The Doctor's Art

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

Though often invisible in our society, studies have shown that more than seven out of ten people experience trauma at some point in their lives, whether it's physical, sexual, or emotional abuse or a life-threatening accident or illness. In this episode, we speak with Bessel van der Kolk, MD, a psychiatrist and pioneering researcher on post-traumatic stress. His 2014 book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, spent 27 weeks at the top of the New York Times bestseller list. He is the past president of the International Society for Traumatic Stress Studies. Over the course of our conversation, we discuss why Dr. van der Kolk began studying trauma, the role of non-pharmaceutical methods in treating post-traumatic stress, how health care providers can overcome the psychological and emotional burden of encountering stressful situations in their practice, and how we can get back in touch with the irreducible human dimensions of love, belonging, and meaning through creativity, fellowship, self-expression, and imagination.In this episode, you will hear about:Why Dr. van der Kolk finds trauma a fascinating area of study - 2:16How Dr. van der Kolk views the emotional burden he carries from helping patients - 3:47A discussion of empathy and sympathy, and how they impact physicians dealing with patient suffering on a daily basis - 7:53Self-compassion: what does it look like and how do you cultivate it? - 14:10A discussion of trauma how it manifests physically and mentally - 19:22The difference between the “top-down” and “bottom-up” paradigms of coping with trauma and stress - 29:31How the complexities of trauma have been oversimplified repeatedly throughout history - 32:06Advice on cultivating a compassionate and sympathetic mindset for new physicians - 41:36How medical practitioners can safely process the trauma of medical training - 47:38Visit 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

We live in a culture that vilifies stress. Stress, we are told, is unhealthy both physiologically and emotionally, and something to be avoided at all costs. But Stanford University health psychologist Kelly McGonigal, PhD believes that by suppressing or ignoring it, we're missing out on the benefits of effective stress management. Kelly is also a bestselling author whose work focuses on the mind-body connection and the psychology of compassion and mindfulness. In this episode, Kelly shares the personal experiences that led her to this work, the myths and misconceptions surrounding stress, the role of physical movement in promoting our wellbeing, and how even busy physicians can find space for self-compassion.In this episode, you will hear about:The early life experiences that led Kelly into a career in psychology - 1:55What health psychology is - 3:50How physical health impacts mental and emotional wellbeing - 6:13Why many physicians find it difficult to maintain physical health - 11:58The behaviors that can make a big difference in one’s physical and mental wellbeing - 15:06How Kelly helps physicians provide care to their patients while holding space for the exhaustion and frustration that can come with this work - 25:50Common misconceptions about stress - 38:39The importance of self-compassion for those working in high-stakes fields like medicine - 43:00Advice to clinicians on better supporting patients going through stressful times - 55:48Dr. McGonigal is the author of several books, including The Willpower Instinct (2012), The Upside of Stress (2015), and The Joy of Movement (2019).Watch Dr. McGonigal’s popular TED talk on stress management.You can follow Dr. McGonigal on Twitter @KellyMcGonigal.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 over 50 years, the National Eye Institute (NEI) has been a driving force for cutting-edge vision research, education, and public health guidance. In this episode, we speak with Michael F. Chiang, MD, Director of the NEI. A pediatric ophthalmologist by training, Dr. Chiang's work focuses on the application of biomedical informatics to ophthalmology, in areas ranging from telehealth to artificial intelligence to health data management. Over the course of our conversation, Dr. Chiang describes the elegant intricacies of the human eye, shares what excites him most about digital health, discusses the urgent need for reformation in medical education, and shares his mission as the leader of the nation's foremost agency for promoting eye health.In this episode, you will hear about:Dr. Chiang’s upbringing in a family of engineers and eventual path found to ophthalmology - 2:22How the practice of ophthalmology is changing and the role of informatics in this change - 6:43What pediatric ophthalmology entails, and why this work inspires Dr. Chiang to this day - 10:39The mechanical intricacies of the human eye - 14:20Dr. Chiang’s reflections on how his education in engineering shapes the way he practices medicine - 18:03The importance of patient stories and how modern clinical practice leaves little time for them -  22:55How artificial intelligence is changing medicine and what that means for the future role of doctors - 25:55What excites Dr. Chiang most about the future of medicine, and what concerns him the most - 33:40Dr. Chiang’s vision for the National Eye Institute - 44:10Advice to young clinicians on lifelong curiosity and adaptiveness - 46:04In this episode, we discuss Marshall McLuhan’s aphorism “the medium is the message” and the subsequent work of Neil Postman on “medium as metaphor.”You can follow Dr. Chiang on Twitter @NEIDirector.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

