Speaker 1: We all know that good habits are ways that we
Speaker 1: bring what we value into the world, and we each
Speaker 1: have our own list of what matters to us. Maybe
Speaker 1: you want to feel more energetic, improve your relationships, have
Speaker 1: a tidy your home, cook more instead of eating out
Speaker 1: for nights a week. Whatever habit you want to build,
Speaker 1: it's entirely possible to make it happen. But if you
Speaker 1: feel under equipped and overwhelmed to make real sustainable change,
Speaker 1: you are not alone. And that's why I've made my
Speaker 1: free masterclass open to everyone and available to watch any time.
Speaker 2: Now.
Speaker 1: It's called Habits that Stick, How to be remarkably consistent
Speaker 1: no matter what goal you set. You can grab it
Speaker 1: at oneufeed dot net slash habits. Again, it's free and
Speaker 1: you can watch it whenever it works for you. Go
Speaker 1: to one you feed dot net slash habits.
Speaker 3: So many people are feeding off this lucrative truth that
Speaker 3: is medical care, trillions of dollars in this twenty percent
Speaker 3: of our GDP almost and we are all excavating from this,
Speaker 3: and what really matters, the human connection, is increasingly getting lost.
Speaker 3: You know, if we don't have that, what do we have?
Speaker 4: Welcome to the one you feed Throughout time, great thinkers
Speaker 4: have recognized the importance of the thoughts we have. Quotes
Speaker 4: like garbage in, garbage out, or you are what you
Speaker 4: think ring true. And yet for many of us, our
Speaker 4: thoughts don't strengthen or empower us. We tend toward negativity,
Speaker 4: self pity, jealousy, or fear. We see what we don't
Speaker 4: have instead of what we do. We think things that
Speaker 4: hold us back and dampen our spirit. But it's not
Speaker 4: just about thinking. Our actions matter. It takes conscious, consistent,
Speaker 4: and creative effort to make a life worth living. This
Speaker 4: podcast is about how other people keep themselves moving in
Speaker 4: the right direction, how they.
Speaker 5: Feed their good wolf. Thanks for joining us. Our guest
Speaker 5: on this episode is Abraham Verghese, a graduate of the
Speaker 5: Iowa Writers Workshop and the author of books including the
Speaker 5: NBCC Award finalist My Own Country and the New York
Speaker 5: Times notable book The Tennis Partner for Geese was awarded
Speaker 5: the National Humanities Medal in twenty sixteen, has received five
Speaker 5: honorary degrees, and is an elected member of the National
Speaker 5: Academy of Medicine in the American Academy of Arts and Sciences.
Speaker 5: He lives and practices medicine in Stanford, California, and is
Speaker 5: Vice chair of the Department of Medicine at the Stanford
Speaker 5: University School of Medicine. Today, Eric and Abraham discuss his book,
Speaker 5: The Covenant of Water.
Speaker 1: Hi, Abraham, Welcome to the show.
Speaker 3: Eric. It's a great pleasure to be with you. Thank you.
Speaker 1: It is a great pleasure to have you on your
Speaker 1: newest book called The Covenant of Water. I imagine it's
Speaker 1: a New York Times bestseller and been kind of all
Speaker 1: over the best seller charts. And Oprah is over the
Speaker 1: moon about this book. She thinks it's one of the
Speaker 1: best books she has ever ever read, and that's pretty
Speaker 1: high praise from somebody who does a lot of reading.
Speaker 1: So I'm excited to discuss your work with you. But
Speaker 1: before we get into that, we'll start like we always do,
Speaker 1: with a parable. There's a grandparent who's talking with their
Speaker 1: grandchild and they say, in life, there are two wolves
Speaker 1: inside of us that are always at battle. One is
Speaker 1: a good wolf, which represents things like kindness and bravery
Speaker 1: and love, and the other's a bad wolf, which represents
Speaker 1: things like greed and hatred and fear. And the grandchild
Speaker 1: stops think about it for a second. They look up
Speaker 1: at their grandparent, they say, well, which one wins, and
Speaker 1: the grandparent says, the one you feed. So I'd like
Speaker 1: to start off by asking you what that parable means
Speaker 1: to you in your life and in the work that
Speaker 1: you do.
Speaker 3: Yeah, I'd never heard that before, and it really was
Speaker 3: thought provoking. Maybe because of my background, I immediately thought, well,
Speaker 3: it's going down one mouth, one esopha goes into one's stomach,
Speaker 3: even if two beace. I'm sure you've heard that before,
Speaker 3: you know. I really feel that you inevitably feed both
Speaker 3: pieces and the challenges finding a way to sort of
Speaker 3: use the energy of the so called bad wolf because
Speaker 3: you need both. I don't think that we are destined
Speaker 3: to be angels in this world, and sometimes it's the
Speaker 3: darkness that informs the light.
