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

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

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

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

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

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

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

Pat Brown, MD, PhD, is a physician and molecular biologist who founded Impossible Foods to revolutionize our food system. He shares his transition from clinical pediatrics to biochemical innovation, including creating the DNA microarray. Dr. Brown discusses the challenges of developing plant-based alternatives that taste better than meat while addressing the environmental toll of animal agriculture. He emphasizes the necessity of cultural shifts in eating habits for sustainability and inspires individual agency in tackling climate challenges.

Dasha Kiper, a clinical psychologist and author of "Travelers to Unimaginable Lands," passionately advocates for the dignity and identity of dementia patients. She discusses the profound emotional toll dementia takes on caregivers, from feelings of guilt to the heartbreaking reality of seeing loved ones decline. Dasha emphasizes the importance of compassion in caregiving and navigating the complex dynamics of identity. Her insights highlight the need for empathy, support, and understanding within this often-isolating experience.

Tom Frieden, a former Health Commissioner of New York City and leader of Resolve to Save Lives, discusses his pioneering public health initiatives to combat tobacco use and infectious diseases. He shares his journey into medicine and highlights the ethical dilemmas between individual freedoms and community health. Frieden also addresses challenges in tuberculosis control, the politics shaping public health, and innovative strategies to tackle cardiovascular disease. His insights on transparency during the COVID-19 pandemic stress the importance of public trust in health initiatives.