Conventionally, we are taught that evolution implies there is no ultimate purpose to our existence, that life lacks inherent meaning — we are the product of countless intricate molecular and genetic accidents. And to many, evolution leaves little room for, and perhaps even contradicts, the existence of a deity.

However, our guest on this episode, Samuel Wilkinson, MD, a professor of psychiatry at Yale University, thinks there is another way to look at evolution. Drawing from an array of disciplines ranging from evolutionary biology to cognitive science, Dr. Wilkinson provides a framework for evolution suggesting not only that there is an overarching purpose to our existence, but what that purpose is. He presents this framework in his 2024 book, Purpose: What Evolution and Human Nature Imply about the Meaning of Our Existence.

Over the course of our conversation, Dr. Wilkinson shares how an existential crisis during medical school led him down the path of exploring the ways evolution can be reconciled with fundamental questions and answers about life's meaning; how navigating the dual potential of human nature — pulling us between selfishness and altruism, aggression and cooperation — is key to understanding our purpose; why evolution does not exclude the possibility of existence of a god or gods; the importance of relationships in living fulfilling lives; the role of free will in the choice between good and evil; and more.

In this episode, you’ll hear about:

3:37 - How a drive to understand human nature drove Dr. Wilkinson to leave his engineering studies and pursue a career as a psychiatrist.

4:44 - The scope of Dr. Wilkinson’s work at Yale

7:13 - What studying depression has taught Dr. Wilkinson about human nature

9:00 - How Dr. Wilkinson views the connection between evolution and God

24:00 - How the central argument of Dr. Wilkinson’s book differs from intelligent design

26:41 - Dr. Wilkinson’s view of selfishness in human nature

37:49 - The deeper meaning that Dr. Wilkinson sees within the biological patterns of evolution

39:04 - The validity of moral relativism

43:42 - “The Rider and the Elephant” as a metaphor for human nature

45:43 - Dr. Wilkinson’s thoughts on free will

55:15 - How marriage can provide a cornerstone to building “a good life”

58:10 - The way in which Dr. Wilkinson’s faith fits into his personal view of human nature

1:04:42 - How Dr. Wilkinson brings these principles into his clinical practice

Dr. Samuel Wilkinson is the author of Purpose: What Evolution and Human Nature Imply about the Meaning of Our Existence (2024).

Works and Individuals Discussed:

The Selfish Gene by Richard Dawkins

Determined: A Science of Life Without Free Will by Robert Sapolsky

Michael Behe and the concept of intelligent design

Free Will by Sam Harris

For Mark Lewis, MD, cancer has defined his entire life. Growing up, he witnessed his father's valiant struggle with cancer before it eventually ended his life. While still in medical training, he not only developed pancreatic cancer but also discovered the culprit. Multiple endocrine neoplasia type 1, an inherited syndrome that drastically increases one's risk of cancers, runs in his family. So now, as a father, he guides his son in making sense of a life burdened with that risk. What’s more, as an oncologist, Dr. Lewis has also dedicated his professional life to understanding and treating cancers of the gastrointestinal system.

In this deeply personal conversation filled with pathos, wisdom, and hope, Dr. Lewis shares how he learned to cope with the rage he felt towards cancer in his early years, the solace he finds in religion and how he tactfully approaches matters of spirituality with his patients, how he was fundamentally transformed after undergoing the daunting Whipple surgical procedure, the wonder he feels when considering the remarkable progress science has made in cancer therapies, and how he channels his personal experiences to connect with patients.

This is an episode that paints a portrait of grace, resilience, and courage in the face of suffering and loss, and it reminds us to search for the dignity that is inherent in the act of caring for another person.

In this episode, you’ll hear about:

2:43 - How watching his father deal with cancer led Dr. Lewis to a career in medicine.

7:04 - How Dr. Lewis managed the grief and rage that came with his father’s passing.

11:10 - How the speed of medical innovation drives Dr. Lewis’ optimism.

19:51 - The role that faith plays in Dr. Lewis’ work and in his relationships with patients.

