See, Hear, Feel

I am still turning this over in my head, that Dr. Ricardo Nuila says the purpose of Arts and Humanities is...beauty. I have not thought of it in that way before, and he has really made me think about the role of beauty in my life, in my work, in small and big spaces of good and bad. I think this is a must listen! Dr. Ricardo Nuila, MD is an Associate Professor of Medicine at Baylor College of Medicine and sees patients at Ben Taub hospital in Houston, Texas as part of the Harris Health System. Ben Taub is a safety-net hospital where the focus in on a given individual’s healthcare problem. He is also a writer, and his pieces on health disparities, politics and medicine, and art and medicine have been published in VQR, The Atlantic, The New York Times Sunday Review, The New Yorker, and The New England Journal of Medicine.

Emily Dickinson was one of the first poets that I was introduced to when I was younger, and Dr. Ricardo Nuila refers to one of her lines, Tell the truth but tell it slant. We talk about this, about nuance and context, and how that relates to algorithmania. It comes back to metacognition, gestalt vs algorithmic thinking. Dr. Ricardo Nuila, MD is an Associate Professor of Medicine at Baylor College of Medicine and sees patients at Ben Taub hospital in Houston, Texas as part of the Harris Health System. Ben Taub is a safety-net hospital where the focus in on a given individual’s healthcare problem. He is also a writer, and his pieces on health disparities, politics and medicine, and art and medicine have been published in VQR, The Atlantic, The New York Times Sunday Review, The New Yorker, and The New England Journal of Medicine.

I love talking about metacognition, in hopes of improving how I think, how I diagnose, and how I learn. Dr. Smoller loves to teach and is interested in learning theory, and he has active research experience in learning/teaching visual recognition through pattern recognition, fast thinking. And yet, algorithmic thinking (slow thinking) is important, too. Our conversation is based on a lecture he gave at the recent March, 2024 International Society of Dermatopathology meeting. Don't miss this conversation! Dr. Bruce Smoller MD trained in anatomic and clinical pathology at Harvard's Beth Israel Hospital and in dermatopathology with Dr. Scott McNutt at Cornell Medical School/ New York Hospital. He has worked at Stanford University, rising to the rank of Professor of Pathology and Dermatology as well as at the University of Arkansas, where he was Chair of the Department of Pathology and the Director of Dermatopathology from 1997 to 2011. In 2011, he became Executive Vice President of the United States and Canadian Academy of Pathology. Since 2014, he has been Professor and Chair, Department of Pathology and Laboratory Services and Professor of Dermatology at the University of Rochester School of Medicine and Dentistry. Dr. Smoller is a former Editor-in-Chief of the Journal of Cutaneous Pathology and served as the President of the American Society of Dermatopathology, receiving the Nickel Award, which recognizes lifetime excellence in teaching, from the American Society of Dermatopathology. He received a Lifetime Achievement Award from the College of American Pathologists in 2022. He has written over 300 articles and has primary involvement in 18 books.

Three magic words to help conquer fear, that may also be a secret to having a long and productive career. I really enjoyed this conversation with Dr. Bruce Smoller, a giant in the field of dermatopathology and pathology. Also tune in next week for Part 2! Dr. Bruce Smoller MD trained in anatomic and clinical pathology at Harvard's Beth Israel Hospital and in dermatopathology with Dr. Scott McNutt at Cornell Medical School/ New York Hospital. He has worked at Stanford University, rising to the rank of Professor of Pathology and Dermatology as well as at the University of Arkansas, where he was Chair of the Department of Pathology and the Director of Dermatopathology from 1997 to 2011. In 2011, he became Executive Vice President of the United States and Canadian Academy of Pathology. Since 2014, he has been Professor and Chair, Department of Pathology and Laboratory Services and Professor of Dermatology at the University of Rochester School of Medicine and Dentistry. Dr. Smoller is a former Editor-in-Chief of the Journal of Cutaneous Pathology and served as the President of the American Society of Dermatopathology, receiving the Nickel Award, which recognizes lifetime excellence in teaching, from the American Society of Dermatopathology. He received a Lifetime Achievement Award from the College of American Pathologists in 2022. He has written over 300 articles and has primary involvement in 18 books.

