Oncologist, podcast host: ‘Embracing the mystery’ can help find medicine’s deepest meaning
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During his educational progression from an intern at Stanford University’s ICU to that unit’s senior resident, Tyler Paul Johnson, MD, learned to take an “impenetrable forest of data” and reduce it to its simplest form.
“I had learned to see clearly through that forest and differentiate the signal from the noise,” Johnson, a medical oncologist and clinical associate professor of oncology at Stanford, said during an ASCO Annual Meeting education session that explored how to find inspiration in an oncology career. “This was possible because I had learned to digest all of this complex data and distill it down into a seemingly simplistic understanding of what was wrong and what we could do about it.”
Without realizing it, Johnson eventually came to believe that everything he needed to know about his patients could be reduced to a set of numbers and letters.
For his professional role at that time, he knew the importance of maintaining this mindset.
“This kind of thinking is absolutely necessary if you’re going to take care of critically ill patients in the ICU,” Johnson said. “However, I would like to suggest that there is a critical other part to this story, something that perhaps we don’t think about often enough.”
A ‘cresting tide of burnout’
Johnson underscored the value of utilizing key data to guide treatment for patients with cancer, but he also discussed the intangible qualities that make each patient unique.
“About 3 years ago, a colleague at Stanford and I both recognized that there was a cresting tide of burnout in the medical community,” Johnson said. “We set out to get to the bottom of what was causing this and what we could do to ameliorate it.”
Johnson and that colleague — Henry Bair, MD, MBA — created a podcast called “The Doctor’s Art.”
They expected to gain a small but devoted following that would include their moms and “a couple of close friends at Stanford,” Johnson said.
Instead, “The Doctor’s Art” became one of the most popular medical podcasts in the world.
Over the past 2.5 years, Johnson and Bair have recorded nearly 150 hours of conversations that focus on how to restore a sense of meaning in medicine among burned-out physicians.
Through the podcast, the duo learned about the challenges of digitization, corporatization and bureaucratization of health care. However, their interviews revealed a deeper, more personal truth.
“There is an element of caring for patients that, even now, remains beyond the reach of corporations and generative AI,” Johnson said.
The truth that emerged from hours of interviews can be summarized in one sentence, Johnson said: The essence of our shared humanity remains an irreducible mystery.
Johnson then displayed a slide showing a photo of his two young sons, taken a few weeks before.
“If one of them were admitted to the ICU, one of the doctors there could know every vital sign, every part of their medical history and every one of their medications and doses,” he said. “Yet, as their parent, I would still know that this doctor knew nothing at all about who my children really are.”
Shared humanity
This suggests that an equally important aspect of patient care is an acknowledgement of the patient’s identity as a unique human being, Johnson said.
Clinicians should not only spend more time considering the individual mystery of each human being; they also should contemplate the even larger mysteries that underlie human existence, Johnson said.
“I’m referring to fundamental questions like, ‘What is suffering?’ ‘What makes us human?’ and ‘Is there a soul?’” he said.
Sometimes Johnson thinks about the miraculous fact that each person began as a single cell with a single copy of DNA, and they evolved into “the walking, living, laughing loving humans” that filled the room in which he spoke.
“That is to say that the whole is — and forever will be — so much more than the sum of its parts,” he said.
The interviews Johnson and Blair conducted on the podcast illustrate that although patient data is important to provide optimal therapy for people with cancer, there needs to be a focus on the person who is undergoing treatment, he said.
Contemplating the mystery of each patient’s irreplaceable humanity is as important to clinicians as it is to the patients themselves, he added.
“The point I want to make is not that any of these questions have an easy or concrete answer, but rather that the questions merit asking,” he said. “Embracing the mystery of those answers is ultimately what grants medicine its deepest meaning.”
For more information:
Tyler P. Johnson, MD, can be reached at tpjmd@stanford.edu.
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Johnson TP. How we can enhance compassion in the practice of medicine. Presented at: ASCO Annual Meeting; May 31-June 4, 2024; Chicago.
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