29:07 - Dr. Lewis’ experience as a cancer patient and how it has informed his work as an oncologist.

39:21 - The ethical challenges involved in administering toxic treatments in oncology.

42:24 - The deeper meaning that Dr. Lewis has found through his experiences at the intersection of science and faith.

48:57 - Dr. Lewis’ advice for empathizing and connecting with patients.

Dr. Mark Lewis can be found on Twitter/X at @marklewismd.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

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The Bill & Melinda Gates Foundation, with an endowment of over $50 billion, is one of the largest and most influential philanthropic organizations in the world. With a focus on addressing global health, poverty, and education, its initiatives have led to the reduction of malaria mortality by 60% over the past two decades, the near eradication of polio, increased educational opportunities of millions of students, and improved sanitation conditions for millions of people in developing countries.

For six years, oncologist Sue Desmond-Hellmann, MD, MPH was the CEO of this organization. Prior to that, she served as Chancellor of the University of California at San Francisco, as well as President of Product Development at Genentech, where she oversaw the development of Herceptin, Avastin, Rituxan, and other blockbuster cancer drugs that are now staples in the arsenal of many medical oncologists.

The topics of our discussion in this episode are as varied as Dr. Desmond-Hellman's career. We discuss, among other things, how seeing the work of her pharmacist father encouraged her to pursue a career in medicine, how her early experiences treating HIV patients in Uganda spurred her to tackle global health challenges, how she discovered a passion for product development in the pharmaceutical industry, how she reconciles the ethical quandaries of developing medications that can cause serious adverse effects and that can sometimes cost hundreds of thousands of dollars per dose, what her mission while at the Gates Foundation was, and her perspectives on the role of artificial intelligence and human health and well-being, now that she has joined the board of directors of OpenAI, the company behind ChatGPT.

In this episode, you will hear about:

2:50 - How working in her father’s pharmacy led Dr. Desmond-Hellmann to a career in medicine

4:56 - A brief summary of Dr. Desmond-Hellmann’s multifaceted career trajectory

15:36 - What the day to day work of pharmaceutical drug development looks like

18:30 - The challenging ethical concerns that surround drug approvals especially as it pertains to safety concerns

23:44 - Dr. Desmond-Hellmann’s experiences in Uganda that forever transformed her views on poverty

27:55 - The aims of the Gates Foundation

30:47 - How Dr. Desmond-Hellmann views her work both in the non-profit and the for-profit sectors

37:15 - Dr. Desmond-Hellmann’s mission when she took on a leading role at The Gates Foundation

38:38 - How Dr. Desmond-Hellmann thinks about shaping the future of AI as she takes a seat on the board of OpenAI

45:14 - Dr. Desmond-Hellmann’s advice for medical trainees and clinicians on how to navigate the many opportunities available to them along their career path

Dr. Sue Desmond-Hellmann can be found on Twitter/X @suedhellmann.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

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In today's world, the idea of “identifying your values” is so ubiquitous, appearing from corporate mission statements to self-help books, that it can seem trivialized to the point of meaninglessness. But in this episode, Ira Bedzow, PhD reminds us it does not have to be this way—explorations of personal values can be an inspiring, holistic, and thought provoking process that transforms everything that we do, from finding joy in work to building fulfilling relationships.

Bedzow is the executive director of the Emory Purpose Project, an initiative at Emory University that provides opportunities for students to develop a capacity for reflection on purpose and meaning. He is also an associate professor in the Department of Medicine, a core faculty member of Emory's Center for Ethics, a senior fellow in Emory's Center for the Study of Law and Religion, and an Orthodox rabbi.

Over the course of our conversation, Bedzow discusses how he helps people discover their life purpose, how he teaches moral leadership, how he wrestles with questions of moral relativism, the connection between a loss of purpose and burnout, how he counsels clinicians on resolving ethical quandaries, and more.

