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 - 2:13Why Dr. Lembke dedicates herself to addiction medicine, and how her philosophy can help others find meaningful work - 9:16The historical shift, with the advent of the opioid epidemic, to understanding addiction as a medical condition instead of a moral or personal failing - 12:53Reframing addiction as a medical diagnosis and approaching patients facing addictive disorders with compassion - 17:58How flaws in contemporary medical practice and misaligned incentives for doctors contributed to the opioid crisis - 24:15A discussion of Dr. Lemke’s book Dopamine Nation, including how easy access to pleasure causes addictagenic responses in nearly every aspect of our lives - 29:32How humans can reconnect with meaning despite living in a culture that often substitutes meaning with cheap pleasure - 34:15Dr. Lembke’s advice to all clinicians for how to better connect with patients - 45:20Tyler 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.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 2022

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 - 5:05How an ethicist determines what is “right” in a given circumstance - 9:10How Dr. Magnus’ deals with patients who refuse to accept his recommendations for care - 11:33Dr. Magnus’s journey from professor of philosophy to leading thinker on medical ethics - 14:00How the intense specialization of modern medicine may be contributing to clinician burnout - 23:31How misinterpretation of language can be a major barrier to good health care - 32:25Why clinicians use “hedge language” and “shield attributions” and how they can dramatically alter a patient’s understanding of their situation - 40:46Dr. Magnus’s advice to new clinicians on cultivating skills in ethical thinking and responsible patient communication - 50:45Learn more about the American Society for Bioethics and Humanities here.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 2022

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 - 2:13Grappling with complications that arise during surgery - 9:40Dr. Pearl’s transition from surgeon to CEO of the Permanente Medical Group - 12:49The mission that Dr. Pearl brought to his role as CEO and how he implemented that mission - 17:21How 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 - 20:32The toxic culture of denial in medicine and why it is killing doctors and patients - 27:45How status and compensation disparity contributes to physician burnout, and what to do about it - 35:47Dr. Pearl’s administrative strategy that led Kaiser Permanente to much success during his tenure as CEO - 43:08Dr. Pearl’s advice to physicians on how to stay connected and empowered in their careers - 46:38Dr. 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 BordersA frequent contributor to Forbes Magazine The host of two podcasts: Fixing Healthcare and Coronavirus: The TruthFind more information at RobertPearlMD.com or follow Dr. Pearl on Twitter @RobertPearlMDVisit 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 2022

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 - 1:59Dr. Sanders’ revelation about diagnosis as detective work and how she developed her passion for it - 4:59Being part of the handful of “weirdos” that Yale Medical School admits every year, and combating imposter syndrome - 7:14Dr. 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 - 12:39Medical diagnosis itself as a kind of healing, allowing patients to contextualize their circumstances within their personal narratives - 18:05Dr. Sanders’ best-practices on communicating with patients - 29:03The methodology of solving and describing medical mysteries - 32:10Challenges and opportunities in eliciting and listening to patient stories - 42:16Dr. Sanders’ hope that the human dimension of medicine does not get displaced by the technical dimension, and why storytelling is integral to patient healing - 46:41Dr. Lisa Sanders is the author of several books, including Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis (2009), andDiagnosis: Solving the Most Baffling Medical Mysteries (2019)She writes a column for the New York Times called Diagnosis, which can be found archived hereFollow Dr. Sanders on Twitter @LisaSandersmdVisit 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 2022

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 - 1:38Ellen and Tyler’s second meeting, under drastically different yet parallel circumstances - 5:03What it was like for both Ellen and Dr. Johnson at the moment her diagnosis was delivered - 7:24What was surprising to Ellen about going through cancer treatment - 13:24Ellen’s advice to medical professionals in light of her own treatment journey - 16:40Ellen’s reflections on the process of writing her play about receiving a terminal cancer diagnosis - 21:12The meaning of medicine, as seen by Ellen - 27:45Ellen’s advice to all patients on the importance of advocating for oneself - 29:00Ellen’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.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 2022

Essayist Emily Maloney offers a wholly unique vantage point when it comes to American healthcare. At 19 years old, a suicide attempt landed Emily in the hospital for an extended stay, which then saddled her with a massive 5-figure load of unexpected medical bills. In an attempt to pay off her debt, Emily became an emergency room technician and began working in the very same system that was crippling her financial life. In today’s episode, Emily discusses her experiences as both patient and caregiver, and shares her insights on the true cost – financial and personal – that the flawed US medical system exerts on everyone involved, from patients to physicians.  In this episode, you will hear about:Emily’s motivation for writing her recently published book of essays, “Cost of Living”  - 2:33How finding herself in suffocating medical debt changed Emily’s life  - 10:24Why the true costs of medical interventions are impossible to know under the current system -  18:20What drew Emily into the medical profession despite her negative experiences as a patient - 24:43Emily’s ideas on how healthcare in the US should be reformed - 37:28Emily is the author of the essay collection “Cost of Living”Follow Emily on Twitter @emilyfmaloneyVisit 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 2022