Speaker 1: Absolutely absolutely is. Maybe we'll use that as a jumping
Speaker 1: off point to one of the places I wanted to go,
Speaker 1: and I wanted to talk about an earlier book of
Speaker 1: yours called The Tennis Partner. It's a book about a
Speaker 1: deep friendship you formed with somebody who also happened to
Speaker 1: be an intravenious drug addict. And I used to be
Speaker 1: that myself. I was a heroin Addict when I was younger,
Speaker 1: and so I was really interested in that Covenant of
Speaker 1: Water was pretty long. I didn't give me a chance
Speaker 1: to read a whole bunch of your other stuff. I'd
Speaker 1: read Cutting for Stone in the past. I now really
Speaker 1: want to read The Tennis Partner. But I was wondering
Speaker 1: if if you could share what it was like to
Speaker 1: be in close relationship with somebody who was self destructing.
Speaker 3: Yeah. I think it was, you know, extraordinarily humbling for me,
Speaker 3: because by then I was a practicing physician attending on
Speaker 3: the wards, and I really thought I understood addiction, you know,
Speaker 3: But I don't think that I really did. At some level.
Speaker 3: My friendship with my former medical student who was a
Speaker 3: former tennis professional, and so you know, on the wards
Speaker 3: I was his teacher. On the courts, he was mine,
Speaker 3: and then at some point him telling me about his
Speaker 3: past and then eventually relapsing. It was so humbling. And
Speaker 3: I had the opportunity to visit one of the many
Speaker 3: places where physicians almost exclusively are being treated in large groups,
Speaker 3: and to see, you know, these very distinguished people in
Speaker 3: a big, giant AA circle fessing up the most amazing stories.
Speaker 2: I immediately sort of.
Speaker 3: Viscerally got it that this was really not about some
Speaker 3: sort of moral weakness temptation. I know this is a disease,
Speaker 3: and you know, I'm embarrassed to say that something that
Speaker 3: I should have understood maybe fifteen years before. That only
Speaker 3: really hit me then that, you know, these people were
Speaker 3: powerless under this disease, and when they were confronted as physicians,
Speaker 3: their first reaction was intense shame and that dangerous moment
Speaker 3: they could be suicidal, the often are, But the second
Speaker 3: was a relief because they knew that they were powerless.
Speaker 3: So I learned so much about addiction and you know,
Speaker 3: applied it to my own life in many ways. But
Speaker 3: it was a tragic and yet a very insightful story
Speaker 3: for me.
Speaker 1: It is extraordinarily humbling working with addicts. I got sober,
Speaker 1: and you know, we're taught to help other people, and
Speaker 1: you just realize, like it doesn't matter what you do,
Speaker 1: you're not going to help everyone. I've lost way too
Speaker 1: many people over the years, you know who didn't make it.
Speaker 1: You know, my best friend who's the editor of this show,
Speaker 1: has gone through several battles with sobriety. While I've been
Speaker 1: in sobriety. I've been in sobriety a long time, and
Speaker 1: the most recent one, I mean I really thought like,
Speaker 1: I don't think he's going to make it, you know,
Speaker 1: And the guy listens to every single podcast episode I do,
Speaker 1: which are intended to help people. I'm like, it's not
Speaker 1: doing anything. It's so humbling, you know, like nothing I
Speaker 1: can do here, you know, despite all my knowledge, all
Speaker 1: my understanding, all my compassion. It's not to say that
Speaker 1: we don't have a role and that we don't influence,
Speaker 1: but ultimately it is something that is beyond us.
Speaker 3: That was the hardest thing for me to really digest
Speaker 3: is that inevitably all of us around David, our well
Speaker 3: meaning efforts, were in a funny way, enabling him and
Speaker 3: my epiphany towards the end of the book and towards
Speaker 3: the end of his shortened life. I must tell you
Speaker 3: was you know, ultimately David was responsible for David. You
Speaker 3: know that there was only so much we could all
Speaker 3: do you know who knew more about his addiction than
Speaker 3: he did. Yeah, it's a hard journey.
Speaker 1: Yeah, And an addiction is just so remarkably complex. It's
Speaker 1: a syndrome almost more than anything else. It has multiple causes,
Speaker 1: it's multivariate. I mean, there's just so much that goes
Speaker 1: into it and why some people are able to get
Speaker 1: sober and others not. If there is a creator who
Speaker 1: created all this and has something behind it, and I
Speaker 1: get a chance to have a conversation with them after
Speaker 1: squaring away some fairly fundamental universal basics, my top question
Speaker 1: is like, why do some people get sober and others don't?
Speaker 4: Like?
Speaker 1: What is it? And people will put forth all kinds
Speaker 1: of theories about it, but none of it really explains
Speaker 1: what is fundamentally a mystery to me.
Speaker 3: Yeah, this might interest you. The good news in physicians
Speaker 3: with addiction is the incentive to sobriety is so huge
Speaker 3: because you lose your license, you're suspended, and unless you
Speaker 3: demonstrate sobriety you're not coming back, and then you're monitored.