In this episode, you will hear about:

2:21 - The varied roles that make up Dr. Bedzow’s current career

8:06 - What “values” mean

15:53 - The principles Dr. Bedzow employs when counseling students on their career and life aspirations

19:07 - Applying ethical thinking to medical scenarios

27:36 - How Dr. Bedzow counsels leadership at an organizational level

31:02 - The connection between a loss of sense of purpose and burnout

39:01 - How organizations and individuals can proactively foster a sense of mission

42:05 - The deep meaning that Dr. Bedzow finds in his religion

45:23 - Truths that Judaism can offer the world

Ira Bedzow is the author of the essay How Purpose and Employee Empowerment Can Stop Burnout.

Ira Bedzow can be found on Twitter/X at @ijbedzow.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

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Terminal lucidity is a mysterious yet well-documented phenomenon in which someone at the end of life—including those who have suffered strokes or other brain injuries, or those afflicted by dementia—suddenly returns with mental clarity and is able to recognize loved ones and engage in meaningful and emotionally rich conversations. It challenges our fundamental understanding and assumptions about the nature of consciousness, brain function in the context of severe illness, and personhood.

In this episode, Alexander Batthyány, PhD, a cognitive scientist and the Director of the Viktor Frankl Institute, offers insights on terminal lucidity from his years of study on this phenomenon from a philosophical, ethical, neurological, and psychological perspective. He is the author of the 2023 book Threshold: Terminal Lucidity and the Border of Life and Death.

Over the course of our conversation, he shares how witnessing terminal lucidity in his grandmother has shaped his life purpose, why he chooses to use the word “soul” in his academic research, the role of spirituality and religion in making sense of terminal lucidity, the limits of our scientific and materialistic understanding of the brain, what terminal lucidity reveals about the dignity and unpredictability inherent in the human condition, and what it ultimately teaches us about kindness and compassion.

In this episode, you’ll hear about:

2:31 - The personal experience that drew Dr. Batthyány to study terminal lucidity

6:34 - An exploration of human dignity

12:26 - The importance of talking and thinking about the human “soul”

18:26 - Definition and phenomenology of terminal lucidity

23:57 - What is known about brain functioning during episodes of terminal lucidity

31:44 - Advice for caregivers, family members, and clinicians if a patient experiences terminal lucidity

36:55 - The prevalence of terminal lucidity

40:14 - Whether individuals who experience terminal lucidity have insight into their condition

42:15 - Why phenomena like terminal lucidity matter

Dr. Alexander Batthyány is the author of Threshold: Terminal Lucidity and the Border of Life and Death (2023).

Dr. Batthyány can be found in Twitter/X at @Alxdr_Batthyany.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

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The Association of American Medical Colleges (AAMC) plays a crucial role in health care. As the organization that oversees medical education and thus the pipeline of future medical professionals in the United States, its critical duties include administering the Medical College Admission Test (MCAT), managing the residency application service, drafting guidelines for faculty members and departments at medical schools and academic hospitals, disseminating data on medical education and workforce trends that shape policymaking at medical schools and government bodies, and promoting diversity in health care.

Leading this organization is David Skorton, MD, a cardiologist and pioneer of cardiac imaging and computer processing techniques, who also previously served as the 13th Secretary of the Smithsonian Institution and as President of Cornell University and of the University of Iowa. In this episode, Dr. Skorton shares with us how his family's immigrant past has shaped him, how he went from struggling during his own medical school application process more than 50 years ago to now leading an organization that represents all medical schools and teaching hospitals, why the arts and humanities matter to him, how he thinks about medical education given the emergence of generative artificial intelligence, what great mentors look like, how effective leadership often means learning from everyone around you, and more.

In this episode, you will hear about:

2:42 - Dr. Skorton’s unexpected path from jazz musician to President of the AAMC

7:42 - Why current medical admissions aim to be “holistic”

12:09 - The lessons Dr. Skorton learned through mentorship and why the arts and humanities can create better doctors

17:32 - How Dr. Skorton has been able to “see past himself” enough to receive challenging criticism from mentors

28:01 - The core tenets of Dr. Skorton’s leadership philosophy

31:35 - How the AAMC views the future of medical education especially in light of advances in artificial intelligence

38:47 - The importance of diverse healthcare teams

46:32 - Issues that Dr. Skorton addresses through his role at the AAMC

Dr. David Skorton can be found on Twitter/X at @DavidJSkorton.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

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In spring of 2020, Cornelia Griggs, MD was finishing her nearly decade-long training to become a pediatric surgeon in New York City, when COVID-19 struck and life fell apart. The hospital was flooded with mysteriously sick patients for whom no known treatments existed, basic supplies disappeared from shelves, and each day at work took on an existential burden as she wondered if this would be the day she caught the deadly disease herself.