I am always curious about how others continually improve, and Dr. Thomas Brenn gives good insights on this. Learning in whatever way works for you, getting exposure to new things in ways that you can remember, discovering true mentorship...it's definitely a fun journey. Dr. Thomas Brenn MD PhD received both his doctorate degrees in Germany. He completed postdoctoral fellowships  in Genetics and Pathology at Stanford University, residency training at the Brigham and Women’s Hospital, and dermatopathology and soft tissue pathology fellowships with Dr. Phillip McKee and Dr. Christopher Fletcher. He has worked in the United Kingdom, Canada, as well as the US and is currently based at the University of Michigan.

I love to talk to people who are honest and confident in their honesty! Dr. Richard Carr is an internationally known expert in dermatopathology and pathology, and he speaks honestly about emotional intelligence as a muscle, recognizing our own weaknesses, and tailoring emotional intelligence to the individual. Being hypercritical can be a strength in that you think deeply about things, and it is worth hearing how he deals with hypercritical thoughts. Dr. Richard Carr trained in dermatopathology with Dr. Phillip H. McKee and Dr. Eduardo Calonje at St Thomas’ hospital and the St John’s Institute of Dermatology. He received the Royal College of Pathologists (RCPath) Diploma in Dermatopathology (set at expert referral level) and consults on cases throughout the United Kingdom. After being educated in Sheffield which is north of London, he started practicing in London with “big city ways”. He has now been practicing in the same community for 25 years in Warwick, England. He is a dedicated teacher, locally, nationally, and internationally. He is married with two daughters.

Dr. Ron Stotts has been meditating for decades, and he shares some of the foundational building blocks of being able to transformatively lead. Learn about "big mind", "STOP", and how to breathe. We touch on emotional intelligence, self-compassion, other compassion, and more. Dr. Ron Stotts, PhD explores what is possible for individuals, organizations, nations, and the world. He guides people into the highest levels of conscious leadership where they create a 40% percent increase in productivity and profit through creating what are referred to as “learning” or “developmental” organizations to bring out the best of all the stake holders involved. Dr. Stotts is a three-time best-selling author, has a Ph.D. in psychology, is a licensed Doctor of Chiropractic, and has been a meditation teacher for decades. 

Dr. Mitesh Patel is a physician and behavioral scientist! He helped found the Penn Medicine Nudge Unit, a first for healthcare. We talk about behavioral nudges, both for healthcare and home life, and the small things that we can each do to nudge behavior. Dr. Mitesh Patel MD MBA is a physician executive and behavioral scientist. He is currently Chief Clinical Transformation Officer at Ascension , the largest non-profit healthcare system in the US. He works on strategic vision and implementation of programs to transform clinical care using behavior nudges, EHR Apps, machine learning, artificial intelligence, remote patient monitoring, and virtual care. Previously, he was the Founding Director of the Penn Medicine Nudge Unit, the world’s first behavioral design team embedded within health system. 

LOOK AGAIN! A world full of colors can become gray due to habituation. Waking ourselves up to truly see the amazing things around us, as well as the problems that should be fixed, takes dishabituation. This conversation focuses on habituation and dishabituation, how they are defined, and what we can do to get life to resparkle. Cass R. Sunstein is the nation’s most cited legal scholar and is also a prolific writer of popular nonfiction. His most recent book, which he coauthored with Dr. Tali Sharot, is Look Again: The Power of Noticing What Was Always There, which will be hitting bookstores on 2/27/24. He is also the coauthor of Nudge with Dr. Richard Thaler as well as the coauthor of Noise with Drs. Daniel Kahneman and Olivier Sibony. He served in multiple different capacities in the US government and has advised the United Nations as well as the World Health Organization. He is currently the Robert Walmsley University Professor at Harvard Law School.

