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

Explore the vital connection between storytelling and medicine, highlighting how personal narratives can enhance understanding and empathy in patient care. Discover Anna Reisman's journey from English major to physician and her experience with burnout. Learn about innovative writing workshops that deepen reflective practices and observational skills in future doctors. Dive into the healing power of stories during challenging times, using creative writing as a tool for professional growth and emotional connection.

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

Euan Ashley, Chair of Medicine at Stanford University, is a trailblazer in precision medicine and genetic sequencing. He shares his inspiring journey from a small Scottish town to the forefront of cardiology, revealing the emotional depth of working in a cardiac intensive care unit. The conversation delves into the power of precision medicine in diagnosing rare diseases, the founding of the Undiagnosed Diseases Network, and the hopeful future of AI in healthcare ethics, underscoring the transformative potential of personalized treatment.

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