the most financially and medically vulnerable people, Ricardo Nuila, MD finds meaning and beauty through stories he hears from his patients. In addition to his duties as a hospitalist at Ben Taub Hospital, Dr. Nuila is an associate professor of medicine at Baylor College of Medicine, where he directs the Humanities Expression and Arts Lab, as well as an author whose writings have appeared in the Atlantic, the New Yorker, the New York Times Sunday Review, and more. His 2023 book, The People's Hospital: Hope and Peril in American Medicine, explores the ups and downs of American medicine through the lens of patients he has encountered at Ben Taub.

Over the course of our conversation, we discuss what it's like to practice in a safety net hospital, the power of narrative medicine in connecting with patients, and how clinicians can hold onto their strength of character, even when working in a system that often feels broken and indifferent to human suffering.

In this episode, we discuss:

2:25 - How Dr. Nuila became drawn to both medicine and creative writing

6:07 - The characteristics that define different types of hospitals

12:06 - A patient story that exemplifies the experience of being a doctor at a public safety net hospital

20:33 - How Dr. Nuila finds deeper meaning in providing care, even when faced with systemic circumstances that a doctor can’t fix

25:34 - Dr. Nuila’s advice for how to get through the moments when you feel like you are “at war” with gaps in the system

42:32 - How narrative medicine and storytelling can make more effective clinicians

45:45 - Dr. Nuila’s advice on how to make a career in medicine meaningful

Dr. Ricardo Nuila can be found on Twitter/X at @Riconuila.

Dr. Nuila is the author of The People’s Hospital (2023).

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.

Shaping a Soul, Building a Self | William Deresiewicz Jan 16, 2024

Show notes

As an English professor at Yale University, essayist and literary critic William Deresiewicz observed a trend across American higher education that troubled him deeply. Instead of learning to think independently, critically, creatively, and courageously, students were increasingly subscribing to a mode of careerism, credentialism, and conformism that focused on climbing the academic or professional ladder.

So what is the value of higher education? As Deresiewicz writes in his 2014 book Excellent Sheep: The Miseducation of the American Elite and the Way to a Meaningful Life, colleges, first and foremost, are supposed to teach you to think, to help you develop a habit of skepticism and the capacity to put it into practice. More than that, college is where you build a soul — your moral, intellectual, sensual, emotional self, through exposure to books, ideas, works of art, and pressures of the minds around you that are looking for their own answers to the big questions. Questions of love, family, God, mortality, time, truth, dignity, and the human experience.

Over the course of our conversation, we discuss the search for a meaningful life, the worth of a liberal education, the role of mentorship, the relationship between solitude and leadership, what it means to cultivate moral imagination, and more.

In this episode, we discuss:

3:00 - Deresiewicz’ approach to teaching during his years as a college professor

6:25 - The reason why parents are not ideally positioned to guide their children through questions of what they want to do with their lives

8:02 - What Deresiewicz believes is the purpose of higher education

10:50 - What it means to “shape the soul” of students

17:12 - What we miss when we take a scientistic view of the world

20:45 - The challenge of establishing normative values in society, and why a “moral education” should be prioritized instead

28:25 - The search for individualism among students today

30:55 - What true leadership looks like and why people in powerful positions in our society do not often exhibit these traits

40:28 - What does it mean to have a sense of purpose?

43:00 - How young people can work to develop their sense of a calling or purpose

William Deresiewicz is the author of four books, including A Jane Austen Education (2011), Excellent Sheep(2014), The Death of the Artist (2020), and The End of Solitude (2022), as well as multiple essays, including Solitude and Leadership (2010) and The Disadvantages of an Elite Education (2008).

William Deresiewicz can be found on Twitter/X at @Wderesiewicz.

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

Random Acts of Medicine | Anupam Jena, MD, PhD Jan 09, 2024

Show notes

What happens to the mortality rates of cardiac arrest patients on days when there is a marathon happening in the city? What happens to surgical complication rates when it's the surgeon's birthday? Why do patients of younger doctors seem to have better health outcomes?

These and other quirky questions are what preoccupy health economist, Anupam Jena, MD, PhD. Dr. Jena is a professor of health care policy at Harvard Medical School, professor of medicine at Massachusetts General Hospital, host of the popular Freakonomics, MD podcast, and, together with Dr. Christopher Worsham, co-author of the 2023 book Random Acts of Medicine.

Over the course of our conversation, we discuss the often-unintuitive role that random chance plays in our health outcomes, the hidden drivers of medical decision-making, misconceptions about physician burnout, and more. As we'll see, through tackling what can be amusing questions about why physicians and patients behave the way they do, Dr. Jena encourages us to reconsider our own ways of thinking and imagine how we can do better and be better.

