We have featured many techno-optimists on this show — healthcare leaders who believe that precision medicine and emerging technologies promise to revolutionize and democratize medicine in the best of ways. But look under the glossy veneer of this optimism and we see a far more complex story, one that touches on questions of power, inequity and the troubling ways in which genetics can be wielded, intentionally or not, to shape society in potentially dangerous ways. 

Our guest on this episode is James Tabery, PhD, a bioethicist, philosopher, and author of the book Tyranny of the Gene” Personalized Medicine and its Threat to Public Health (2024). Tabery gives us a tour of the rise of personalized and precision medicine, a field that promises to tailor treatments to our unique genetic profiles. Importantly, though, he highlights how the blind pursuit of these advances can distract us from larger public health challenges and exacerbate inequality. In our conversation, we explore the historical forces that have shaped modern genetics, ethical dilemmas involving the tension between patient autonomy and societal justice, and necessary guardrails around technological advances. 

We hope this conversation will challenge your assumptions, whether you are a clinician, a patient, or simply someone fascinated by the ways science shapes our world.

In this episode, you’ll hear about: 

3:15 - How Tabery became drawn to his work in philosophy and bioethics 

5:30 - Tabery’s view on the potential perils of the constant march of scientific progress 

9:34 - The ways in which his father’s early experience with precision medicine shaped Tabery’s thinking on the topic  

19:33 - Examining the promises and realities of precision medicine 

30:12 - Navigating the inequities caused by the exorbitant cost of precision medicine

35:29 - The challenges doctors face when approaching “financial toxicity”

40:00 - Tabery’s worries about medical genetics and AI

49:51 - How innovation be controlled in order to better align with ethical concerns

James Tabery can be found on Twitter/X at @jamestabery. 

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 [email protected].

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Life can be hard when we are sick. But even when we aren't, life can still wear us down in quiet, surprising ways. Indeed, major traumas are relatively rare, and it's the moments when too many things go wrong at once, or we are exposed to prolonged periods of stress, that we fall into a spiral of exhaustion, fatigue, burnout, and hopelessness. 

Vincent Deary, PhD is an author and health psychologist who explores the mundane struggles of everyday life. His writings blend clinical insight, literary finesse and wisdom drawn from philosophy and art to illuminate how the wear and tear of life affect all of us, and how we can navigate through it all. He is the author of How We Are (2024), which explores the power of human routines and the challenges of personal change, and How We Break (2024), which delves into how individuals cope when pushed to their limits. 

Over the course of our conversation, we discuss what the clinical work of health psychology looks like, what happens to our minds when we deal with stressors in life, the importance of storytelling for psychological growth, balancing self-improvement with self-acceptance, the role of constitutional luck in our search for happiness, the importance of restorative rest, how clinicians can cope with grief and guilt from their work, and more. By bringing an empathetic lens to the complexities of modern existence, Vincent helps us create a path through difficult times. 

In this episode, you’ll hear about: 

2:43 - What health psychology is and how Deary became drawn to this field 

18:58 - Deary’s motivations for exploring the emotional toll of experiencing life in his writings 

22:42 - The benefit of approaching each patient as a “case” 

31:46 - Finding a balance between self-improvement and self-acceptance 

38:10 - Using the bio-psycho-social model to explain our capacities for weathering stress

43:14 - Fostering a healthier perspective on work-life balance 

50:55 - The importance of community and institutional support in helping people process compassion fatigue 

58:05 - Strategies for connecting more deeply with patients within a clinical setting 

Vincent Deary can be found on Twitter/X at @vincentdeary.

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 [email protected].

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Variations of cryonics — the long term storage of human beings, usually at low temperatures — have long been featured in science fiction. In stories involving space travel, it’s often used as a solution for long-duration journeys. But increasingly, this is not just the stuff of fiction anymore. 

The prospect of preserving ourselves, potentially indefinitely, forces us to ask some of the most profound questions we have ever faced: are we meant to transcend the boundaries of our mortal lives? What does it mean to be alive? If life can be extended, what happens to its meaning, urgency, and beauty? These questions, by turns technological, philosophical, ethical and even spiritual, are what we explore in this episode. 

Ariel Zeleznikow-Johnson, PhD is a neuroscientist who studies the nature of conscious experiences to better understand how we can preserve cognitive function. His book The Future Loves You: How and Why We Should Abolish Death (2024), explores the viability of delaying death and its societal implications. Over the course of our conversation, we discuss the science of human preservation, definitions of life and death, broader questions about how we derive meaning from life, whether or not the finitude of human experience is essential to our conceptions of a well-lived life, our social contract with future generations, and more.