Awe is a feeling we've all experienced but often struggle to articulate. Whether it's the sheer scale of a skyscraper, the infinite expanse of a starry night sky, or the miracle of childbirth, moments of awe can strike us at unexpected times, leaving us speechless, inspired, and even profoundly transformed. In this episode, we speak with Dacher Keltner, PhD, a psychologist at UC Berkeley, where he is the founding director of the Greater Good Science Center and the host of The Science of Happiness podcast. Keltner is a leading researcher on human emotion whose work focuses on the socio-biological origins and effects of compassion, beauty, power, morality, love, and social class. His most recent book is AWE: The New Science of Everyday Wonder and How It Can Transform Your Life. In this episode, we discuss the eight sources of wonder in life, how we can nurture an openness to experiencing awe, and how this openness can help us navigate grief, uncertainty, loneliness, and mortality, ultimately allowing us to lead more meaningful lives.In this episode, you will hear about:How growing up in a family of artists and humanists led Dr. Keltner to psychology - 2:26What the scientific study of emotions looks like - 4:54How scientists grapple with the difficulty of defining and studying emotions and feelings - 8:20A discussion of Jonathan Haidt’s revolutionary study of morality, The Righteous Mind - 11:57How Dr. Keltner defines and studies awe and wonder - 14:39The Eight Wonders of Life - 27:31Awe, beauty, and the sublime - 36:16Reflections on how digital technologies have negatively impacted our ability to experience awe - 38:35Advice for how we can practice the experience of awe - 44:26How awe can help with human suffering and physician burnout - 46:39Dr. Dacher Keltner is the author of many books, including AWE: The New Science of Everyday Wonder and How It Can Transform Your Life, The Power Paradox: How We Gain and Lose Influence, and Born to Be Good: The Science of a Meaningful Life.In this episode, we discuss Bertrand Russel’s Power: A New Social Analysis, Paul Ekman’s work on emotions and facial expressions, William James’ What is an Emotion?, Jonathan Haidt’s The Righteous Mind, Richard Lazarus’ “core relational themes,” Edmund Burke’s A Philosophical Enquiry into the Origin of Our Ideas of the Sublime and Beautiful, Daniel Kahneman’s Thinking, Fast and Slow, Anna Lembke’s Dopamine Nation, and Jean Twenge’s work on social media and self-focus.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 send an email to info@thedoctorsart.com.Copyright The Doctor’s Art Podcast 2023

First used in the context of Vietnam war veterans, the term "moral injury" refers to the psychosocial, behavioral, and spiritual distress that comes from perpetuating or witnessing events that contradict deeply held moral beliefs. In recent years, moral injury has increasingly been used to describe one of the main challenges clinicians face in modern medicine — the challenge of knowing what care patients need but being unable to provide it due to constraints beyond the clinicians control, such as limited time or misaligned financial structures. Even more than emotional exhaustion and detachment, moral injury leads to profound shame and guilt. One of the leading voices addressing moral injury among health care workers is Wendy Dean, MD, a psychiatrist who has written widely on the issue, most recently in her book, If I Betray These Words: Moral Injury in Medicine and Why it's So Hard for Clinicians to Put Patients First. In this episode, Dr. Dean shares her own winding journey from orthopedic surgery to general surgery and finally to psychiatry, discusses where moral injury comes from and what it looks like, and explores what clinicians can do to address it.In this episode, you will hear about:Dr. Dean’s early explorations in medicine - 2:35How Dr. Dean’s desire to become a surgeon was deterred by gender discrimination - 5:12What led Dr. Dean to psychiatry, and then eventually out of clinical medicine entirely - 13:22A discussion of what moral injury is and why Dr. Dean began to study it - 18:03Examples of how moral injuries occur in the day-to-day of medical practice - 24:19How physicians and hospital administrators can address moral injury, citing as an example the court case of Raymond Brovont M.D. vs EmCare Holdings Inc - 38:57Dr. Dean’s advice for how navigate and push back against seemingly insurmountable bureaucracy - 42:22Moral Injury in Healthcare, the non-profit Dr. Dean founded - 47:39What setting personal and professional boundaries looks like in medicine - 53:04Dr. Dean’s advice to students and clinicians about fighting burnout - 57:37In this episode, we discuss Achilles in Vietnam: Combat Trauma and the Undoing of Character by Jonathan Shay, MD, PhD, and The Business of Health Care is Built on the Exploitation of Doctors and Nurses by Danielle Ofri, MD, PhD.Dr. Wendy Dean is the cohost of the Moral Matters podcast.You can follow Dr. Dean on Twitter @WDeanMD.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 COVID-19 rapidly emerged, the World Health Organization (WHO) was thrust into an unprecedented challenge. The global pandemic response was in disarray; health care resources were limited and inequitably distributed; and misinformation burgeoned. At the center of this maelstrom was Soumya Swaminathan, MD, who served as the WHO’s first Chief Scientist, from 2019 until 2022. Dr. Swaminathan not only spearheaded efforts to disseminate the latest scientific findings about the coronavirus and vaccine development, but also became one of the major public faces of the WHO. In this episode, we discuss Dr. Swaminathan's formative years becoming a pediatrician in India, specializing in treating children with tuberculosis and HIV, as well as the challenges she faced as a leader at the WHO in a time of eroding public trust.In this episode, you will hear about:Dr. Swaminathan’s experiences training to become a doctor in India - 2:05How Dr. Swaminathan discovered the balance between her interests in clinical medicine and research - 6:00Dr. Swaminathan’s reflections on the challenges of caring for children with tuberculosis and HIV - 9:38A discussion of global research funding disparity - 14:08How Dr. Swaminathan joined the WHO and eventually came to fill such a critical leadership role there - 19:04Dr. Swaminathan’s recollections of the arrival of COVID-19 from her perspective as the WHO’s first Chief Scientist - 21:28Lessons learned in health communication from the pandemic - 27:46The experience of being a lightning rod for online harassment and misinformation - 35:07Dr. Swaminathan’s advice to new clinicians who are considering pursuing a career in global health - 39:25You can follow Dr. Swaminathan on Twitter @DoctorSoumya.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