As the founding medical director of Palliative Care Services at Stanford Hospital, Stephanie Harman, MD is no stranger to death and grief. In this episode, she shares the story of how she discovered palliative care through the death of someone close and what it looks like to transform what are often the moments of greatest patient suffering into moments of profound meaning and humanism. In addition to her palliative care work, Dr. Harman is a clinical associate professor of medicine, a co-chair of the Stanford Health Care Ethics Committee, and Associate Chair for the Women in Medicine initiative in Stanford’s Department of Medicine.In this episode, you will hear about: How PBS, zebrafish, and comparative literature influenced Dr. Harman’s decision to enter medicine - 3:08How the death of someone close propelled Dr. Harman into palliative care and informs her philosophical focus on honoring a patient’s values and wishes - 8:09Why Dr. Harman felt drawn to a medical specialty that so often deals with the most painful part of medicine: witnessing patients dying - 15:53How Dr. Harman had to advocate for the legitimacy and dignity of palliative medicine, despite being told it was “a waste of her career” - 19:18How Dr. Harman processes the emotional weight of her chosen field with preventive and supportive measures - 22:20A discussion of how the COVID-19 pandemic has forced public and personal conversations about grief to the forefront - 27:24Dr. Harman’s vision for the future of medicine, and specifically the broader adoption of palliative care services - 33:33Dr. Harman’s advice to new medical professionals and students - 38:49You can follow Dr. Harman on Twitter @Steph_HarmanMDVisit 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 2022

Victoria Sweet, MD is a prize-winning author, medical historian, and professor of medicine at the University of California, San Francisco. She is the author of two bestselling books: “God's Hotel,” which details her time as a doctor in the last almshouse in the United States, and “Slow Medicine,” a memoir that outlines her approach to medicine as both a craft and art. In this episode, Dr. Sweet discusses why she reframes the doctor-patient relationship from one of a mechanic repairing a machine, to one of a gardener tending to her plants. Through vivid stories of her remarkable experiences, she illustrates how combining insights of premodern medicine with advances of modern health care can lead to better healing.In this episode, you will hear about: How the writings of Carl Jung drew Dr. Sweet to medicine - 2:18The story of how a resourceful nurse and a stubborn patient taught Dr. Sweet what it meant to be “a real doctor” - 9:36The origin of the Slow Medicine movement and how it shapes Dr. Sweet’s approach to patient care - 16:19The Philosophy of the Minimum and why examining side effects and placebo groups is critical to delivering the best patient care - 22:03Dr. Sweet’s time at Laguna Honda Hospital, the “last almshouse in the United States”, and what she learned about healing from the slower pace of that hospital - 27:07How studying medieval figures like Hildegard of Bingen influenced Dr. Sweet’s appreciation for premodern medicine and how she pairs it with modern medicine - 33:58Dr. Sweet’s advice for clinicians facing the mounting challenges of the modern corporate medical landscape - 40:02Dr. Sweet is the author of God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine and Slow Medicine: The Way to Healing.Dr. Sweet discusses the influence of Carl Jung’s memoir Memories, Dreams, and ReflectionsVisit 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 2022

Pamela Kunz, MD is the Director of the Center for Gastrointestinal Cancers at Yale Medicine. For 19 years, she was at Stanford University, most recently serving as Director of the Stanford Neuroendocrine Tumor Program. But in 2020, Dr. Kunz announced her departure, citing years of gender discrimination, microaggressions, and harassment. In this episode, Dr. Kunz opens up about the challenges she faced, how she overcame them, and how she now taps into a clear-eyed awareness of her values to lead health care settings that empower underrepresented individuals and to advocate for diversity, equity, and inclusion in academic medicine.In this episode, you will hear about: How Dr. Kunz’s science-filled childhood led her to a career in medicine, and why she took on the daunting task of treating cancer patients - 2:21What it is like to build relationships with patients who have life-limiting cancer diagnoses - 7:25Dr. Kunz’s past struggles working in a toxic environment due to constant disrespect and denigration based on her gender - 12:18How leadership coach Rebecca Merrill (our guest on Episode 7) helped Dr. Kunz realize why she was so unhappy in her work and what she could do about it - 16:15The development of Dr. Kunz as an advocate of diversity, equity, and inclusion in academic medicine - 18:48Dr. Kunz’s advice for women and other underrepresented individuals going into medicine on preparing against potential hostility in their chosen careers, and how to create a “tapestry” of mentors - 22:01How Dr. Kunz addresses her own burnout, and how seeing oneself as an advocate can be a tool to self-empowerment - 32:25 The advice Dr. Kunz would give to her past self if she could go back in time - 41:02Dr. Kunz mentions the book “Dare to Lead” by Brené Brown as being especially transformational in her journey to overcome challenges in the workplace.Follow Dr. Kunz on Twitter @PamelaKunzMDVisit 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 2022

A former dean of Stanford Medical School and past leader at the National Cancer Institute, Phil Pizzo, MD is as renowned for his groundbreaking research on childhood cancers and immunodeficiency as he is for his promotion of medical education. He is also a tireless scholar who continues pursuing knowledge and purpose deep into what many would consider the retirement years. In this episode, Dr. Pizzo shares what caring for children with some of the most harrowing diseases has taught him about courage, and how his creation of Stanford’s Distinguished Careers Institute epitomizes his vision for longevity and philosophy of lifelong learning.In this episode, you will hear about: How Dr. Pizzo’s love of learning and objection to the Vietnam War led him to a career in medicine - 2:00Teddy, a “boy in the bubble” whom Dr. Pizzo cared for and who profoundly shaped Dr. Pizzo’s career and life philosophy - 5:54Leaning into the work of treating severe diseases, despite the realities of the deep suffering involved - 14:46The guiding principles behind Dr. Pizzo’s time in leadership at the National Institutes of Health, Harvard Medical School, and Stanford Medical School - 20:01How Dr. Pizzo manages to maintain tranquility of mind and buoyancy of spirit over his long career, and why he created the Distinguished Careers Institute - 22:51The surprising next step in Dr. Pizzo’s scholarly journey - 30:42Dr. Pizzo’s advice to young people about the value of a habit of lifelong learning - 34:40Read more about Teddy DeVita, the “boy in the bubble” whom Dr. Pizzo cared for, in this Washington Post article.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 2022