In this episode, you’ll hear about: 

2:44 - How Dr. Zeleznikow-Johnson became interested in the future of longevity

6:00 -  Dr. Zeleznikow-Johnson’s definitions of “life” and “death”

14:29 - Why Dr. Zeleznikow-Johnson thinks that believing death is inevitable is a form of “learned helplessness”

17:52 - The level of faith one would need to have in the future of technology to consent to cryosleep 

24:16: - Whether the finitude of human existence is essential to its meaning

29:05 - Whether every death is an inherent tragedy

30:25 - How the limitations of the human brain could impede longevity 

33:16 - The ethical dilemma that would arise due to the financial costs of this technology 

36:30 - Why Dr. Zeleznikow-Johnson is confident that cryonics will be successful 

46:42 - The core thesis of Dr. Zeleznikow-Johnson’s book The Future Loves You

50:15 - Whether immortality is a desirable objective

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 [email protected].

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One of the most mysterious and frightening entities in medicine are prion diseases — rare neurodegenerative disorders that are usually infectious in nature but involve not bacteria or viruses, but proteins. Prions are misfolded proteins that can induce normal proteins to become misfolded as well, resulting in a chain reaction that leads to irreversible brain damage and death. What makes prions alarming is that they are incurable, can incubate for decades in a person's brain without symptoms, and are usually associated with 100% mortality within months to a few years. 

Sonia Vallabh, PhD was a recently-married lawyer in her early career when she witnessed her mother's baffling sudden health decline and death. Her mother was ferried from hospital to hospital, yet dozens of doctors could not figure out why she was seemingly succumbing to rapidly progressive dementia at the age of 52. It wasn't until after her death that Vallabh discovered the cause was a genetic prion disease. Subsequent testing revealed that Sonia Vallabh herself had inherited the same genetic abnormality. Determined to find a solution, Vallabh and her husband Eric, a transportation engineer, decided to retrain as biomedical scientists in a race to cure her before it grew too late. The couple now leads a prion research lab at the Broad Institute at MIT and Harvard. They are also the co-founders of the nonprofit Prion Alliance. 

Over the course of our conversation, Vallabh opens up about what it was like to accompany her mother in her last months of life, the psychological toll of dealing with a fatal medical mystery, how she lives each day with an awareness of how ephemeral life is, what prion diseases are and what makes them so difficult to treat, what makes her optimistic about the future of her work, and more. 

In this episode, you’ll hear about: 

3:23 - Vallabh’s early memories of her mother and the devastating experience that overcame her at 52 years old

16:37 - The process of grieving the loss a parent

22:32 - What prion diseases are

25:35 - How Vallabh made the decision to undergo the genetic testing that confirmed she inherited a mutation thah causes prion disease 

36:27 - Vallabh’s major career change to become biomedical researchers 

45:50 - Where the quest for an effective therapy for prion disease currently stands 

52:08 - Vallabh’s message to listeners on how to approach life 

View Sonia Vallabh’s TED Talk on her quest to cure prion disease. 

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 [email protected].

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The second half of the 20th century saw monumental shifts in civil rights in the United States, with the end of legalized racial segregation, discrimination, and disenfranchisement affecting all spheres of life, from education to health care to housing to marriage and more. 

Judge David S. Tatel is a civil rights lawyer who has contributed to key advancements in voting rights, educational equality, and disability rights. Over the course of his five-decade career, he has served as Director of the National Lawyers Committee for Civil Rights Under Law, as Director of the Office for Civil Rights during the Carter administration, and as a federal judge on the D.C. Circuit, considered the second highest court in America. 

Judge Tatel also happens to be blind, due to a rare genetic condition called retinitis pigmentosa. In 2024, he published a book titled Vision: A Memoir of Blindness and Justice. 

Over the course of our conversation, Judge Tatel opens up about how he has wrestled with vision impairment in both his legal career and his personal life. He discusses what it was like to be diagnosed with an incurable, progressive, blinding disease as a teenager, how he struggled to make sense of his identity as a blind individual even as his career was taking off, his philosophy as a lawyer, how his beautiful relationship with his wife and children have helped him navigate the world, and how he met his guide dog, Vixen. Judge Tatel's legacy is one of judicial integrity, a lifelong commitment to equality, and a testament to the boundless potential of individuals living with disabilities.

In this episode, you’ll hear about: 

3:45 - Judge Tatel’s experience of being diagnosed with retinitis pigmentosa as a teenager 

15:33 - The inspiration that led Judge Tatel to focus his legal career on civil rights

22:47 - Judge Tatel’s experience of progressively losing his vision while ascending in his legal career 

28:05 - Visual elements of life that Judge Tatel misses and how he now “experiences” vision

33:12 - Why Judge Tatel regrets concealing the truth about his blindness early in his career 

37:01 - How Judge Tatel’s blindness has influenced his civil rights work

44:45 - Judge Tatel’s concerns about the future of democracy in the United States 

46:27 - The ways in which getting a guide dog late in life changed Judge Tatel’s sense of freedom and his perspective on blindness 

49:06 - Judge Tatel’s advice to his former self 

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 [email protected].