Dr. Angelina Hong wrote about love and medicine, describing  “the blurry spectrum, balancing out physical, mental, and emotional pain with the immense honor of saving and cherishing human life, while simultaneously struggling to reconcile our altruistic goals with realistic but necessary human incentives.” Her writing resonates with me. Dr. Angelina Hong, MD, is currently an internal medicine resident at HCA Healthcare in Florida. She attended the University of Texas Medical Branch School of Medicine and the University of Houston for her undergraduate degree. She is a poetess who has written about love and medicine, and in honor of Valentine’s Day, she is here today.

2023 was a tough year for me (if you've been listening, you know some of the reasons why). My memory was somewhat affected, and it was hard for me to hold things in my head (thankfully, this has gotten better). Listening back to these past episodes was a treat for me, and I hope that this compilation might help other listeners as well. 

Dr. Ashley Wysong is a force of nature, and I recently had the pleasure of hearing her lecture at Yale. She seamlessly integrated practical advice in a presentation full of clinical pearls. She's learned a lot to help her be successful, and she shares some of her useful tips with me. Dr. Ashley Wysong, MD is the University of Nebraska Medical Center Department of Dermatology Founding Chair, Professor, and William W. Bruce MD Distinguished Chair of Dermatology. She is a nationally recognized leader, Mohs micrographic surgeon, and translational researcher. She is passionate about educating and mentoring others.

Dr. Jeffrey Cohen took a course called Mindful Medicine as a medical student, and it continues to influence him today. He learned about metacognition and cognitive biases, and he emphasizes approaching all interactions with humility, curiosity, and grace. Dr. Jeffrey M. Cohen, MD is a board-certified medical dermatologist and the Director of the Psoriasis Treatment Program at Yale School of Medicine. Graduating from Harvard Medical School, Dr. Cohen completed his dermatology residency at New York University School of Medicine. His current research focuses on skin condition epidemiology, the links between skin disorders and other medical issues, and improving the delivery of dermatologic care. He has over a hundred peer-reviewed articles and serves on the Editorial Board of the Journal of the American Academy of Dermatology and the Medical Board of the National Psoriasis Foundation.

Dr. Doolittle has a Master's in Divinity as well as an MD, and his research spans hepatitis, HIV, and wellness and burnout. He'll often ask his trainees, "How is your spirit?" It was a pleasure to talk to him about the intersection of medicine and spirituality, the inner life, how it might relate to burnout, insights on how to stave off burnout, and the connection among curiosity, wonder, and love. Dr. Benjamin Doolittle, MaDiv MD is a Professor of Medicine, Pediatrics, and Divinity, the Director of the Internal Medicine-Pediatrics Residency Program, Medical Director of the Faculty-Resident Continuity Clinic, and a Professor of Religion and Health at Yale University. He has special expertise in addition, hepatitis C, HIV, and primary care. His research focuses on the intersection of medicine and spirituality, wellness, and burnout. Dr. Doolittle is an ordained minister and serves at New Haven’s Pilgrim Congregational Church. He is quoted as saying, “The medicine is easy, but everything else is hard,” and, “Faith offers…mystery, wonder, love – which are not illogical, but are not logical either.” More on Dr. Doolittle as well as an article on bio-psycho-social-spiritual training for trainees.

It's always instructive to hear how someone who started a movement, like that of Narrative Medicine, defines it. Listen in to how Narrative Medicine began for Dr. Charon, why narrative capacity is a better term than narrative competence, and what burnout might really mean.  Dr. Rita Charon, MD PhD is a physician, literary scholar, and founder of the narrative medicine program at Columbia University. She is a Professor of Medicine and Professor of Medical Humanities and Ethics at the College of Physicians and Surgeons of Columbia University. She has received numerous awards, including a Kaiser Faculty Scholar Award, a Rockefeller Foundation Bellagio Residence, a John Simon Guggenheim Fellowship, the Virginia Kneeland Frantz Award for Outstanding Woman Doctor of the Year, Outstanding Woman Physician of the year in 1996, the National Award for Innovation in Medical Education from the Society of General Internal Medicine in 1997, and the 2018 Jefferson Lecturer in the Humanities by the National Endowment for the Humanities.

