The Doctor's Art

Multiple sclerosis is the most common disabling neurological disease among young adults. It's a disease in which the body's immune system begins attacking the protective covering around nerve cells, leading to a wide variety of symptoms, ranging from vision problems to difficulty walking fatigue to dizziness to speech problems. Our guest on this episode, neurologist Stephen Hauser, MD, has led research that has been key to developing our understanding of this disease, and his work has resulted in treatments that have helped hundreds of thousands of people. Dr. Hauser is a director of the Weill Institute for Neurosciences at the University of California, San Francisco, and the author of the memoir The Face Laughs While the Brain Cries: the Education of a Doctor. Over the course of our conversation, we discuss not only his groundbreaking scientific work, but also reflect on how clinicians can help patients heal even when there are no medical therapies available, as well as how neurological disorders affect our sense of personhood and meaning in life.In this episode, we discuss:2:07 - The childhood experiences that drew Dr. Hauser to a career in medicine, and specifically to neurology 8:15 - The ways in which practicing medicine was “simpler” 50 years ago9:53 - Why Dr. Hauser chose to focus his career on multiple sclerosis 13:58 - Advancements in multiple sclerosis treatment over the course of Dr. Hauser’s career15:37 - The importance of developing deep relationships with patients, even when curative treatments don’t yet exist19:45 - The unique challenge that arises when neurological diseases affect a person’s central identity 25:49 - The enduring power of love that transcends the loss of a patient’s cognitive identity 31:50 - The biggest lessons that Dr. Hauser have learned from his courageous patients35:10 - Dr. Hauser’s perspective on “failure” when treating patients 39:30 - Dr. Hauser’s hopes for the next generation of doctor scientists 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

According to emergency physician Leana Wen, MD, MS, "public health saved your life today, you just don't know it." Having been appointed the Baltimore City Health Commissioner at the age of 31, she certainly has the credentials and stories to illustrate this assertion. Prior to the COVID-19 pandemic, public health played a frequently misunderstood and under-appreciated role in our society, ranging from sanitation and immunization to mental health support and pollution control. In addition to her public health work, Dr. Wen is the author of the 2021 memoir Lifelines: A Doctor's Journey in the Fight for Public Health. She is a regular contributor to The Washington Post, a medical analyst for CNN, professor of health policy and management at George Washington University, former president of Planned Parenthood, and in 2019 was named one of TIME magazine's 100 Most Influential People. In this episode, Dr. Wen not only unpacks what public health is, but also shares her challenging upbringing as a child of immigrants, how she became the health commissioner of a city she had not previously worked or lived in, lessons on decision making in a crisis, the importance of finding good mentors, and more. In this episode, you will hear about:2:08 - Dr. Wen’s childhood as an immigrant to the US and her early experiences as a patient6:34 - Why Dr. Wen decided to train as an emergency medicine physician and how she got into public health9:27 - The ways in which emergency medicine training prepared Dr. Wen for a career in public heath13:34 - Dr. Wen’s objectives as she entered the role of Baltimore City Health Commissioner17:05 - Balancing priorities when confronted with the complexities of public health21:50 - Navigating public health policy within our challenging political climate 26:16 - The importance of telling success stories in public health to spread awareness of its importance28:24 - Dr. Wen’s advice on what to look for in a good mentor32:15 - What ties together the many experiences Dr. Wen has had throughout her career Dr. Leana Wen is also the co-author of When Doctors Don’t Listen: How to Avoid Misdiagnosis and Unnecessary Tests(2014).Follow Dr. Wen on Twitter @DrLeanaWen.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