In this episode, we discuss:

2:18 - The path that took Dr. Jena to the intersection of medicine and economics

8:54 - How Dr. Jena discovers topics for research

12:12 - Unexpected and important findings that Dr. Jena has learned over the course of his work

19:18 - Dr. Jena’s focus on “natural experiments”

22:02 - Thinking about physician burnout from an economist’s perspective

36:42 - The mission Dr Jena had when he set out to write Random Acts of Medicine

44:08 - Dr. Jena’s advice for medical trainees on how to understand the hidden forces of the medical system

Dr. Anupam Jena can be found on Twitter/X at @AnupamBJena.

Dr. Jena is the co-author of Random Acts of Medicine (2023) and the host of Freakonomics, MD.

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

Being (Im)Mortal | Tony Wyss-Coray, PhD Dec 19, 2023

Show notes

From ancient myths to science fiction, humans have long been fascinated by the idea of transcending the limits of our natural lifespan. But what does modern medicine say about the practical, actual possibilities of extending human life? Joining us to explore this tantalizing question is Tony Wyss-Coray, PhD, a neuroscientist and director of the Phil and Penny Knight Initiative for Brain Resilience at Stanford University. While his research focuses on age-related cognitive decline and Alzheimer's disease, his work has involved identifying the “biological age” of various organs and its implications on various diseases, and treating old animals with the blood of young animals to halt, and even reverse, aging of the body.

Over the course of our conversation, we not only discuss the mysterious mechanisms underlying neurodegeneration, but also venture beyond the lab to explore the philosophical and ethical dimensions of life extension. We ask: how does our understanding of aging affect our perception of self and identity? Is aging a disease to be treated? What are our social and moral obligations when it comes to prolonging life or enhancing brain function? Is immortality even desirable?

In this episode, we discuss:

2:30 - How Dr. Wyss-Coray became drawn to neuroscience

4:45 - Defining neurodegeneration and aging

9:26 - The studies that led Dr. Wyss-Coray and his team to finding the gap between biological age and chronological age

21:06 - Is reversing the aging of an organism’s body a realistic goal?

28:31 - The possibilities and limits of treating neurodegenerative conditions

33:49 - Dr. Wyss-Coray’s groundbreaking work in treating old animals with the blood of young animals to reverse aging

38:51 - The philosophical and moral implications of life extension

48:57 - Dr. Wyss-Coray insight into the “secrets” behind some people’s longevity

Dr. Tony Wyss-Coray can be found on Twitter/X at @wysscoray.

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

Caring for a Broken World | Arthur Kleinman, MD Dec 12, 2023

Show notes

Medical anthropology provides a lens through which we can view the intricate tapestry of human health, woven with the threads of cultural beliefs, social structures, and biological realities. Few have played a more significant role in creating this discipline than psychiatrist Arthur Kleinman, MD, whose early, extensive field work in Taiwan and China have shaped how we think about cross-cultural healthcare systems and their impacts on human suffering. Many of his books, including The Illness Narratives and Patients and Healers in the Context of Culture, have become seminal texts in medical anthropology. Dr. Kleiman is also a moral philosopher whose writings have explored the frailty of our existence and how uncertainty and crises sharpen our moral identities.

Over the course of our conversation, we discuss Dr. Kleinman's bold explorations of human wellness across cultures, the search for meaning amid pain and suffering, the struggle to lead a moral life, and medical anthropology as a clarion call for a more nuanced and empathetic approach to health and healing.

In this episode, we discuss:

2:26 - Dr. Kleinman’s path to medicine

7:00 - How anthropology and psychiatry became central to Dr. Kleinman’s work

11:23 - The four core questions that define Dr. Kleinman’s decades of study

16:09 - How cultural definitions of a healthcare system greatly impact its effectiveness and reach

22:12 - Finding meaning in experiences of pain and sorrow

33:56 - An anthropological view of human existence, morality, and ethics

46:00 - The basis for Dr. Kleinman’s book The Soul of Care

47:51 - How Dr. Kleinman’s search for meaning shapes his approach to medicine

50:35 - The delineation between “morality” and “Morality”

57:40 - Connecting to our shared humanity by “doing” care

Dr. Kleinman has authored seven books, including his most recent, The Soul of Care.

In this episode, We share excerpts from: Dr. Kleinman’s book What Really Matters, Morten Lauridsen’s choral piece O Nata Lux, and Bryan Stevenson’s book Just Mercy.

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

Inside a Suicidal Mind | Clancy Martin, PhD Dec 05, 2023

Show notes

Since childhood, Clancy Martin has been preoccupied with, and even addicted to, the idea of suicide. A survivor of more than ten suicide attempts. Clancy has spent his life wrestling with questions like: where do these impulses come from? Why am I haunted by them? Why do I feel so much guilt? Can I be helped?

