"Death is not waiting for us at the end of a long road. Death is always with us, in the marrow of every passing moment. She is the secret teacher hiding in plain sight, helping us to discover what matters most."   
So writes Frank Ostaseski, an internationally respected Buddhist teacher and pioneer in end-of-life care. Frank is the founder of the Zen Hospice Project in San Francisco, the first Buddhist hospice in America. Over the course of his career, Frank has accompanied over 1000 people through the dying process; these experiences have taught him lessons on how maintaining an ever-present consciousness of death can bring us closer to our most authentic selves. He describes these lessons in his bestselling 2017 book, The Five Invitations. In this episode, Frank joins us to share hard-earned wisdom from his unique life journey. Over the course of our deeply reflective and even meditative conversation, we discuss matters ranging from Japanese death poems, to Buddhist mindfulness practices, to what courage looks like in the face of death.

In this episode, you will hear about:

• How the AIDS crisis led to the founding of the Zen Hospice Project - 2:16
• What Frank’s work looks like on a daily basis - 3:52
• Frank’s role as an ‘interpreter’ between patients and doctors - 5:57
• How clinicians can develop their own rituals in the process of healing patients - 9:09
• How Frank makes sense of the grief and suffering he witnesses and, despite it all, keep his spirit balanced - 13:40
• How the tenets of Buddhism influenced care at the Zen Hospice Project - 25:58
• How progresses in modern medicine sometimes hinders us in our acceptance of the impermanence and inevitability of death - 33:56
• Lessons on love, mindfulness, and finding meaning from Frank’s stories of patients at the end of life - 38:20
• The Five Invitations and what they look like in practice - 45:20

Frank Ostaseski is the author of The Five Invitations: Discovering What Death Can Teach Us About Living Fully.

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 ICU can be a traumatizing place for patients, who are frequently heavily sedated, rendered unable to speak by breathing tubes, isolated by family visit limitations, and sometimes even physically restrained. In fact, a significant proportion of patients discharged from the ICU later develop persistent cognitive impairments and physical disabilities. Over the past two decades, Wes Ely, MD has worked to improve the care of patients in the ICU, leading landmark studies resulting in the development of delirium prevention protocols that are now adopted in ICUs everywhere. Today, Dr. Ely co-directs the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center at Vanderbilt University Medical Center. In this episode, Dr. Ely joins us to share his career-long fight to reform ICU medicine and to recount poignant stories that illuminate and elevate the humanity of patients amid the chaos of the ICU — and in the process discusses themes that seldom appear in contemporary medical discourse, such as love, beauty, and mercy.

In this episode, you will hear about:

• How Dr. Ely discovered medicine as a calling while growing up in rural Louisiana - 2:33
• How a fascination with cardiopulmonary physiology, combined with an interest in patient relationships, led Dr. Ely to critical care medicine - 4:27
• A discussion of how patients in ICUs can often be “de-humanized” - 6:31
• A story from early in Dr. Ely’s career that illustrates “malignant normality” — when treatment norms led to patient harm - 10:40
• A discussion of physician burnout and how the dehumanization of patients contributes to it - 13:27
• What Dr. Ely and his colleagues have learned through years of research about the harmful standard practices of ICU care - 18:53
• An explanation of the ABCDEF treatment bundle designed by Dr. Ely and his collaborators to improve outcomes of patients in the ICU patients - 24:04
• How Dr. Ely processes the guilt and shame he feels from the harm he inadvertently caused to patients early in his career - 29:37
• Reflections on how eye contact, physical touch, and openness of the heart are essential to good medicine - 36:03
• A discussion on how Dr. Ely’s spirituality has influenced his approach to patient care - 44:51
• What it means to provide healing when patients are facing serious illness, even at the end of life - 50:45

Dr. Wes Ely is the author of Every Deep-Drawn Breath, a chronicle of his experiences caring for ICU patients.

You can find out more about his work at ICUDelirium.org

Follow Dr. Ely on Twitter @WesElyMD

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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A pivotal development in the history of cancer research was the discovery that cancers can arise from mutations in genes already present in normal, healthy cells. Joining us in this episode is Harold Varmus, MD, who shared the Nobel Prize in Physiology or Medicine in 1989 with his colleague, J. Michael Bishop, for this discovery. Their work has enabled scientists to explore why certain cancers develop in the human body and how we can develop better cancer treatments that target these genetic mutations. In addition to his pioneering research, Dr. Varmus has served as Director of the National Institutes of Health and the National Cancer Institute, President of Memorial Sloan-Kettering Cancer Center, and Scientific Advisor to the US Government, World Health Organization, and various other foundations and academic institutions. Over the course of our conversation, Dr. Varmus describes his groundbreaking research, approach to institutional leadership, and his advocacy for the democratization of scientific knowledge through his role in the founding of PubMed Central and the Public Library of Science.

