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 info@thedoctorsart.com.

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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 info@thedoctorsart.com.

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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 info@thedoctorsart.com.

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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 info@thedoctorsart.com.

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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 info@thedoctorsart.com.

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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 info@thedoctorsart.com.

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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 info@thedoctorsart.com.

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Precision medicine — the approach to health care that involves tailoring medical interventions to an individual's genetic makeup, environment and lifestyle — promises to deliver the right treatment to the right person at the right time. From preventing diseases decades before they appear, to specially designed cocktails of cancer drugs, to genetic modification of rare diseases, many of these applications sound straight out of science fiction.

At the forefront of precision medicine and medical genomics is Euan Ashley, MBChB, DPhill, Chair of Medicine at Stanford University Medical Center. A cardiologist and intensive care physician by training, Dr. Ashley has pioneered the use of genetic sequencing to identify risk factors for heart disease and new treatments for rare diseases. He is also the author of The Genome Odyssey: Medical Mysteries and the Incredible Quest to Solve Them (2021).

Over the course of our conversation, we discuss his path from growing up in a small Scottish town to now working at the cutting edge of medicine, the excitement and fulfillment he experiences as a clinician in the cardiac intensive care unit, remarkable patient stories of healing and resilience, the future of precision medicine, why he is optimistic about the development of artificial intelligence, and more.

In this episode, you’ll hear about:

2:24 - Dr. Ashley’s path to medicine and to cardiology

7:19 - What life is like working in the CCU

21:34 - How the Undiagnosed Diseases Network was founded and what it does

33:22 - An overview of precision medicine

38:09 - The impact that genetic testing and genomic medicine is having on modern medicine and where it could go from here

45:00 - Dr. Ashley’s thoughts on how AI will change the field of medicine

51:40 - Making access to medical advancements in AI and genomics more equitable

1:04:39 - Dr. Ashley’s advice for healthcare professionals in training

Dr. Euan Ashley can be found on Twitter/X at @euanashley.

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

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

Copyright The Doctor’s Art Podcast 2024