Clancy is a professor of philosophy at the University of Missouri — Kansas City, where he teaches existentialism, moral psychology, philosophy of the mind, and ethics. He is a Guggenheim Fellow and the author of more than ten books, most recently 2023’s How Not to Kill Yourself: A Portrait of the Suicidal Mind, in which he chronicles his struggles with suffering, substance use, and an obsession with self-destruction. At the same time, the book is a prescription of hope and an eloquent reminder of the interconnectedness of our lives. These are the issues we grapple with in this episode.

Content warning: Due to the sensitive nature of the topic of suicide, this episode might be distressing for some listeners. If you or someone you know is struggling with thoughts of suicide, in the United States, you can contact the National Suicide Prevention Lifeline by texting or calling 988, available 24 hours a day, seven days a week. For our international listeners, please refer to local resources in your country for support.

In this episode, we discuss:

3:53 - The importance of “speaking honorably” about suicide and removing the taboo surrounding the topic

9:23 - Applying the biopsychosocial model of illness to suicide

13:29 - Clancy’s lifelong experience with suicidal ideation

22:58 - Moving past our tendency to see suicidal ideation as a personal sin or failure.

27:07 - Understanding the different reasons why a person would consider suicide

35:54 - In Clancy’s view, what lies on the other side when one moves beyond a suicidal mindset

44:42 - Clancy’s advice for how to cope if you are currently vulnerable to suicidal thoughts

Clancy Martin is the author of How Not to Kill Yourself: A Portrait of the Suicidal Mind (2023).

In this episode, We discuss Clancy’s 2018 essay, I’m Still Here.

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

Healing Our Crisis of Disconnection | Jeremy Noble, MD Nov 28, 2023

Show notes

In recent years, loneliness has transformed from a private, personal experience into a full blown public health crisis. Studies have repeatedly shown that loneliness and social isolation increase the risk of premature death, dementia, and all sorts of mental illnesses. In this episode, Jeremy Noble, MD shares how he is combating our national crisis of loneliness by fostering connection through art and storytelling. Dr. Noble is the founder of the Foundation for Arts and Healing, a lecturer at Harvard Medical School, and the author of the 2023 book Project UnLonely: Healing Our Crisis of Disconnection.

Over the course of our conversation, we discuss Dr. Noble's unique path to arts and medicine, the three types of loneliness—social, emotional, and existential, what meaningful social connection looks like, and the healing power of creativity.

In this episode, we discuss:

2:08 - Dr. Nobel’s journey to becoming a “public health practitioner” and the personal meaning that the has found in his work

5:44 - The issues that Dr. Nobel is most interested in addressing within public health

7:03 - How Dr. Nobel found his way to the arts and humanities

14:21 - The benefits available at the intersection of the arts and medicine

16:09 - The mission of the Foundation for Art and Healing and Project UnLonely

22:26 - The definition of “loneliness” and the importance of loneliness literacy

24:19 - The “pyramid of vulnerability” for loneliness

27:10 - Evolutionary reasons for loneliness and how those are exacerbated today

34:19 - The three types of loneliness

38:20 - How we can cultivate a culture of connection in a society that has grown to distrust people and institutions

42:24 - What public health agencies should do to better prepare our society to reckon with loneliness

44:11 - The importance of addressing the loneliness inherent in medical training

Dr. Nobel is the author of Project UnLonely: Healing Our Crisis of Disconnection(2023).

Learn more about Project UnLonely and The Foundation for Art & Healing: www.artandhealing.org.

Dr. Nobel can be found on Twitter/X @JeremyNobel1.

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

A Seat at the Table — Leading the AMA | Jesse Ehrenfeld, MD Nov 21, 2023

Show notes

When Jesse Ehrenfeld, MD attended his first meeting at the American Medical Association (AMA) as a first year medical student, he was struck by the collaborative spirit he witnessed among physicians of all specialties from across the United States. But he was also filled with insecurity over whether he, as a gay man, would ever be truly accepted for who he was. 22 years later, Dr. Ehrenfeld is now the first openly gay president of the AMA. An anesthesiologist by training, he is also a senior associate dean and tenured professor at the Medical College of Wisconsin.

In this episode, Dr. Ehrenfeld shares his journey in medicine — from how he has channeled his experiences with discrimination, to becoming a leading advocate of health equity especially for LGBTQ individuals, to his time as a combat veteran in the Navy, to now leading one of the most influential medical organizations in America. Our conversation also ranges in topic from the future of medical education, to physician burnout, to the promises of digital health, and more.