In this episode, you will hear about:

• How Dr. Varmus' broad educational interests led him to pursue a medical career - 2:56
• How working at the National Institutes of Health drove Dr. Varmus’s passion for research and the trailblazing path his career took - 8:48
• A summary of Dr. Varmus’s research on retroviral oncogenes, which led to major advancements in cancer diagnoses and treatments - 16:35
• How Dr. Varmus became involved in the politics of science after receiving a Nobel Prize -  27:13
• Dr. Varmus’ mission while he was Director of the National Institutes of Health and his perspectives on the elements of effective healthcare institutional leadership - 30:28
• A discussion of open access publishing, a mechanism of distributing the results of scientific research online for free - 32:37

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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For all the crucial work physicians do in the hospital, no one spends more time with hospitalized patients than nurses. This is especially true in the intensive care unit, where nurses serve as patients’ conduits with their medical team and perhaps even with the outside world. Joining us in this episode is Christin Thankachan, an ICU nurse at Stanford Health Care who cares for the most seriously ill cancer patients in the hospital. Over the course of our stirring conversation, we ask her to reflect on how she guides patients and their families, with a comforting and compassionate hand, through life’s darkest moments. In addition, Christin shares the unique challenges she has faced as a frontline worker during the COVID-19 pandemic, and how she has maintained hope and meaning through these trying times.

In this episode, you will hear about:

• How Hurricane Sandy pushed Christin towards a career in nursing - 2:06
• The differences between a nurse’s responsibilities in an intensive care unit and a medical/surgical unit - 5:13
• What a typical day is like for an ICU nurse - 7:26
• How Christin finds the physical, emotional, and psychological stamina to care for some of the sickest patients in the hospital - 10:22
• The kinds of relationships Christin forms with her patients and how she strives to elevate the human connection - 13:49
• The importance Christin places on recognizing the fullness of the humanity within each patient - 21:16
• The power of hope for patients facing serious illnesses - 31:50
• What it was like to serve as a frontline worker in the early days of the COVID-19 pandemic - 36:38
• Advice on how to stay connected to the most meaningful aspects of a healthcare profession, even in the darkest times - 40:47

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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Few would dispute that vision is just about our most important sense. From a neurophysiological perspective, more than half of the human brain is dedicated to processing vision. But beyond that, it also enables us to meaningfully interact with the world and the people around us, and allows us to engage in many of the activities that bring us joy in life. Joining us in this episode is Michael Marmor, MD, Professor Emeritus and former chair of ophthalmology at Stanford University School of Medicine. In addition to his significant contributions to our understanding of diseases of the retina, Dr. Marmor is a patron of the arts who has published several books on vision and visual art. Over the course of our conversation, we discuss the fascinating inner workings of eyesight, how art appreciation can help create better doctors, and how Dr. Marmor accompanies patients facing vision loss.

In this episode, you will hear about:

• How a desire to “wear multiple hats” — researcher, surgeon, educator — led Dr. Marmor to ophthalmology - 2:04
• A brief exploration of the sense of sight - 4:01
• Dr. Marmor’s research on the retina and why he believes a thorough understanding of how diseases work is critical for physicians caring for patients - 8:07
• Why helping a patient understand their condition provides comfort, even with serious illnesses - 11:53
• Dr. Marmor’s passion for the fine arts and how his expertise in vision complemented this passion - 18:23
• What art appreciation can do for physicians and how it gives us new ways of thinking and seeing - 23:52
• How medical curricula can be improved to integrate the arts and humanities, and the importance of an emphasis on breadth in addition to technical depth - 33:06
• Why an appreciation for all kinds of art keeps us in touch with culture -  46:29

Dr. Marmor is the author of several books on art, including The Eye of the Artist (1996), Degas Through His Own Eyes: Visual Disability and the Late Style of Degas (2006), and The Artist’s Eyes (2009).