Storytelling is the oldest medical technology — so claims our guests on this episode, Laurel Braitman, PhD, an acclaimed author and Writer-in-Residence at Stanford School of Medicine. Laurel offers a uniquely qualified perspective on the matter, having grown up in a medical family and now mentoring clinicians everywhere to help them fulfill their writing goals. She received her doctorate in History and Anthropology of Science from MIT, and her most recent work is a 2023 memoir titled What Looks Like Bravery: An Epic Journey Through Loss to Love. Over the course of our conversation, we explore the challenges Laurel has faced on her journey as an author, how creative writing can lead to better doctoring, and how we can find the courage to discover our own identities in the face of expectations others have of us.In this episode, you will hear about:What it means to be Writer-in-Residence at Stanford Medical School - 2:06Why physicians write and how storytelling can help clinicians - 6:42How Laurel’s writing career began and her advice for how to break into the writing world - 14:43What it's like to be in the medical field as an “embedded outsider” - 23:15Laurel’s most recent book What Looks Like Bravery: An Epic Journey Through Loss to Love, which details her experience of growing up with parents with high expectations and struggling through the grief of her father’s death - 28:15The importance of carving out time to reflect on your journey and your ‘why’ in the medical profession - 36:54Laurel’s advice for healthcare professionals who want to take the first step towards writing - 44:55All are welcome to join Laurel’s Writing Medicine workshops, a pay-what-you-can public resource for healthcare professionals. Visit www.LaurelBraitman.com or www.WritingMedicine.org for more details.Laurel Braitman is the author of several books, articles, and essays. You can find more at her website www.LaurelBraitman.comVisit 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 professor of English literature Theresa Brown, PhD, BSN, RN decided to become an oncology nurse, she suddenly found herself juggling seemingly-impossible patient expectations. And when she later was diagnosed with breast cancer herself, she was forced to confront the paradoxes of a healthcare system that demands so much of its practitioners yet provides insufficient support for them. She recounts these revelations in her recent book, Healing: When a Nurse Becomes a Patient. A frequent contributor to the New York Times, Theresa is also the author of several bestselling books detailing her experiences helping patients through some of the most devastating moments in their lives. Over the course of our conversation, Theresa shares her unusual journey to nursing, the daily struggles she encounters caring for the sickest patients in the hospital, and what her experiences as a cancer patient have taught her about finding solace in the midst of our imperfect healthcare system.In this episode, you will hear about:Theresa’s path from English professor to oncology nurse - 2:07What “whole person care” means to Theresa - 5:54A day in the life of an oncology nurse - 11:26How Theresa managed the emotional stress of working with seriously ill patients in such a prolonged and often intimate way - 18:47The high risk of moral injury in the nursing profession - 34:34Theresa’s experiences when the tables were turned and she became a cancer patient herself - 38:53Theresa’s practical advice for leading with kindness with patients - 44:43Theresa Brown is the author of several books about her experiences in nursing, including: The Shift: One Nurse, Twelve Hours, Four Patients’ Lives (2016) and Critical Care: A New Nurse Faces Death, Life, and Everything in Between(2011).You can follow Theresa Brown, RN on Twitter @TheresaBrown.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

Despite the optimism of modern healthcare promising ever more miraculous cures, there are inevitably moments in medicine that compel us to face the fact that not all problems can be fixed. Recognizing the limits of medicine and navigating the space between what can be done and what should be done for a patient requires a fundamental shift in mindset, one imbued with an understanding that sometimes acceptance is the most compassionate response. Our guest on this episode, palliative care physician Sunita Puri, MD, has dedicated her life to probing this delicate space, uncovering wisdom along the way on what it means to live and die with purpose and dignity. She is the author of the 2019 memoir That Good Night: Life and Medicine in the Eleventh Hour, and her writings have often appeared in The New York Times. In this conversation, we explore how she discovered palliative medicine, the importance of language in medicine's most difficult moments, and how impermanence and grief help us make meaning out of a world that often seems chaotic and senseless.In this episode, you will hear about:How Dr. Puri’s relationship with her parents drew her into medicine - 2:46The inspirational way that Dr. Puri’s physician mother connected with patients - 4:49Dr. Puri’s experiences entering the field of palliative care - 10:56Reflections on what Dr. Puri needed to “unlearn” over the course of her career as a physician - 15:36The recognition that not all diseases can be cured and not all problems can be fixed - 21:37Advice on how to engage patients and families when further curative medical interventions are futile - 32:29Dr. Puri’s experiences on helping other doctors through difficult moments - 38:56Why Dr. Puri writes and how she came to write her book That Good Night: Life and Medicine in the Eleventh Hour - 43:43Grief, empathy, and the sacred mission of medicine - 49:24In addition to her memoir That Good Night, we also discussed her New York Times article "We Must Learn to Look at Grief Even When We Want to Run Away."You can follow Dr. Sunita Puri on Twitter @SunitaPuriMD.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

