The REIMAGINE Podcast

What happens to transplantation when the organ no longer has to come from another human being?In this episode, Gabe Schnickel, MD, MPH, sits down with transplant surgeon, scientist, and author Josh Mezrich, MD for a conversation about xenotransplantation, its remarkable history, and what the field may mean for patients waiting for an organ.Mezrich traces the story from early primate transplants and Baby Fae through the transition to pigs, Dolly the sheep, gene editing, CRISPR, and the first era of genetically modified pig organs being transplanted into humans. Along the way, Schnickel and Mezrich explore a deeper question: if xenotransplantation someday changes where our organs come from, how do we preserve the generosity, compassion, and human connection that have always been at the heart of transplantation?The conversation reflects on the pioneers who built modern transplantation, the personal cost of innovation, and Josh’s idea of the 'courage to succeed': the willingness to learn from failure and keep moving toward something others still believe is impossible.Key Topics Discussed What xenotransplantation is and why this moment feels different from earlier attempts The organ shortage and the promise of genetically modified pig organsHuman donation as an act of connection, generosity, and shared experienceThe early primate era of xenotransplantation, including Keith Reemtsma and Baby FaeWhy pigs became the preferred potential source of organsThe role of alpha-gal, cloning, Dolly the sheep, and CRISPR gene editingDavid Sachs and the scientists who sustained the field through decades of uncertaintyThe pioneers of transplantation, including Joe Murray, Tom Starzl, and Roy CalneThe emotional burden of innovation and what Josh calls the 'courage to succeed'Where xenotransplantation stands today: promise, uncertainty, and the need for realistic expectationsEthics, animal research, immunosuppression, and the path from experimental therapy to broader useWhy hope, community, and a sense of wonder remain central to transplantationNotable Quotes and Ideas“The courage to succeed.” Josh’s phrase for the persistence required not only to tolerate failure, but to keep believing that success is possible.“Another goddamn miracle.” Keith Reemtsma’s ritual at the end of a transplant, and Josh’s reminder not to lose the sense of wonder behind something that can become routine to those who do it every day.Resources Mentioned Every Living Creature: How Xenotransplantation Will Change Our Lives — Joshua D. MezrichWhen Death Becomes Life: Notes from a Transplant Surgeon — Joshua D. Mezrich The Puzzle People — Thomas E. StarzlThe Courage to Fail — Renée C. Fox and Judith P. SwazeyThe Wright Brothers — David McCulloughREIMAGINE Center — reimagine.ucsd.eduAbout the GuestJoshua D. Mezrich, MD, is a transplant surgeon, scientist, and author at the University of Wisconsin. His writing brings together the history and science of transplantation with the experiences of patients, donors, families, and the clinicians who care for them. He is the author of When Death Becomes Life and Every Living Creature, which explores the history, science, personalities, ethical questions, and promise of xenotransplantation.If this conversation moved you, share it with someone you think needs to hear it. Learn more about the REIMAGINE Center and support our work at reimagine.ucsd.edu.The REIMAGINE Podcast is produced by Leila Adler and Lyndsey Fedorko with music by Geoff Bowman.The views expressed by guests featured on the REIMAGINE Podcast are those of the individual and do not represent the opinions of UC San Diego.

In this episode of the REIMAGINE Podcast, host Gabe Schnickel, MD, MPH, speaks with Thupten Jinpa, PhD, a former Tibetan Buddhist monk, longtime principal English translator for His Holiness the Dalai Lama, author of A Fearless Heart, and founder of the Compassion Institute.Jinpa reflects on his childhood as a Tibetan refugee in India, where compassion was not just a concept, but a lived experience. He shares how early experiences of care, including the kindness of his uncle after the death of his mother, helped shape his understanding of what compassion means in practice.Schnickel and Jinpa discuss the three elements of compassion: recognizing suffering, emotionally connecting with that suffering, and feeling moved to respond. Jinpa explains why compassion is not weakness, why it requires courage, and why it must be expressed in order to be felt by others.The conversation also explores Jinpa’s work with the Dalai Lama and the Dalai Lama’s vision for bringing compassion into a universal, secular and scientific framework. Jinpa describes the development of Compassion Cultivation Training at Stanford, the founding of the Compassion Institute, and the opportunity to bring compassion more intentionally into healthcare, education, workplaces and systems.For the REIMAGINE community, this episode speaks directly to the heart of organ donation and transplantation. This work lives in the space between suffering and generosity, grief and hope, vulnerability and connection. Jinpa offers a powerful reminder that compassion is not only an individual virtue, but a framework for creating more humane systems of care.Music by Geoff BowmanProduced by Leila Adler