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Addiction is often misunderstood not just by the public, but also by clinicians. It challenges us as individuals, families, and communities. To understand addiction is to understand not only human behavior and neuroscience, but also social networks, public policies, and bioethics. Our guest on this episode, Keith Humphreys, PhD, is a psychologist who specializes in addiction and has served on the White House Commission on Drug Free Communities during the Bush administration, and as Senior Policy Advisor to the White House Office of National Drug Control Policy during the Obama administration. His research on recovery support systems like Alcoholics Anonymous and on the opioid crisis has shaped how we understand addiction recovery.

Over the course of our conversation, Dr. Humphreys shares how he became interested in addiction medicine, what happens to our brains when we become addicted, the difficulty of balancing interventions with a respect for patient autonomy, why social networks can be powerful tools in addiction recovery, possible solutions to the opioid crisis, and how clinicians can better establish trust with patients facing addiction.

In this episode, you’ll hear about: 

2:36 - How Dr. Humphreys became interested in studying the psychology of addiction 

4:34 - The neuroscience of addiction 

9:15 - Whether addictive behavior is a matter of personal choice 

16:27 - How clinicians can address patients who do not yet recognize their addiction as a problem

21:36 - What GLP-1 inhibitors can tell us about the mechanisms of addiction 

26:07 - The benefits of peer support groups (like Alcoholics Anonymous) for addiction recovery

32:55 - Dr. Humphreys' work on drug policy 

37:32 - The rise of the opioid crisis

43:05 - Policy models to address substance abuse

48:24 - How medical professionals who are struggling with addiction can seek help 

51:25 - Dr. Humphreys' advice for clinicians on how to connect with patients who are struggling with addiction 

Dr. Keith Humphreys can be found on Twitter/X at @KeithNHumphreys.

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 [email protected].

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One of the most fascinating concepts in human health is the idea of social contagion, meaning that emotions, behaviors, and health outcomes can spread through social networks, much like infectious diseases. Examples in the medical literature abound: if a person becomes obese, their friends have a significantly higher chance of becoming obese — even their friends of friends have increased odds of becoming obese. Similarly, someone who quit smoking is likely to create a ripple effect through their social networks, influencing many more people to quit smoking. Social contagion affects life and death itself — after the death of a spouse, the surviving partner's mortality risk increases, and conversely, strong social networks are protective against early death. 

Much of the groundwork of our understanding of the powerful health effects of social networks laid by Nicholas Christakis, MD, PhD, MPH, a physician-turned-social scientist who is the author of multiple best selling books, including Apollo's Arrow: The Profound and Enduring Impact of Coronavirus On the Way We Live (2020) in Blueprint: The Evolutionary Origins of a Good Society (2019).

In this episode, Dr. Christakis shares his remarkable path to medicine and sociology, beginning from witnessing his mother's struggle through serious illness, to his foray into palliative medicine, and finally to his life's work on the social, economic and evolutionary determinants of human welfare. We discuss the mechanisms by which social contagion functions, why modern medicine does a disservice to patients by atomizing their medical problems, how the COVID-19 pandemic illustrates the effects of social networks on public health, the philosophical implications of living an interconnected life, and why human beings are wired to build good societies through our capacity for love, friendship and cooperation.

In this episode, you’ll hear about 

3:17 - Dr. Christakis’s path to medicine through witnessing his mother’s serious illness 

15:05 - How Dr. Christakis became passionate about studying the effects of social networks 

24:43 - How social networks affect an individual’s health 

31:28 - The negative effects that COVID-19 restrictions had on patients and their loved ones

38:58 - The central thesis of Dr. Christakis’s 2019 book Blueprint: The Evolutionary Origins of a Good Society 

50:38 - Dr. Christakis’s thoughts on how to live a meaningful life  

Dr. Nicholas Christakis can be found on Twitter/X at @NAChristakis.

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 [email protected].

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Digital technologies have saturated our lives and there is no going back. Given this, it's worth pondering whether and how they are fundamentally reshaping our mind and our relationships. 

A seminal work that explores these issues is the 2010 book The Shallows: What the Internet Is Doing to Our Brains, by journalist Nicholas Carr. In it, he argues that the internet is “shallowing” our brains, meaning that as we offload cognitive tasks to digital tools, our ability to read linearly, to absorb and immerse ourselves in complex information, is reduced. But more than that, the internet curtails our emotional depth and compassion, diminishing our humanity and rendering us more computer-like, as we process information in short bursts, skim for quick answers, and operate with frenetic attention spans. In Carr’s 2014 book The Glass Cage, he discusses how the increasing automation of tasks leads to a decrease in human agency, creativity, and problem solving capability.