As a medical student, former college quarterback David Fajgenbaum, MD was at the peak of his health and physique when he suddenly came down with a mysterious disease that, within weeks, led to multiple organ system failure. Dr. Fajgenbaum found himself on the brink of death over and over again in the intensive care unit, at one point receiving his last rites, with all of his doctors baffled about the cause of his illness. When the culprit was eventually found to be Castleman Disease, a rare disease entity that to this day defies categorization, he took matters into his own hands, researching and testing treatments on himself before finally discovering his own cure. Today, Dr. Fajgenbaum is not only the co-founder of the Castleman Disease Collaborative Network, but is leading efforts to discover therapies for other rare diseases. He is the author of the 2019 memoir Chasing My Cure. In this riveting conversation, Dr. Fajgenbaum shares his incredible, inspiring story to turn hope into action.In this episode, you will hear about:How the loss of his mother to cancer led Dr. Fajgenbaum to pursue a career in medicine - 2:13The rapid deterioration from peak physical health to multiple organ system failure that struck Dr. Fajgenbaum - 6:04Dr. Fajgenbaum reflects on the terror of his unknown affliction and how he maintained resilience - 12:59How a brief remission gave Dr. Fajgenbaum an opportunity to turn passive hope into action - 21:47How a relapse led to a series of experimental treatments and a realization that his cure might already exist - 24:47How deep research and self-experimentation led to a breakthrough - 36:42Dr. Fajgenbaum’s nonprofit Every Cure and its mission to discover new uses of existing drugs - 42:02How Dr. Fajgenbaum feels when he cares for patients in similar plights to his own prior - 47:03What clinicians can do to comfort patients even when treatment options are limited - 51:37Advice to clinicians and students who are interested in medical research - 53:25Lessons on presence and compassion that Dr. Fajgenbaum has learned from having been both physician and patient - 56:32You can follow Dr. Fajgenbaum on Twitter @DavidFajgenbaum.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

According to our guest on this episode, Gail Gazelle, MD, there has never been a more difficult time to be a doctor. Whether or not you agree with this statement, it's true that clinicians today are expected to see more patients in less time than ever before, spend hours on the electronic medical record, and manage countless administrative and organizational pressures. Dr. Gazelle is a physician coach who specializes in helping doctors build resilience and confidence in order to overcome burnout and rediscover joy in medicine. She is the author of the book Mindful MD: Six Ways Mindfulness Restores Your Autonomy and Cures Healthcare Burnout. Over the course of our conversation, we discussed the psychological and organizational factors that contribute to burnout and what we can do to overcome them.In this episode, you will hear about:What drew Dr. Gazelle into medicine and what eventually led her away from clinical practice - 1:58The differences and similarities between coaching and therapy - 7:22How much of coaching is about helping people change the narratives of their lives - 9:45The kinds of people who seek Dr. Gazelle’s help - 14:18The increasing acceptance of coaching in the healthcare profession - 15:51The extent to which an individual clinician can address burnout - 24:49Reflections on how perfectionism creates overstressed physicians and how to change that - 34:04A discussion of Dr. Gizelle’s book Mindful MD and the six ways mindfulness can help physicians - 40:25In this episode, we discussed the Atul Gawande's 2011 Harvard Medical School commencement address, titled Cowboys and Pit Crews,  later published in the New Yorker. We also discuss the article Does Medicine Overemphasize IQ? by Ezekiel J. Emanuel & Emily Gudbranson, originally published in the Journal of the American Medical Association.Gail Gazelle is the author of the book Mindful MD: Six Ways Mindfulness Restores your Autonomy and Cures Healthcare Burnout; you can download a free chapter at GailGazelle.com. She also authored the article The Slow Code: Should Anyone Rush to Its Defense? published in the New England Journal of Medicine, which we discussed in this episode.You can follow Dr. Gazelle on Twitter @GailGazelleMD.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