Dr. Griggs describes these dramatic stories from the early days of the pandemic in her 2024 memoir, The Sky Was Falling. Today, she is a triple board-certified pediatric surgeon, having completed medical school and pediatric surgery fellowship at Columbia University Medical Center, and her adult general surgery residency and surgical critical care fellowship at Massachusetts General Hospital, where she currently practices.

Over the course of our conversation, Dr. Griggs describes the course of her challenging training in medicine, why it takes “a little crazy” to succeed as a surgeon, harrowing moments that defined heroism amid the throes of the pandemic, how she continued working even when giving up was the easy option, and more.

In this episode, you’ll hear about:

2:26 - What initially drew Dr. Griggs into the field of medicine and to the speciality of pediatric surgery

14:35 - Why the operating room is a “safe space” for Dr. Griggs

19:36 - The sense of alarm that Dr. Griggs experienced in the early days of the pandemic that drove her to write her viral New York Times op-ed, The Sky is Falling

28:26 - How Dr. Griggs fell into an “investigative reporter” headspace as the pandemic raged around her in New York City

30:26 - The sense of fear that enveloped both patients and the medical community during the first months of the pandemic

40:27 - A moment during the early pandemic when Dr. Griggs seriously considered leaving the city and her post in the hospital

46:30 - How ICU nurses brought dignity and humanity when tending to seriously ill COVID-19 patients

51:16 - The hopefulness Dr. Griggs carries in seeing the large number of people who have entered medicine since the pandemic

Dr. Cornelia Griggs can be found on Twitter/X at @CorneliaLG.

Dr. Griggs is the author ofThe Sky Was Falling (2024).

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

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To many health economists, the growing aging population is the greatest public health challenge facing America. The current fragmented and costly healthcare system is simply incapable of dealing with the complex medical and socioeconomic needs of this population, especially in an equitable way.

Our guest on this episode, Linda Fried, MD, MPH, has dedicated her life to rethinking how we can create better health futures for older adults. Her pioneering research has expanded our notions of aging and longevity in the 21st century. Dr. Fried, a geriatrician and epidemiologist, is Dean of the Columbia University Mailman School of Public Health, Senior Vice President of the Columbia University Irving Medical Center, and former Founding Director of the Center on Aging and Health at Johns Hopkins University.

Over the course of our conversation, Dr. Fried shares how her early experiences as a caseworker drove her to study medicine, surprising lessons from the martial arts aikido, what frailty means in the context of caring for older adults, why America is one of the most age segregated societies in the world, the flaws of over medicalizing health issues, redefining the roles of older adults in society, the importance of meaning and community in sustaining happiness in life, and more.

In this episode, you’ll hear about:

2:30 - What Dr. Fried’s early experiences in social work taught her about justice, social inequity, and taking care of another person

11:47 - How an awareness of the social determinants of health shaped Dr. Fried as a clinician

16:46 - Why physicians need to stop “medicalizing” all aspects of a patient’s life

25:00 - How Dr. Fried came to be interested in geriatrics

28:19 - Dr. Fried’s dedication to extending “healthspan” as well as “lifespan” in our society

31:08 - The clinical definition of “frailty”

34:15 - The value that an older population could bring to our society

38:49 - The United States’ unique culture of age segregation and how it contributes to poor health outcomes for the elderly

45:38 - What the healthcare system and society at large can do to better serve elderly populations

50:55 - Dr. Fried’s advice for keeping true to your purpose as a medical professional

Dr. Linda Fried can be found on LinkedIn.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

Copyright The Doctor’s Art Podcast 2024