In this episode of the REIMAGINE Podcast, Gabe Schnickel, MD, MPH speaks with Shireen Mansouri, MD, a family physician, certified Compassion Cultivation Training Instructor, and member of the healthcare team at the Compassion Institute.Together, they explore what compassion really means: the ability to recognize suffering and respond with the wish to relieve it. Mansouri helps distinguish compassion from empathy, kindness, and pity, and explains why presence itself can be a meaningful form of compassionate action.The conversation also looks honestly at the realities of healthcare — time pressure, documentation, exhaustion, lack of resources, and systems that often make compassionate care difficult. She shares how compassion cultivation training can help clinicians reconnect with meaning, practice self-compassion, build awareness, and experience compassion as a source of renewal rather than depletion.Schnickel and Mansouri also reflect on organ donation and transplantation as profound expressions of compassion, and on their recent time together in Dharamsala, India, where they participated in a compassion retreat and had an audience with His Holiness the Dalai Lama.Produced by Leila AdlerMusic by Geoff Bowman

In this episode of the REIMAGINE Podcast, host Gabe Schnickel, MD, MPH, speaks with Lisa Eyler, PhD, professor of psychiatry at the UC San Diego School of Medicine and director of the Center for Empathy and Compassion Training in Medical Education at the Sanford Institute for Empathy and Compassion.Eyler shares how her early research in aging, resilience, optimism, schizophrenia, bipolar disorder and brain health eventually led her toward the science of empathy and compassion. She describes empathy as the capacity to feel with and understand another person’s experience, while compassion goes one step further: it is the wish or action to relieve suffering. As Eyler puts it, compassion is empathy in action.The conversation explores how empathy and compassion show up differently in the brain. Empathy for another person’s pain can activate some of the same neural systems involved in experiencing pain oneself, which helps explain why unregulated empathy can lead to empathic distress. Compassion, by contrast, engages brain systems associated with reward, motivation, and care. For clinicians and caregivers, this distinction matters deeply: compassion may not be the cause of burnout, but one of its antidotes.Eyler and Schnickel also discuss the idea of “exquisite empathy,” the ability to walk the fine line between being open enough to recognize suffering and grounded enough to move toward compassionate action rather than becoming overwhelmed.A major focus of the episode is medical education. Eyler describes the work her center is doing to help medical students build durable skills in empathy, compassion, self-compassion, and compassionate communication. This includes Compassionatomy, an innovative program integrated into the anatomy course at the UC San Diego School of Medicine. Students engage in reflection, gratitude practices, contemplative exercises, and ceremonies that help them relate to body donors as their first patients. Eyler shares how students have responded powerfully to this work, asking for compassion practices to be included before every anatomy session.The episode also highlights CARE (Compassionate Action and Real Engagement in the Community), a core course for first- and second-year medical students. Through classroom sessions, community-based service learning, clinical observerships, arts and humanities exercises, role play, narrative medicine and contemplative practice, students learn that compassion is not simply a personal virtue — it is a clinical skill.Eyler also looks ahead to the future of compassion science, including better measurement tools, longitudinal studies of empathy and burnout in medical students, AI-enabled feedback on clinical encounters, neurobiological approaches to training, and the possibility of using neuroscience to improve how compassion is taught.At its heart, this conversation is about reimagining medical education so that knowledge and technical skill are paired with presence, humility, self-care and compassionate action.

In this episode of the REIMAGINE Podcast, Gabe Schnickel, MD, MPH, speaks with Susan Angel Miller about the life and legacy of her daughter, Laura, who died suddenly at age 14 after an aggressive brain tumor. Amid profound shock and grief, Susan and her family made the decision to donate Laura’s organs — a decision that saved the life of Trish, a critically ill liver recipient. The gift of life created ripples of connection, meaning and advocacy that continue today.Susan shares the story of Laura’s creativity, kindness and ambition; the unimaginable experience of losing a child; the role of community in grief; and the healing power of continuing to say Laura’s name. She also reflects on the relationship her family developed with Trish, the founding of SODA: Student Organ Donation Advocates by her daughter Sarah, and the lessons she has learned about resilience, vulnerability and human connection. This is a conversation about grief without easy answers, donation as an act of love, and the possibility of finding meaning after devastating loss.The REIMAGINE Podcast is produced by Leila Adler, with theme music by Geoff Bowman.The views expressed by guests featured on the REIMAGINE Podcast are those of the individual, and do not represent the opinions of UC San Diego.