Episode 126 - Dr. Mark Lewis: Family History

Podcast Summary

• Online healthcare for weight loss and comfortable clothing from Bombas: Online healthcare platform PlushCare connects users with certified doctors for weight loss meds. Bombas offers comfortable clothing and donates items per purchase.

  PlushCare offers a convenient and effective way to start your weight loss journey with online access to board certified physicians who can prescribe FDA approved medications. Meanwhile, Bombas provides comfort and gives back by donating items for every purchase made. Regarding the discussion about drug users, Hollywood's portrayal of substance use in media was identified as a significant contributor to perpetuating stereotypes and misconceptions. Movies like "Requiem for a Dream" and "4 Good Days" were cited as examples of inaccurate and misrepresentative portrayals. It's important to remember that drug users are human beings deserving of compassion and understanding.

• Media portrayal of addiction and treatment can be misleading: Media often sensationalizes addiction and treatment, perpetuating harmful stereotypes. The complexity of addiction requires nuanced depictions, not commercialized or simplistic portrayals.

  The portrayal of addiction and treatment in media, such as movies, can be misleading and perpetuate harmful stereotypes. For instance, the movie "The Third Wife" may have used a real medicine, VIVITROL, but its representation seemed more like a commercial rather than an honest depiction. Furthermore, the movie failed to acknowledge that people struggling with addiction don't necessarily look different from others, and there is no single movie that gets it right. Additionally, while the pharmaceutical industry's role in the opioid crisis is a significant issue, it is not the sole contributor to the problem. The root causes are complex and multifaceted, involving federal policies and societal attitudes towards addiction. As for the medical side, becoming a GI oncologist involves completing oncology training and then specializing in gastrointestinal oncology after fellowship.

• Navigating Complex Healthcare Systems and Specializing in Oncology: Adjusting to a new healthcare system and accessing specialized care are crucial for effective oncology treatment. Specialization in a sub-field of oncology, like GI oncology, allows for more effective and focused patient care.

  The field of oncology is incredibly complex and specialized, making it nearly impossible for a single physician to master every aspect of it. The speaker, who grew up in Edinburgh and moved to Texas with his family, shared his personal experience of adjusting to a new healthcare system in the U.S. after his father received a job offer there. However, their arrival was met with a shock when they received news that the father's chest x-ray showed a completely whitened out side, indicating a potential serious health issue. This experience highlighted the importance of being able to navigate the healthcare system and having access to specialized care. The speaker's own career path in oncology reflects this trend towards specialization, as he chose to focus exclusively on GI oncology after realizing the impossible balancing act of managing both general oncology and a specific sub-specialty. The ongoing oncology conference, which is happening during the podcast recording, further emphasizes the depth and breadth of research and treatment options available in this field.

• A father's inspiring journey through oncology: Through personal connections and long-term relationships, oncologists can make a significant impact on patients' lives, even amidst the challenges and sadness.

  Even in the field of oncology, which can seem dismal and hopeless, there are remarkable advancements and progress being made every day. The speaker's father, who passed away when he was 49, benefited from such an advancement in the form of a new drug called Neupogen that saved his life. The father's oncologist took the young speaker under his wing and let him work in his clinic, providing him with a valuable apprenticeship and inspiring him to pursue a career in medicine. This experience showed the speaker the importance of personal connections and long-term relationships in oncology, and the potential for making a meaningful impact on patients' lives. Despite the challenges and sadness, the speaker found solace and motivation in his father's story and the advancements in the field.

• The power of personal connections in oncology: Oncology professionals' dedication to staying updated and forming deep, caring relationships with patients makes a difference in their lives.