In this episode, Carr joins us to discuss the neuroplasticity of the brain, the mechanisms by which digital technologies reduce our ability to think deeply, how the failures of electronic medical records illustrate the limitations of technology, what social media does to our relationships, the value of focused, reflective thought in a fast paced world, what we can all do to remain independent of technology, and more.

In this episode, you’ll hear about: 

2:42 - Carr’s path to researching and writing about the human consequences of technology

5:38 - The central thesis of Carr’s 2010 book The Shallows 

15:27 - Whether the cognitive impacts of digital technologies are reversible or permanent

21:18 - Whether society is better or worse off due to social media and the internet

25:38 - How modern technology has changed the medical profession 

38:22 - Carr’s thesis for his upcoming book Superbloom

45:21 - How society can address the loss of focus and empathy that has occurred as a result of social media 

Nicholas Carr can be found on Twitter/X at @roughtype.

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 [email protected].

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Medicine is filled with stories that illustrate the most beautiful, devastating, hopeful, and consequential moments of life. But how do we capture these moments and transform them into everlasting lessons that guide us on our search for meaning? That's where the art of storytelling comes in. 

Our guest on this episode is Anna Reisman, MD, director of the Program for Humanities in Medicine at the Yale School of Medicine. Dr. Reisman is not only a physician-writer whose essays have appeared in The Atlantic, The New York Times, and other major outlets. She has also dedicated her career to helping clinicians better reflect and write about their experiences. 

Over the course of our conversation, we discuss how Dr. Reisman went from being an English major in college to working as a physician, her own experiences with burnout and what helped her overcome it, her approach to creative nonfiction writing, concrete ways that writing sharpens the mind of the physician, and more.

In this episode, you’ll hear about: 

2:00 - Dr. Reisman’s path from English major to physician 

3:45 - The scope of Dr. Reisman’s current work 

8:22 - How Dr. Reisman became involved in medical humanities and how she created a writer workshop at Yale Medicine

14:19 - How writing and the medical profession goes hand in hand 

22:49 - The VA Writes reflective writing group 

27:56 - Teaching observational skills to medical students in today’s technology-forward landscape

30:25 - How to approach the writing process if you are new to writing 

45:57 - What Dr. Reisman wishes she would have known at the beginning of her career 

Dr. Anna Reisman can be found on Twitter/X at @annareisman. 

A list of Dr. Reisman’s essays can be found on MuckRack. 

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 [email protected].

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During the first year of the COVID-19 pandemic, the phrase “Healthcare Heroes” echoed through hospital walls and city streets. For many people, this felt like an overdue acknowledgment of the difficult and important work that healthcare professionals carried out during the most devastating healthcare crisis the world had seen in a century. But this phrase can also be problematic, romanticizing the sacrifices of individual clinicians without addressing the systemic failures that put them at risk, overlooking the mental health struggles they experienced, and undermining healthcare environments that encourage reflection about respect and duty. 

Our guest on this episode is Dhaval Desai, MD, a hospitalist at Emory Healthcare in Georgia and the author of the book Burning Out on the Covid Front Lines: A Doctor's Memoir of Fatherhood, Race, and Perseverance in the Pandemic (2023), in which he details his personal narrative as a healthcare leader and frontline physician fighting to hold his hospital together. 

Over the course of our conversation, Dr. Desai shares why he decided to train in both internal medicine and pediatrics, how his experiences caring for his ailing father revealed the flaws of our healthcare systems, the nerve-wracking first few months of the COVID-19 pandemic, his own struggles as a leader, healer, father, and husband during a time of deep uncertainty, how we can all better connect with patients through even a few moments of shared humanity amid our busy days, and more.

In this episode, you’ll hear about: 

2:36 - Dr. Desai’s path to medicine

5:05 - How a Med-Peds residency differs from other medical residency tracks 

8:06 - How Dr. Desai’s personal experiences have shaped his approach to patient advocacy 

11:53 - Dr. Desai’s personal and professional life leading up to the COVID-19 pandemic

18:46 - Dr. Desai’s opinion on why it is important for leaders to be able to express emotion 

24:53 - How Dr. Desai used his leadership role to help his staff navigate the emotional turmoil of the pandemic experience 

28:32 - Moments when Dr. Desai suffered heavily from burnout

34:47 - Stories of the isolating effects of COVID-19 in the ER 

39:53 - Our society’s support of healthcare workers

46:19 - Advice for young clinicians on ensuring humanity stays central to their work 

Dr. Dhaval Desai can be found on Instagram at @doctordesaimd and on X/Twitter @DrDesaiMDx.

In this episode, we discussed the New York Times article “I Couldn’t Do Anything: The Virus and an E.R. Doctor’s Suicide” 

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 [email protected].

Copyright The Doctor’s Art Podcast 2024