Imagine practicing medicine not within the sterile confines of a hospital, but in the unpredictable world of city streets and shelters, where every patient encounter challenges conventional notions of care, empathy, and human dignity. We explore this reality through the extraordinary journey of Jim O'Connell, MD , whose groundbreaking work with Boston's homeless population has profoundly reshaped health care for society's most marginalized individuals. Dr. O'Connell is the founding president of ...
Jul 25, 2025•1 hr•Ep. 154
The relationship between physicians and the larger healthcare system is incredibly complex, raising difficult questions about patient care, advocacy, and the role of doctors in shaping public policy. In this episode, we explore these critical issues and the realities faced by healthcare providers today. Our guest is Bruce Scott, MD , an otolaryngologist and 2024 – 2025 President of the American Medical Association (AMA). Motivated by a serious childhood injury and the life changing care he recei...
Jul 04, 2025•55 min•Ep. 153
George Mark Children's House is a pediatric palliative care center in California that provides respite and hospice for children with serious illnesses and their families. In March 2025, we heard the personal story of the House’s director. In this episode, we have been invited on site to speak with someone whose life has been touched by the House. Our guests are Kaitlyn, a young woman living with epilepsy, her mother Liz, and Kyle, a child life specialist. Kaitlyn has lived with seizures since sh...
Jun 03, 2025•47 min•Ep. 152
If you were asked to build a medical school from scratch, how would you do it? It's not a chance most of us get — but that was exactly the task given to our guest on this episode, Sharmila Makhija, MD, MBA . Dr. Makhija is a gynecologic oncologist by training, a clinician who has spent her career working with patients through some of life's most vulnerable and uncertain moments. She has also served as chair of obstetrics and gynecology at Montefiore Health System in New York, and before that, at...
May 14, 2025•55 min•Ep. 151
What happens to the practice of medicine when machines begin to reason, summarize and even empathize — at least in the linguistic sense — better than humans do? In this episode, we meet with Michael Howell, MD, MPH, Chief Clinical Officer at Google , to explore the seismic shifts underway in healthcare as artificial intelligence becomes more deeply embedded in clinical workflows. Dr. Howell, a pulmonary and critical care physician, has spent his career at the crossroads of clinical excellence an...
May 06, 2025•1 hr 2 min•Ep. 150
If you could be plugged into a machine that simulated the perfect experience — limitless joy, deep connection, a sense of purpose — yet you knew it wasn't real, would you choose to stay plugged in? This isn't just a philosophical exercise. As our lives become increasingly digitized, our relationships filtered through screens, our emotions managed by algorithms, our attention parceled out to feeds and notifications, we are confronted with a deeper question: what does it mean to have an authentic ...
May 01, 2025•1 hr 2 min•Ep. 149
There is something uniquely haunting about many neurological diseases. These conditions often don't only affect the body — they reshape the very foundation of who we are, our memories, our personalities, our language. When the brain begins to fail, the boundary between illness and identity start to blur; the person we know begins to fade even before their life has ended. In this episode, we are joined by John Rhee, MD, MPH , a neuro-oncologist and palliative care physician at Dana-Farber Cancer ...
Mar 26, 2025•55 min•Ep. 148
Neurosurgery is known as one of the most precise and demanding specialties in medicine. It requires absolute technical mastery in a surgical field where a millimeter’s difference can be the deciding factor between lifelong disability or a life restored. But what happens when a surgeon trained to be objective and detached experiences deep personal loss? How does it reshape the way they practice medicine? In this episode, we are joined by Joseph “Jody” Stern, MD, a neurosurgeon and the author of G...
Mar 18, 2025•57 min•Ep. 147
In medicine, we are trained to fight for life — to extend it, preserve it and restore it. But sometimes the goal shifts from curing to comforting. That, in brief, is the essence of palliative care. It compels us to ask what it means to truly care for a person at the end of life, not as a failure of medicine but as a profound act of love. In this episode, we enter a space where time slows down, where every moment is cherished, and where medicine is tantamount to presence, dignity, and grace. Geor...
Mar 04, 2025•59 min•Ep. 146
Medicine is often framed as a meritocracy, where intelligence, hard work, and dedication dictate success. Yet, institutions of medicine are shaped by histories of exclusion, bias, and systemic inequities. And for clinicians coming from marginalized backgrounds, the journey is not just about learning the science. It's also about learning an entirely different set of rules — rules that are unspoken and unwritten, but deeply felt. For Damon Tweedy, MD , this struggle was deeply personal. Raised in ...
Feb 20, 2025•54 min•Ep. 145
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 Association...
Feb 12, 2025•57 min•Ep. 144
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 this episo...
Jan 31, 2025•54 min•Ep. 143
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 human...
Jan 22, 2025•1 hr 5 min•Ep. 142
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 episode is Ja...
Dec 31, 2024•58 min•Ep. 141
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, literary...
Dec 05, 2024•1 hr 3 min•Ep. 140
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 lives? What ...
Nov 26, 2024•58 min•Ep. 139
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...
Nov 14, 2024•59 min•Ep. 138
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 ...
Nov 05, 2024•53 min•Ep. 137
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 Polic...
Oct 31, 2024•58 min•Ep. 136
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...
Oct 24, 2024•56 min•Ep. 135
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 an...
Oct 17, 2024•59 min•Ep. 134
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...
Oct 08, 2024•49 min•Ep. 133
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,...
Oct 01, 2024•52 min•Ep. 132
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 ge...
Sep 24, 2024•1 hr 8 min•Ep. 131
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 Director of E...
Sep 18, 2024•52 min•Ep. 130
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 after an i...
Sep 10, 2024•59 min•Ep. 129
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 Perlmu...
Sep 03, 2024•1 hr 2 min•Ep. 128
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 at...
Aug 27, 2024•1 hr 2 min•Ep. 127
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 Hea...
Aug 22, 2024•42 min•Ep. 126
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 this ...
Aug 13, 2024•47 min•Ep. 125