  The personal connections formed between healthcare professionals and patients, particularly in the field of oncology, can be deeply meaningful and sustaining. The speaker's experience with a former doctor who showed compassion towards her father despite their professional differences, inspired her to pursue a career in oncology. This field, marked by constant change and complexity, presents unique challenges but also rewards in terms of fostering caring relationships and making a difference in people's lives. The speaker's respect for oncologists comes from their dedication to staying updated with the latest research and treatments, ensuring they provide the best possible care for their patients. Additionally, the speaker's own emotional connection to the field, shaped by a childhood trauma, underscores the powerful role personal experiences can play in shaping one's career choices.

• Personal experiences shaping healthcare perspectives: Healthcare professionals' personal experiences can impact their work, including misdiagnoses and recognizing the complexity of healthcare. Understanding the importance of compassion and accurate diagnoses is crucial.

  Personal experiences can significantly shape our perspectives and actions, even in the realm of healthcare. The speaker, who was diagnosed with cancer on her first day of oncology fellowship, shared how her father's diagnosis and her own experience converged, leading her to become a healthcare professional. She also emphasized the importance of recognizing that not everyone who develops a disease, such as lung cancer, deserves it based on their lifestyle choices. The speaker's father, who was a non-smoker, had a neuroendocrine tumor that arose in his thymus, which is a feature of multiple endocrine neoplasia type 1. The speaker's diagnosis impressed her colleagues, but in real life, her diagnosis was initially misdiagnosed as hypochondriasis by her assigned internist at Mayo Clinic. This experience underscores the complexity of healthcare and the importance of accurate diagnoses. Overall, the speaker's story highlights the interconnectedness of personal experiences, healthcare, and morality, and the need for compassion and understanding in healthcare.

• The Diagnostic Dilemma: Anxiety or Legitimate Health Concern?: Believing in a health concern despite medical expertise or evidence can lead to important diagnoses, but it's crucial to remember that illness is a complex interplay of genetics, environment, triggers, and chance.

  Being a hypochondriac, or convinced of having an illness that may not exist, is common in today's era of easy access to medical information. The speaker's personal experience of this phenomenon, where he believed he had a tumor syndrome despite being a medical professional, highlights the diagnostic dilemma - is it anxiety or a legitimate health concern? There's still some professional courtesy among doctors, and the speaker was able to convince his doctor to test him, revealing a rare genetic condition. If he had been tested earlier, he would have been told it was negative and likely never revisited it until it was too late. This story underscores the importance of progress in medicine and the admission that no oncologist knows everything. The stigma surrounding illness, particularly cancer, can lead to accusatory comments from friends and family about lifestyle choices. Siddhartha Mukherjee's formula that all illness is the sum total of our heredity, environment, triggers, and chance emphasizes the underestimated role of chance. It's essential to remember that a patient's illness is not a result of anything they did wrong beforehand.

• Understanding the Limits of Personal Control in Health: Recognize external factors impact health outcomes, personal choices don't absolve individuals from medical treatment, and the belief in alternative treatments to cure cancer is dangerous.

  While personal choices and lifestyle factors play a role in health outcomes, they do not absolve individuals from the realities of illness or the need for medical treatment. Drastic dietary changes during cancer treatment can make it more difficult for patients to tolerate therapy, and the belief that willpower alone can prevent or cure cancer is harmful and unfair. The speaker's father, a theology professor with cancer, understood this and wrote about the importance of recognizing the limits of personal control. It's crucial to acknowledge that external factors, including genetics and environmental influences, also impact health outcomes. The pervasive belief in the power of positive thinking or alternative treatments to cure cancer can be dangerous, and it's essential to promote healthy lifestyles while acknowledging their limitations. The speaker's personal experience with hypercalcemia highlights the importance of addressing the underlying causes of health issues, even if they are not related to personal choices.

• Open communication and education reduce fear in medical procedures: Documenting and sharing surgical experiences can demystify procedures, early detection and intervention are crucial, and technology and open dialogue improve patient experiences.