"All dying is a spiritual process," says our guest on this episode, hospice chaplain Kerry Egan. By this, she means that each person's death is more than just a biological event; it's an opportunity to reflect on the culmination of our human experiences, the lessons we’ve learned, and the impact we've had on others. The recognition of our impermanence prompts us to grapple with questions of legacy and purpose, infusing our mortal existence with depth and significance. Over the course of our conversation, Kerry describes how she became a chaplain, how she supports patients and other clinicians through difficult times, and the process of reconciling the strength of the human spirit with the limitations of the body.In this episode, you will hear about:An overview of hospice care and the role of the chaplain - 1:53The difference between hospital chaplaincy and hospice chaplaincy, and what led Kerry to this work - 7:15A discussion of the distinction between the person’s physical body and their intangible soul, consciousness, or spirit - 26:00How a chaplain offers spiritual counseling to clinicians in addition to patients - 32:51How years of being a chaplain has taught Kerry to love her own body - 34:20Why viewing the body as a machine and the physician as a mechanic leads to harm - 39:01Kerry’s advice to doctors for keeping compassion alive - 49:08Kerry Egan is the author of On Living, a memoir about her experiences as a hospice chaplain.You can follow Kerry Egan on Instagram @KerryEganWriter.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

A lung transplant—taking some or all of one person's lungs and putting them into someone else, giving the recipient years of additional life—sounds nothing short of miraculous. Today, over 2500 lung transplants are performed every year in the US. Still, it's among the most medically and ethically complex areas of medicine. Joining us in this episode is David Weill, MD, former director of the Lung and Heart-Lung Transplant Center at Stanford Health Care. He is also the author of Exhale: Hope, Healing, and a Life in Transplant. Over the course of our conversation, we discuss the challenges of transplantation, including how we find suitable organs, transport them, and decide who gets them. Dr. Weill also shares the high-stakes human drama that accompanies each triumph and failure, why he eventually decided to leave the practice, and the importance of staying connected in the midst of suffering. In this episode, you will hear about:How Dr. Weill’s early experienced inspired him to pursue a career as a transplant pulmonologist - 2:14What a lung transplant entails - 5:51The risks of lung transplantation - 8:31Stories of successful and unsuccessful transplantations - 11:50Challenges of navigating difficult conversations with patients awaiting transplant - 15:53A discussion of the organ transplant selection process - 25:24Dr. Weill’s reflections on his transition out of medical practice and what it was like to face burnout - 38:46Advice on staying balanced and connected with patients, colleagues, and loved whens when dealing with suffering - 45:20Dr. Weill is the author of Exhale: Hope, Healing, and a Life in Transplant (2021).You can follow Dr. David Weill on Twitter @DavidWeillMD.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 no longer a surprise that the race and ethnicity of a patient influence their health outcomes. But back in the 1990s, when Lisa Cooper, MD first documented and published findings that supported the role of patient race on the quality of physician-patient interactions, these were groundbreaking, even radical ideas. Today, Dr. Cooper, a physician and social epidemiologist, is the Director of the Johns Hopkins Center for Health Equity and a Bloomberg Distinguished professor at the Johns Hopkins University School of Medicine. She has designed innovative approaches to improve physician communication skills and the ability of healthcare organizations to address health disparities. She is a recipient of the MacArthur Fellowship and a member of the President's Council of Advisors on Science and Technology. In this conversation, we discuss her international upbringing, implicit bias in medicine, what good physician-patient relationships look like, and how we can more effectively prepare doctors to create a more equitable future.In this episode, you will hear about:Dr. Cooper’s international upbringing and how an early understanding of privilege shaped her career path - 2:21How privilege can change based on community and culture, and how Dr. Cooper experienced this shift - 7:25The observations Dr. Cooper made early in her career that led her to study how race and class impacts health outcomes in America - 12:58Facing stereotypes in a culture that is not your culture of origin - 18:44How Dr. Cooper began her research on racial inequities in health and the findings from those initial studies - 26:48The unrecognized assumptions that doctors are taught to make when it comes to patient care - 32:56How physicians can learn to take better care of patients from all backgrounds - 38:36The current state of medical education around implicit bias training and racial disparities - 46:40Dr. Cooper’s advice to her younger self - 52:53Dr. Cooper is the author of several highly-regarded medical research papers; in this episode we discussed Race, Gender, and Partnership in the Patient-Physician Relationship (1999), published by Journal of the American Medical Association.You can follow Dr. Lisa Cooper on Twitter @LisaCooperMD.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