The Doctor's Art

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 economics8:54 - How Dr. Jena discovers topics for research12:12 - Unexpected and important findings that Dr. Jena has learned over the course of his work19:18 - Dr. Jena’s focus on “natural experiments”22:02 - Thinking about physician burnout from an economist’s perspective36:42 - The mission Dr Jena had when he set out to write Random Acts of Medicine44:08 - Dr. Jena’s advice for medical trainees on how to understand the hidden forces of the medical systemDr. 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.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

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 age21:06 - 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 aging38:51 - The philosophical and moral implications of life extension48:57 - 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.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 2023

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 reach22:12 - 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 medicine50:35 - The delineation between “morality” and “Morality”57:40 - Connecting to our shared humanity by “doing” careDr. 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.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 2023

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 topic9:23 - 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.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 2023

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 work5:44 - The issues that Dr. Nobel is most interested in addressing within public health7:03 - How Dr. Nobel found his way to the arts and humanities14:21 - The benefits available at the intersection of the arts and medicine16:09 - The mission of the Foundation for Art and Healing and Project UnLonely22:26 - 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 today34:19 - The three types of loneliness38:20 - 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 trainingDr. 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.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 2023

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 anesthesiologist5:03 - 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 health24:42 - Dr. Ehrenfeld’s perspectives on physician burnout32:02 - 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 Network45:27 - 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.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 2023

"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 adventure13:16 - How medical training differs in the UK and the US14:34 - Dr. Fabes’ planning process for his 6+ year international bicycle journey16:20 - A recap of the path that Dr. Fabes took on his 53,000 mile21:15 - The most challenging aspects of Dr. Fabes’  journey and how they gave him the urge to visit medical projects on his travels23:11 - How Dr. Fabes grappled with the moments when his health or life was in jeopardy27:28 - Dr. Fabes’ takeaways from observing such a wide variety of international medical practices32:38 - The challenges that arose as Dr. Fabes’ transitioned back to regular life after his trip35:27 - 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 areTo 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.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 2023

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 health10:17 - How doctors know if remote monitoring and other digital interventions  truly work in the interest of patients15:57 - Dr. Singh’s concerns over the digitization of health21:36 - How we can center digital health interventions on patients and what clinicians can do to be a part of the solution34:54 - 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 clinician43:25 - The skills that clinicians will need to develop to better work alongside AI59:25 - The values that clinicians will need to cultivate to work effectively in the digital future of healthDr. 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.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 2023

Imagine if, as a teenager, you were told that you would lose your vision over the course of a few decades. How would you approach your life, your world, and the people in it? Joining us to discuss these questions is writer Andrew Leland. Andrew has retinitis pigmentosa, a condition that affects the retina's ability to respond to light, leading to progressive irreversible vision loss. Andrew's works have appeared in The New York Times Magazine, The New Yorker, and elsewhere, and he is the author of a 2023 memoir titled The Country of the Blind: A Memoir at the End of Sight. Over the course of our conversation, we explore the culture and language of blindness, what it's like to grieve the gradual loss of sight, how visual impairment changes the appreciation of beauty, how blind individuals can harness the full richness of the human senses, and more. Ultimately, Andrew's deeply personal stories and sharp insights remind us to see the dignity in those living with disabilities, both visible and invisible.In this episode, we discuss:2:16 - Andrew’s journey with vision loss starting from his teenage years6:58 - The isolation of having a condition that most around you cannot experience or fully understand11:56 - How blindness exists on a spectrum and in many varieties13:23 - The milestones of gradual blindness that Andrew encountered over the course of his life16:49 - Andrew’s advice for how be tactful when interacting people with disabilities such as blindness25:48 - Andrew’s reflections on the internal psychology of ableism 28:12  - How blindness has altered Andrew’s personal relationships30:16 - How Andrew’s experiences as a sighted individual affects his current perceptions with low vision32:57 - How Andrew’s loss of vision has shaped his relationship with his other senses and how visual impairment affects the appreciation of beauty44:19 - Andrew’s advice to clinicians on how to best meet patients where they are with their disabilitiesLearn more about Andrew and his work at https://www.andrewleland.org/.Andrew is the author of the memoir The Country of the Blind: A Memoir at the End of Sight (2023).In this episode, we discussed John Hull’s book Touching the Rock: An Experience of Blindness.You can follow Andrew on Twitter/X @Quailty.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 2023

For many people, the idea of politics in healthcare conjures up hyperpartisanship, where power and party loyalty trump public interest. But Joshua Sharfstein, MD is passionate about politics and health care because to him, these are opportunities to bring together wide-ranging expertise and navigate seemingly irreconcilable interests to implement changes that change the lives of millions. Dr. Sharfstein has led a career reflective of this passion. He has served as the Secretary of the Maryland Department of Health, the Principal Deputy Commissioner of the US Food and Drug Administration, and the Commissioner of Health for Baltimore City, and is currently Vice Dean for Public Health Practice and Community Engagement at the Johns Hopkins Bloomberg School of Public Health. Over the course of our conversation, Dr. Sharfstein discusses why public health matters, how he handles partisanship in politics, and his career highs and lows and lessons learned on effective crisis management.In this episode we discuss:2:16 - How medicine and politics ended up being a twin focus of Dr. Sharfstein’s career5:07 - The milestones of Dr. Sharfstein’s career in healthcare leadership8:39 - Why healthcare arouses such intense partisan political feelings13:51 - How public health’s messaging and communication must change in light of current advancements in information technology18:42 - The formative public health crises that Dr. Sharfstein has dealt with throughout his career26:33 - Ideas for strengthening the US’s weak public health system29:28 - How COVID-19 revealed the flaws of our public health system33:55 - Dr. Sharfstein’s advice for clinicians who are interested in working in public health38:00 - Sustaining drive and momentum amid bureaucracy in public health41:56 - A sampling of the unsafe products that Dr. Sharfstein has successfully gotten taken off of the market Dr. Sharfstein is the author of The Public Health Crisis Survival Guide: Leadership and Management in Trying Times.You can follow Dr. Joshua Sharfstein on Twitter @DrJoshS.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 2023