  Open communication and education can help reduce fear and anxiety surrounding complex medical procedures. The speaker, who has undergone surgeries for parathyroid problems and pancreatic neuroendocrine tumors, shared how documenting and live-tweeting his surgeries helped demystify the processes for himself and others. By allowing transparency and access to information, he was able to help his patients and himself approach these procedures with less apprehension. Additionally, early detection and intervention are crucial in managing conditions like these, and the speaker emphasized the importance of regular check-ups and monitoring. Overall, the use of technology and open dialogue can lead to better health outcomes and improved patient experiences.

• A doctor's personal experience shapes patient connections: Doctors' personal experiences can deepen patient connections, even in medical specialties like oncology where life-changing diagnoses occur.

  A doctor's personal experience with a condition can significantly impact their ability to connect and empathize with patients. The doctor in this discussion shares how his rare tumor diagnosis has brought him patients who feel he truly understands their experience, even though he hasn't undergone the same treatments they have. He acknowledges the importance of this connection and the value it adds to the patient experience. The doctor also mentions how other doctors, including oncologists, can benefit from sharing their own experiences with patients, even if they haven't gone through the exact same treatments. This empathetic approach can be especially crucial in areas like oncology where patients are facing life-changing diagnoses and treatments. The doctor's unique perspective and willingness to share his story make him a valuable resource for his patients.

• Impact of Genetic Conditions on Families and Ethical Questions around PGD: Genetic conditions can have profound impacts on families, raising ethical questions around the use of technologies like PGD. While some families may choose to use it, others may embrace the condition as part of their identity.

  Genetic conditions can have a profound impact on families, raising complex ethical questions around the use of technologies like preimplantation genetic diagnosis (PGD). The speaker, a parent with a genetic condition, shares his experience of deciding whether to use PGD when planning to have more children. He ultimately chose not to use it, reflecting on the existential implications and the potential benefits of passing on the condition to his son. The speaker's son, who is aware of the condition from a young age, views it as part of his identity, and the family is committed to managing it in an open and supportive way. Despite the challenges, the speaker emphasizes that having the condition is not the end of the world and that it shapes who they are. The speaker's poignant reflection on the potential implications of using PGD also raises ethical questions about the role of technology in shaping the next generation.

• Focusing on leaving a meaningful legacy despite life's challenges: Make the most of life's time, focus on positively impacting loved ones and work, and consider giving back to special moms on Mother's Day.

  Despite the challenges and suffering that come with life, it's important to focus on leaving a meaningful legacy. Dr. Mark Lewis and Ryan Marino discussed how even those facing serious illnesses make a conscious effort to make a positive impact on their loved ones and in their work. Dr. Lewis emphasized that not everyone is guaranteed a long life, and it's essential to make the most of the time we have. Both speakers shared inspiring stories of their own experiences and the impactful lives of their loved ones. Ryan Marino encouraged listeners to follow him on Twitter @RyanMarino for insightful perspectives on healthcare and life. Dr. Mark Lewis, the director of gastrointestinal oncology at Intermountain Healthcare, can be found on Twitter @MarkLewisMD. The podcast is not a substitute for professional medical advice, and listeners are encouraged to consult a healthcare provider for their specific needs. This Mother's Day, consider giving back to the special moms in your life with handmade bouquets, sweet treats, and one-of-a-kind gifts from 1-800-Flowers. Save up to 40% on Mother's Day bestsellers with the code ACAST at checkout.

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  You can save up to 40% on gifts at 1 800flowers.com/acast, while learning an interesting fact about crocodiles not being able to stick out their tongues. Additionally, UnitedHealthcare's short term insurance plans offer flexible and budget-friendly health coverage for durations as short as a month. Meanwhile, Boll and Branch's organic cotton sheets promise to get softer with every wash, as evidenced by a customer survey reporting that 96% of respondents agreed. To experience the softest sheets that continue to soften over time, try them with a 30-night guarantee and a 15% discount using the code "buttery" at bolandbranch.com. Remember, health insurance and comfortable bedding are important investments for your well-being.