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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When it comes to medical humanitarianism, there is no bigger name than Médecins Sans Frontières (MSF), also known in English as Doctors Without Borders. MSF is renowned for its work in regions affected by armed conflict, endemic diseases, and natural disasters. In this episode, we are joined by Cristos Christou, MD, a Greek surgeon who has served as the international president of MSF since 2019. As a field doctor, he has worked in South Sudan, Iraq, Cameroon, and various other conflict zones. Over the course of our conversation, Dr. Christou takes us into the trenches of his medical work in caring for some of the most vulnerable people in the world, shares how he finds meaning and hope amid the depths of human suffering, and discusses the challenges to global health today.

In this episode, you will hear about:

• How the values of his self-described “rustic” childhood led Dr. Christou into medicine - 2:28
• How Dr. Christou’s time in university shaped his life philosophy - 3:27
• The history and mission of Médecins Sans Frontières/Doctors Without Borders - 5:59
• What it is like to practice medicine in regions affected by armed conflict and natural disasters - 8:13
• Dr. Christou’s journey in MSF, from when he first heard of it to how he became its leader - 10:42
• Lessons learned on finding meaning in medicine in some of the most resource-limited settings - 13:41
• Dr. Christou’s stories of inspiring hope in patients even during incredibly challenging times - 16:19
• A discussion of the dangers faced by clinicians who work with MSF - 19:54
• The significance of bearing witness to suffering in giving a voice to vulnerable patients - 23:11
• A discussion of the major threats to global health today: climate change, epidemics, and war - 26:25
• Advice for new clinicians who wish to tackle issues in global health - 30:00

Follow Dr. Christos on Twitter @DrChristou.

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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While digital technologies now permeate nearly every aspect of our lives, their application to improve medicine remains limited. Still, recent advances in artificial intelligence, telecommunications, and other technologies hold enormous potential to transform how healthcare is delivered. At the forefront of exploring this potential is Justin Norden, MD, MBA, a physician and investor at the venture capital firm GSR Ventures, where he focuses on investments in digital health companies. With a background in computer science, Dr. Norden previously worked on the healthcare team at Apple and helped launch the Center for Digital Health at Stanford University. He joins us in conversation to discuss how he discovered investing and entrepreneurship as a way to tackle problems in medicine, clarify misconceptions about digital health and venture capital, and explore how technologies are shaping the future of medicine.

In this episode, you will hear about:

• A brief introduction to venture capital - 1:48
• How Dr. Norden’s experiences during medical training led him explore entrepreneurship and healthcare investing - 3:22
• How Dr. Norden’s passion for computer science influenced his medical education - 7:30
• What it was like to leave a clinical career - 10:18
• The past and current state of technological advancement in medicine - 20:28
• Co-host Dr. Johnson’s concerns over the ways technology has, at times, impeded the delivery of health care - 28:38
• Dr. Norden’s vision for the ideal balance between humanism and technology in medicine - 34:31
• How Dr. Norden considers the reconciliation between the profit motive of companies and the preservation of what makes medicine meaningful - 38:28
• How Dr. Norden decides which digital health companies to invest in - 44:57
• Advice to young clinicians who are curious about healthcare innovation - 50:09

Follow Dr. Norden on Twitter @JustinNordenMD.

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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As one of the most prolific and acclaimed physician writers today, Danielle Ofri, MD, PhD is the author of seven books on the intricacies of modern medical practice and the doctor-patient relationship. Her other writings have appeared in The New York Times, The Atlantic, The New Yorker, in addition to various leading medical journals. She is also the co-founder and editor-in-chief of the Bellevue Literary Review, a literary journal that publishes works focusing on the human body, illness, and health. In her writings, Dr. Ofri uses vivid narratives to shed light on the highs and lows of being a doctor. In this episode, she joins us to share her path to medicine, how doctors can mitigate the moral injury they experience in their work, and how storytelling can comfort us in times of suffering.

In this episode, you will hear about:

• How Dr. Ofri was initially drawn to internal medicine through the patient stories she encountered - 1:54
• A discussion of the tension between the business and art of medicine - 6:07
• Dr. Ofri’s advice on how clinicians can combat the moral corrosion that broken medical systems can induce - 11:29
• How Dr. Ofri’s medical residency during the AIDS epidemic led to her passion for writing - 16:33
• Dr. Ofri’s writing process - 23:30
• A discussion of the moral philosophy of medicine and why doctors do what they do - 27:09
• Dr. Ofri reflections on how her writing has impacted her clinical practice - 31:47
• The wisdom that physicians who encounter suffering every day can share with a world experiencing collective grief from the COVID-19 pandemic - 34:38
• A discussion of the emotional toll on clinicians of delivering bad news and confronting grief, and an exploration of guilt and shame - 42:25
• Dr. Ofri’s advice to clinicians on how to stay connected to meaning in medicine - 48:44

Dr. Danielle Ofri is the author of the following books on being a doctor:
Singular Intimacies: Becoming a Doctor at Bellevue

What Doctors Feel: How Emotions Affect the Practice of Medicine

When We Do Harm: A Doctor Confronts Medical Error

What Patients Say, What Doctors Hear

Medicine in Translation

Intensive Care: A Doctor’s Journey

Incidental Findings

Follow Dr. Ofri on Twitter @DanielleOfri.