Navigating the unforgiving hours and ethical challenges of medical training while holding onto humanism; the medical and cultural history of the human heart; the moving journey of a doctor as he wrestles with his duties as a son and caregiver for a father with dementia. These are just some of the diverse subject matters our guest in this episode, Sandeep Jauhar, MD, has written about. Dr. Jauhar is the director of the Heart Failure Program at Long Island Jewish Medical Center and a multiple-time bestselling author whose writings have also appeared in the New York Times, Wall Street Journal, and other publications. In the first half of our conversation, Dr. Jauhar shares his journey in medicine and struggles with burnout; while in the second half, we discuss his poignant experiences caring for his father, the subject of his most recent book, My Father's Brain: Life in the Shadow of Alzheimer's. In this episode, you will hear about:How Dr. Jauhar’s immigrant parents influenced his choice to pursue a career in medicine - 2:02Dr. Jauhar’s reflections on the role of indecisiveness in shaping his path to cardiology - 4:49A discussion of a doctor’s struggle against a corporate medical system that inflicts moral injury on physicians - 12:51Dr. Jauhar’s advice to physicians on ameliorating moral injury - 18:54Reflections on how Alzheimer’s disease affects the patient’s family, and an overview of Dr. Jauhar’s recent book My Father’s Brain - 25:10A discussion of therapeutic deception, also known as validation therapy, in which caregivers and loved ones are encouraged to “play along” with the distorted reality of a patient with dementia - 36:43The conflicts between Dr. Jauhar and his siblings concerning end-of-life care for his father - 43:18How the medical system needs to changed so that more support is given to dementia patients and their families - 49:05Dr. Sandeep Jauhar is the author of several best-selling nonfiction books: Intern: A Doctor’s Initiation, Doctored: The Disillusionment of an American Doctor, Heart, A History, and My Father's Brain: Life in the Shadow of Alzheimer'sDr. Jauhar also responds to medical students and residents on his blog Advice on Your First Year.You can follow Dr. Jauhar on Twitter @SJauhar.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 1938, the Harvard Study of Adult Development has followed the lives of hundreds, and eventually thousands, of American adults, with the goal of discovering what enables people to live healthier, more meaningful lives. Joining us in this episode is Robert Waldinger, MD, professor of psychiatry at Harvard Medical School and the current director of the study. He is the author of the book The Good Life: Lessons from the World's Longest Scientific Study of Happiness. Over the course of our conversation, we explore the origins and evolution of the study, what adult development actually means, whether happiness is a choice, how social media shapes our relationships, Dr. Waldinger's interests in Zen Buddhism, and the key to leading a fulfilling life.In this episode, you will hear about:What drew Dr. Waldinger to the field of psychiatry - 1:53Dr. Waldinger’s reflections on the work and daily practice of a psychiatrist - 3:31An overview of the Harvard Study of Adult Development, the longest running scientific study on happiness - 6:54The medical and psychosocial concepts of “adult development” - 9:49The most important and surprising findings of the Study of Adult Development - 16:20Why relationships are critical to health and happiness - 23:07How social media distorts reality and why it can be quite harmful to mental health - 29:37Whether happiness is a choice - 34:48The impact of Zen Buddhism on Dr. Waldinger’s life and work - 43:55Dr. Waldinger’s advice to clinicians on leading fulfilling careers - 50:02In this episode, we discuss the book Wherever You Go, There You Are, by Jon Kabat-Zinn.Dr. Robert Waldinger is the author of The Good Life.You can view Dr. Waldinger’s acclaimed TED Talk What Makes a Good Life.You can follow Dr. Waldinger on Twitter @RobertWaldinger.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