On Becoming a Healer

Many residents are not doing well, psychologically, and sometimes physically -- and with good reason. High levels of mistreatment and harassment, patient care that some experience as moral injury, and a lack of voice in the workplace, contribute to burnout and can adversely affect the kind of physicians people become.  A growing path to empowerment is unionization. What are resident and fellow uni...

The opioid crisis was precipitated by physicians overprescribing opioid pain medication, egged on by the pharmaceutical industry, contributing to suffering and death from addiction and overdose. Now, many physicians are forcibly cutting patients off of opioids and refusing to prescribe in the setting of a backlash, contributing to suffering from pain, and death from suicide. Saul and Stefan consid...

On January 1st, the New York Times ran a story about prenatal genetic tests that are "usually wrong" -- but they got it wrong. These are actually just tests to tell if someone is high risk. The real story is that clinicians are not communicating with patients about what these tests mean, causing confusion and trauma. This happens across medicine and we discuss how to avoid it.

There are two qualities we may experience in others who comfort and ground us when we feel vulnerable and lost.  First that they engage with us, meaning that they are fully present with a sense of shared humanity. Second, that they respect our personal boundaries and know their own. Such boundary clarity makes them a safe sounding board. In this episode, first aired last May, we explore the interd...

Lately we've been hearing about bad behavior on airplanes. Here we discuss an incident in which a passenger unselfconsiously stepped up at an inconvenient time to assist a group of passengers in a tough spot. Saul and Stefan reflect on the qualities of people who go through life making the world a better place in small ways.  As millions travel during Thanksgiving, we thought this episode (origina...

Our guest, a physician a few years out of residency, describes an experience from her training when an attending yelled at her and hung up the phone when they were discussing a patient.  We talk about resident abuse, its impact on patient care, and what can be done about it. 

Our guest, a resident physician, describes her reaction and what followed, when she discovered a symbol of hate tattooed on her hospitalized patient's leg.  Most of us appreciate that as physicians we don't get to choose who are patients are, and that all deserve good care. But is there more to it than that? Can one grow as a physician and person, and even feel privileged when caring for patients...

Saul reached out to a former colleague whom he worked with closely so that he could apologize for something he did many years ago that he now sees as racist. Saul is a white man and his former colleague, a subordinate at the time, is a black woman. Because of his apology, along with their longstanding relationship, they are able to have an open and honest conversation about how it affected her lif...

In a widely reported incident, Dartmouth Geisel School of Medicine accused, suspended and expelled medical students for cheating based on faulty data -- and then retracted the decision amidst a large public backlash. During the episode students were allegedly given only 2 minutes to defend themselves and were encouraged to plead guilty. When they complained about the administration online, the sch...

A primary care doctor in solo practice in a small mid-west city who is deeply trusted by his patients talks about talking about vaccine hesitancy.  

We feel safe and can open up in conversations when there is full and open engagement combined with a clear, respectful sense of personal boundaries.  Why are such exchanges so rare and yet so important to medical practice and to the good life? 

Physicians are neither judges nor God, and yet we seem prone to judge our patients...and ourselves. Saul and Stefan discuss. 

Saul and his research team have listened to and analyzed thousands of audio recordings of medical encounters for clinician attention to the life context of each patient when planning their care. Here is what they've learned.   

In Part 2 of our interview with Dr. Bhalla, hear what makes for a good fit for a long term career practicing medicine and leading projects in international settings

A physician describes what attracted her to international medicine where she's worked for Doctors Without Borders in many challenging places. Guest: Naina Bhalla MD, MPH   Intro and Outro are Prelude by J.S Bach, arranged by Sophocles Papas, with permission from Carl Fischer. Also, Largo from Four Seasons by Vivaldi, arranged Per-Olov Kindgren. Guitar played by Saul Weiner.

Stefan interviews Saul about his experiences becoming a doctor with a learning disability, leading to questions such as: Does struggling with multiple choice tests mean you won't be a good doctor? How do grades shape our self image and the culture of medicine? 

What should a doctor do when  a patient behaves in a way that doesn't seem to make sense?  Saul and Stefan discuss a case. 

In Part 2 of our interview with Dr. John Scala, hear how an experienced primary care physician in solo practice responds to the pandemic, particularly as he thinks about the physician-patient relationship, the well being of his staff, and personal risk. 

A primary care physician describes why he's loved being a solo doctor, mostly avoiding corporate medicine.  His patients love him too. Learn how and why this kind of practice is still possible.  

Dr. Conway responds to violence and hopelessness in her community, traumatized by systemic racism, by establishing the I Am Abel Foundation as a haven and resource for young people aspiring to careers in medicine. 

Dr. LaMenta Conway shares what she experienced and learned growing up in an economically and socially marginalized community in Chicago, pursuing a dream to become a physician. 

A middle aged man had been on a high but stable dose of opioids for years for chronic pain.  His provider decides to wean him. He says "I'm not sure I can handle it," but they keep going.  Is this what a caring or evidence-based physician would do?  

What's a better way to pick a student for medical school: High MCAT scores or seeing them help a vulnerable stranger when it's inconvenient and they think no one's watching? Reflections on healing as an organizing principle.

A very bright physician scares a patient from a marginalized community out of the ER with a nasty prank -- and "I laughed too."  How does this happen? Saul Weiner reflects on a moment from residency.

A patient got labelled as "difficult" who really wasn't so difficult, and it cost him his life.  Where did things go wrong? Details changed to assure patient confidentiality.