In this episode, we discuss:

2:18 - Dr. Ehrenfeld’s path to becoming an anesthesiologist

5:03 - How health equity came to the forefront of Dr. Ehrenfeld’s work and how it has taken center stage in his leadership at the AMA

11:57 - The role that the house of delegates plays within the AMA

13:37 - How Dr. Ehrenfeld represents the democratically determined positions of the AMA

17:03 - Dr. Ehrenfeld’s mission for his year as President of the AMA

19:26 - How the AMA invests its resources on tackling systemic issues that affect health

24:42 - Dr. Ehrenfeld’s perspectives on physician burnout

32:02 - How medical training needs to change in order to prepare for the dawning of AI

38:38 - Engaging with the politics of healthcare

41:45 - How the AMA is working to ensure that doctors can affect the future of medicine through programs including Health 2047 and the Physician Innovation Network

45:27 - Why Dr. Ehrenfeld believes that medicine is still a worthwhile calling

For more about the AMA, visit https://www.ama-assn.org/.

Follow Dr. Ehrenfeld on Twitter @DoctorJesseMD.

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

The Doctor Who Cycled the World | Stephen Fabes, MBChB Nov 14, 2023

Show notes

"It's like having a backstage pass to the world."

That's how Stephen Fabes, MBChB describes his epic adventure exploring all six inhabited continents on a bicycle. Over the course of 6+ years, he cycled across 75 countries and 53,000 miles, discovering how human stories shape our conceptions of health and illness. Currently an acute medicine specialist at the Royal London Hospital, Dr. Fabes is also the author of the 2020 memoir Signs of Life: A Doctor's Journey to the Ends of the Earth. His writings have also appeared in The Guardian, The Telegraph, CNN, and the BBC.

In this episode, he joins us to share thrilling, thought-provoking, and amusing moments from his journey, what his travels through refugee camps and war-torn hospital wards have taught him about health care at the margins, and stories of everyday kindness that underscore our common humanity.

In this episode, we’ll discuss:

2:07 - Why Dr. Fabes decided to become a doctor

3:50 - The roots of Dr. Fabes’ sense of adventure

13:16 - How medical training differs in the UK and the US

14:34 - Dr. Fabes’ planning process for his 6+ year international bicycle journey

16:20 - A recap of the path that Dr. Fabes took on his 53,000 mile

21:15 - The most challenging aspects of Dr. Fabes’ journey and how they gave him the urge to visit medical projects on his travels

23:11 - How Dr. Fabes grappled with the moments when his health or life was in jeopardy

27:28 - Dr. Fabes’ takeaways from observing such a wide variety of international medical practices

32:38 - The challenges that arose as Dr. Fabes’ transitioned back to regular life after his trip

35:27 - How Dr. Fabes’ experiences have shaped how he now approaches medicine

36:42 - The importance of keeping an open mind in order to best meet your patients where they are

To learn more about Dr. Fabes’ book Signs of Life: A Doctor’s Journey to the Ends of the Earth and his work, visit https://stephenfabes.com/

Follow Dr. Fabes on Twitter/X at https://twitter.com/DrStephenFabes.

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

The Possibilities and Perils of Digital Health | Jag Singh, MD, PhD Nov 07, 2023

Show notes

It's been less than a year since ChatGPT was released in November 2022, but in that time, reports have emerged of ChatGPT outperforming physicians in everything from clinical reasoning to documentation and even to empathetic communication with patients. How are we to make sense of the role of clinicians when artificial intelligence and digital health technologies seem to be advancing at a pace beyond our reach?

Here to discuss this is Jag Singh, MD, PhD, a professor of medicine at Harvard Medical School and former Clinical Director of Cardiology and Founding Director of the Resynchronization and Advanced Cardiac Therapeutics Program at Massachusetts General Hospital. He is the author of the 2023 book Future Care: Sensors, Artificial Intelligence and the Reinvention of Medicine.Over the course of our conversation, we discuss how digital tools can make healthcare more human-centered, how we validate the effectiveness of these tools, what we can do to prevent the profit motive from corrupting their implementation, and the skills that clinicians need to cultivate in order to thrive in the future.

In this episode, we discuss:

2:21 - Why Dr. Singh chose the specialty of cardiology, and specifically electrophysiology

7:43 - Why Dr. Singh became interested in digital health

10:17 - How doctors know if remote monitoring and other digital interventions truly work in the interest of patients

15:57 - Dr. Singh’s concerns over the digitization of health

21:36 - How we can center digital health interventions on patients and what clinicians can do to be a part of the solution

34:54 - Whether or not academia is doing a good job of preparing future clinicians to work with digital tools

37:33 - How digital tools might change the role of the clinician

43:25 - The skills that clinicians will need to develop to better work alongside AI

59:25 - The values that clinicians will need to cultivate to work effectively in the digital future of health

Dr. Singh is the author of Future Care: Sensors, Artificial Intelligence, and the Reinvention of Medicine(2023).

You can follow Dr. Singh on Twitter at @jagsinghmd.

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

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