The Doctor's Art

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

Shunichi Nakagawa, MD, is the Director of Inpatient Palliative Care Service at Columbia University Medical Center, specializing in end-of-life communication. He shares his journey from aspiring liver transplant surgeon to palliative care advocate after facing career setbacks. Dr. Nakagawa discusses the importance of compassionate conversations in serious illness, addressing cultural views on death, and enhancing shared decision-making in healthcare. His insights shed light on navigating emotional aspects and the rewards of meaningful doctor-patient interactions.

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.

In this conversation, Dr. Mariel Buqué, a health psychologist and expert on intergenerational trauma, draws on her own experiences as an Afro-Latina immigrant. She discusses how trauma from one generation affects the next, often perpetuating cycles of emotional instability. Dr. Buqué emphasizes the importance of understanding the origins of trauma and its multifaceted impact on individuals and families. She also highlights the significance of empathy, breaking mental health stigmas, and fostering trust in therapeutic relationships for effective healing.

The Genocide Against the Tutsi, occurring in Rwanda between April-July 1994, was a devastating episode of mass violence in which nearly 1 million people were killed over a period of 100 days. Fueled by longstanding ethnic tensions, political power struggles, and a deep seated history of discrimination, the genocide saw members of the Tutsi ethnic group slaughtered indiscriminately by extremists of the Hutu ethnic group. Growing up amid this chaos, Christian Ntizimira, MD witnessed some of humanity's most horrific atrocities. Instead of turning away, however, he chose to enter medicine, a profession that would allow him to address the immense suffering he saw. Today, Dr. Ntizimira is a palliative care physician and the founder and executive director of the African Center for Research on End of Life Care. In this episode, Dr. Ntizimira joins us to share his personal experiences with the Rwandan Genocide, his journey to palliative medicine after initially exploring a career in surgery, what palliative care means to him, what it looks like to honor the dignity of a patient, how he advocates better access to palliative care and chronic illness care, and his unique approach to medicine rooted in “ubuntu,” a philosophy emphasizing the universal bond that connects all humanity that is best summarized by the phrase “I am because you are.”In this episode, you’ll hear about: 2:45 - How Dr. Ntizimira’s experience as a young person during the Rwandan Genocide inspired him to become a physician, and how he eventually found himself drawn to palliative care  14:25 - Dr. Ntizimira’s distinction between “treating the disease” and “treating the person”20:22 - How Dr. Ntizimira teaches doctors to fully conceptualize patients as people instead of focusing only on their medical ailments 25:50 - The heart of palliative care that transcends cultures30:54 - The importance of presence in palliative care38:27 - What “reconciliation” means in Dr. Ntizimira’s approach to palliative care 47:17 - “Ubuntu,” an African philosophy emphasizing a shared connection among humans, and how it can revolutionize how we care for patients    Dr. Christian Ntizimira is the author of The Safari Concept: An African Framework for End of Life Care.Dr. Christian Ntizimira can be found on Twitter/X at @ntizimira.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

Mikołaj Sławkowski-Rode, PhD, a philosophy professor who dives deep into the themes of death and grief, illuminates how modern society often sidelines these crucial experiences. He discusses the essential role of mourning in fostering empathy and social connections. The conversation explores the intersection of love and grief, challenges of isolation in contemporary culture, and the superficial pursuit of happiness. Sławkowski-Rode also reflects on the significance of memory in the grieving process and the need for revitalized communal rituals.