This episode included an excerpt from Jacqueline du Pré and Daniel Barenboim’s performance of the Cello Sonata No. 2 in F major, Op. 99 by Johannes Brahms, recorded live in West Berlin in 1968.

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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In 1969, Elisabeth Kübler-Ross identified the five stages of dying in her book On Death and Dying. Her work has radically transformed the way we think and talk about grief and loss, giving us a shared vocabulary and understanding of a previously murky, yet universal, human experience. Towards the end of her life, Kübler-Ross worked closely with David Kessler, with whom she co-authored several books and formally adapted the stages of dying into the stages of grief. Today, David is the world’s foremost expert on grief and has taught health care workers, counselors, and first responders on facing death and loss. His writings and his website Grief.com have reached millions of people. In this episode, David joins us to share his personal experiences with loss and what his decades of helping those on the edge of death have taught him about finding meaning amid suffering, and happiness after tragedy.

In this episode, you will hear about:

• Thanatology — the study of death and dying — and what drew David to this field - 2:10
• Kessler’s friendship with Elisabeth Kübler-Ross, the psychiatrist best known for developing the five stages of dying - 6:06
• How physicians are often ill-equipped to face death and how hey might better engage with dying patients - 11:22
• David’s advice to physicians on finding meaning amid loss and tragedy - 19:05
• A review of the five stages of dying/grief - 28:58
• On Meaning, the sixth stage of grief that David developed - 33:38
• How the pandemic saw a renewed interest in grief management, and how his interview with the Harvard Business Review entitled “The Discomfort You Are Feeling is Grief” went viral - 38:04
• How David manages the overwhelming sadness he sometimes experiences in his line of work - 43:54
• David’s advice to physicians on comforting grieving patients - 48:31

David Kessler is the author of several books, including The Needs of the Dyingand Finding Meaning: The Sixth Stage of Grief, as well as Life Lessons and On Grief and Grieving with Elisabeth Kübler-Ross, who is herself the noted author of On Death and Dying.

Follow David Kessler on Twitter @IamDavidKessler.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you know anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion or send an email to [email protected].

Advances in modern medicine mean a greater proportion of people today than ever before will live well into old age. Despite the seemingly encouraging trend, geriatrician Louise Aronson, MD, MFA argues that we have made old age into a disease, a condition to be dreaded, denigrated, neglected, and denied. Dr. Aronson has made it her life's work to help us reimagine the rich possibilities of human longevity and of later life. Her bestselling book, Elderhood, was a finalist for the 2020 Pulitzer Prize for general nonfiction. In this episode, Dr. Aronson explains what makes geriatrics a meaningful career for her, discusses the faults in our society’s conception of elderhood, and shares her humane and hopeful vision for the future of aging.

In this episode, you will hear about:

• An overview of what geriatrics entails - 1:47
• The need to recognize elderhood as distinct a life stage - 4:42
• Dr. Aronson’s reflections on what drew her into caring for older patients - 6:15
• The ways goals of care change in elderhood - 8:24
• Dr. Aronson’s approach to caring for her patients holistically - 13:27
• How physicians can change the “losers and winners” paradigm in healthcare - 17:34
• A discussion of structural and cultural ageism and the insidious ways it harms our society - 23:03
• How American culture and medicine elevates patient autonomy and how this can sometimes be harmful to older patients - 30:59
• A discussion of Dr. Aronson’s writing and what motivated her to become an author - 38:49
• How Dr. Aronson experienced and overcame burnout - 42:57
• Advice to new clinicians on how to connect with patients and create a more meaningful career path - 46:08

Dr. Aronson is the author of the nonfiction book Elderhood and the short story collection A History of the Present Illness, as well as several essays and articles on ageism and aging and a blog.

Follow Dr. Louise Arondson on Twitter @LouiseAronson, Instagram @LouiseAronsonSF, and LinkedIn.

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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