Physicians are trained to diagnose and treat disease, but they're not always taught how to lead. Yet in an era of increasing administrative burdens, evolving healthcare policies, and growing physician burnout, leadership skills have never been more essential. How can physicians reclaim their voices in healthcare decision making? What makes an effective physician leader in today's complex landscape? Here to answer these questions is Peter Angood, MD, President and CEO of the American A...
The American diet is the leading cause of death among Americans. Accumulating medical evidence now shows that poor diet not only contributes to heart disease, diabetes, and stroke, but also to cancer, Alzheimer's disease, liver disease, and much more. Despite its direct and indirect roles in causing half or more of all deaths, food is not something doctors learn about in their training, nor is it something that's emphasized enough to patients by the medical establishment. Our guest on th...
In recent years, it has become evident that loneliness is one of the most pressing public health challenges of our time — so much so that the US Surgeon General has labeled it an epidemic with far reaching consequences. The pain of isolation doesn't merely gnaw at our sense of belonging: it undermines our physical wellbeing, erodes our mental health, and places an invisible strain on communities. In this climate of ever widening personal and cultural divides, the collective call for deeper hu...
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 episo...
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, ...
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 live...
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, ...
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...
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 Pol...
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 th...
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 abs...
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...
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 ri...
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 me...
Joseph Sakran, MD, MPH was a teenager in a small town in Virginia when, in 1994, his life took a dramatic turn. At the age of 17, he was out with his friends after a high school football game when a nearby gunfight broke out and he was struck by a stray bullet in the throat. The bullet, tearing through his windpipe and a carotid artery, brought him to the razor edge of death before he was saved by trauma surgeons. Thirty years later, Dr. Sakran is now a trauma surgeon who serves as Direc...
To the best of our knowledge, humans appear to be unique among animals in our awareness of mortality — at least in our capacity for existential reflection about death in an abstract, cultural, and symbolic sense. With this capacity comes profound psychological experiences, from our search for meaning, to our struggle with grief, to a yearning for the spiritual. Our guest on this episode is Dr. Rachel Clarke, a palliative care physician based in the United Kingdom who entered medicine aft...
Modern medicine has long considered many neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease to be immutably linked to the fate of certain unlucky individuals through yet-poorly understood genetic mechanisms. But increasingly, we are seeing evidence that some of our lifestyle choices, including our diet, physical activity, and relationships, may play a significant role in the development of, or protection against, these diseases. Our guest on this episode, David Per...
What makes a life worth living? This question has animated great thinkers and faith traditions for millennia. Interestingly enough, in our time of rapid globalization, technological advancement, and material abundance, we often seem more unmoored from our conception of the self and its relation to the world than ever before.Our guest on this episode, Miroslav Volf, has spent his life wrestling with this question of questions and helping others to do the same. Volf is a professor of theology a...
Most people shudder at the idea of an infectious disease outbreak — patients stricken with a mysterious illness, hospitals overflowing, and cities going into lockdown. But for Syra Madad, DHSc, MSc , MCP, rushing into such a scenario, donned in a hazmat suit, to control the chaos has been a dream since childhood. Today, she is an epidemiologist, biosecurity advisor, and a pathogen preparedness expert who serves as Senior Director of the System-Wide Special Pathogens Program at New York City H...
For many physicians, having serious illness conversations with patients — talking about a dire prognosis or the futility of curative treatments — is one of the most daunting aspects of patient care. But to palliative care physician Shunichi Nakagawa, MD, these conversations are fundamentally about communicating the honest truth in an elegant, considerate, and humane way. Dr. Nakagawa, the director of the Inpatient Palliative Care Service at Columbia University Medical Center, joins us in...
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