Please join me in Part 1 of my conversation with Dr. Rita Charon, where we talk about what she is reading, death, the humanities, ontology, the industrialization of medicine, and reasons to be optimistic still. Dr. Rita Charon, MD PhD is a physician, literary scholar, and founder of the narrative medicine program at Columbia University. She is a Professor of Medicine and Professor of Medical Humanities and Ethics at the College of Physicians and Surgeons of Columbia University. She has received numerous awards, including a Kaiser Faculty Scholar Award, a Rockefeller Foundation Bellagio Residence, a John Simon Guggenheim Fellowship, the Virginia Kneeland Frantz Award for Outstanding Woman Doctor of the Year, Outstanding Woman Physician of the year in 1996, the National Award for Innovation in Medical Education from the Society of General Internal Medicine in 1997, and the 2018 Jefferson Lecturer in the Humanities by the National Endowment for the Humanities.

This conversation really helped me understand why I am having more trouble understanding my own self these days. Laurie also shares how taking responsibility, but not blame or praise, and openness can help us make decisions. Dr. Laurie Ann Paul, PhD (publishes under the name L.A. Paul) is the Millstone Family Professor of Philosophy and Professor of Cognitive Science at Yale University. Her main research interests include metaphysics, cognitive science, decision theory, and the philosophy of mind. She has written several books, including one titled, Transformative Experience, in which she suggests that living “authentically” requires occasionally leaving your old self behind “to create and discover a new self.” Part of being alive is awaiting the “revelation” of “who you’ll become.”

Learn how it is that Dr. Lipoff and I ended up connecting to have this conversation! (for the impatient ones [like me], find this info at 5:44). Dr. Jules Lipoff, MD is a dermatologist practicing in northwest Philadelphia and Clinical Associate Professor (Adjunct) in the Lewis Katz School of Medicine at Temple University.  He runs a PRIDE clinic (PRoviding Integrated Dermatology for Everyone) serving both LGBT patients and patients living with HIV for every major health system and LGBT center in the Philadelphia area.  He also serves as senior subspecialist telemedicine consultant for Medecins Sans Frontieres and writes as a columnist for the Philadelphia Inquirer.  In addition to his over 100 published academic articles, his creative work includes podcasts, screenplays, short films, medical consulting for television, and beyond the Inquirer, his writing has appeared in The New York Times, The Los Angeles Times, Slate, Vox, The Hill, STAT News, and JAMA.

Dr. Jason Lee has written and presented on how we think, cognitive bias in medical diagnosis, and errors in the pathologic pathway of a biopsy from clinic to final report. The latter was recently published in the Journal of Cutaneous Pathology.  It is truly a pleasure to hear Dr. Lee talk with ease about errors, including his own. Dr. Jason B. Lee, MD is Professor, Director of the Jefferson Dermatopathology Center, Director of the Dermatopathology Fellowship, and Director of the Jefferson Pigmented Lesion Clinic at Jefferson Medical College of Thomas Jefferson University. He interned at the University of California, Irvine and then did his residency and fellowship at Thomas Jefferson University Hospitals. He has a recent article in the Journal of Cutaneous Pathology that focuses on error in the pathologic diagnostic pathway. 

Dr. Jeremy Howick has spent his career studying evidence-based medicine as well as placebo effects. In part, this started from when he was a competitive rower, developed an allergy to a cat, and was prescribed ginger tea as a treatment. Dr. Jeremy Howick, PhD is the Director of the Stoneygate Centre for Excellence in Empathic Healthcare and a Senior Researcher at Oxford University. He is the author of Doctor You and The Philosophy of Evidence-Based Medicine as well as a book released November 14, 2023, The Power of Placebos: How the Science of Placebos and Nocebos Can Improve Health Care. He obtained his PhD from the London School of Economics.