Speaker 3: We are compassionate, but we're also firm, and so it's
Speaker 3: been nice to see that most physicians who go through
Speaker 3: treatment are successful long term. But it's very much because
Speaker 3: the livelihood depends on this, and I think that when
Speaker 3: you don't have those kind of incentives, it's maybe a
Speaker 3: little harder. I've also come to the feeling that we're
Speaker 3: all addicted. I mean it takes different shapes and forms.
Speaker 3: You know, you might not be addicted to alcohol or heroin,
Speaker 3: but it could be food, it could be sex, it
Speaker 3: could be reinforcement in other ways. So I think there's
Speaker 3: a degree of this where the good and bad wolf
Speaker 3: are always battling, is the bottom line?
Speaker 1: Eric, Yeah, yeah, totally, totally I agree. What did you
Speaker 1: learn about yourself through that process? What did you learn
Speaker 1: about you?
Speaker 3: Well, you know, it was a very painful time for
Speaker 3: me because I was going through a divorce. So in
Speaker 3: a curious way, our friendship, she's really quite deep on
Speaker 3: the courts and off the courts, was you know, a
Speaker 3: powerful reinforcement of myself. You know, I think men don't
Speaker 3: really write or talk adequately about their deepest friendships, which
Speaker 3: I think are as valuable as anything else. You know,
Speaker 3: you only realize how valuable when you lose it. Just
Speaker 3: like health, women write eloquently about their friendships. Gay men do,
Speaker 3: but we tend to couch them in sporting metaphors. You know,
Speaker 3: my tennis buddy, my football buddy, and so to me,
Speaker 3: it was really about rediscovering who I was. In a sense,
Speaker 3: entering this sobriety journey with him. You know, I had
Speaker 3: my own sort of issues. They were very similar, not addiction,
Speaker 3: but you know, here I was in a mess in
Speaker 3: my life, not what I had planned. And a lot
Speaker 3: of it comes back to you, know, to you, you
Speaker 3: are ultimately responsible. You know, I have to forgive, you
Speaker 3: have to move on, you have to acknowledge the higher power.
Speaker 3: All the things that he was going through I completely
Speaker 3: related to.
Speaker 1: You write eloquently about medicine in general. It's a topic
Speaker 1: in a lot of your books. I mean, it's a
Speaker 1: huge topic. You've done ted talks, You've done a lot
Speaker 1: of different things around medicine. And there's an idea that
Speaker 1: has shown up in your work in a few different
Speaker 1: places that I would love to explore, and it's the
Speaker 1: idea of healing versus curing. Can you say more about that?
Speaker 2: Sure?
Speaker 1: Yeah?
Speaker 3: I mean, first of all, I write about medicine because
Speaker 3: I think of medicine as life plus plus. I mean,
Speaker 3: what is medicine but life at its most acute, it's
Speaker 3: most intensely observed. But yeah, I mean I think that
Speaker 3: this concept healing versus curing, I always try to convey
Speaker 3: to my students, because you know, if you break your
Speaker 3: little finger, at one level, it's a you know, it's
Speaker 3: a fracture of your middle phalanx. It's not displaced, it's aligned.
Speaker 3: But another level, it's why me, why now on the
Speaker 3: eve of my big match or my big whatever. So
Speaker 3: I think every illness has the sort of spiritual component,
Speaker 3: and with diseases like HIV or cancer, that second part,
Speaker 3: that sense of violation of your spirit is huge, the
Speaker 3: hy me part. And I often think that in Western
Speaker 3: medicine we've done a great job of addressing the physical part,
Speaker 3: the fracture, but not necessarily addressing the spiritual violation. The
Speaker 3: example I use with my students is, you know, if
Speaker 3: you were to go home after this and find that
Speaker 3: your front door is open, all your valuables missing, your
Speaker 3: belonging strewn around, you've been robbed. At one level, you've
Speaker 3: lost stuff valuable to you. But there's also second kind
Speaker 3: of injuries, like someone came into my precious space and
Speaker 3: violated the sanctity. And if the cops come by a
Speaker 3: few hours later and say we caught the person, here's
Speaker 3: all your stuff back, you are cured, but you are
Speaker 3: not necessarily healed. You might even move out of that
Speaker 3: apartment just because how weird that feels. And I think
Speaker 3: I write a lot about the need for us to
Speaker 3: express caring in medicine, which I think is sort of
Speaker 3: a timeless idea. It's unchanged since antiquity. Someone in distress
Speaker 3: turns to you as a human being. They don't want machines, robots,
Speaker 3: they want a human to be the face of this
Speaker 3: care they're going to receive.
Speaker 1: Yeah, my mother, she's eighty years old. She's a chronic
Speaker 1: back pain. And we did a back surgery for her
Speaker 1: mid June, which was a risky thing to do, but
Speaker 1: life was terrible. Things did not go well. The sheath
Speaker 1: that holds a spinal fluid rupture. She had to be
Speaker 1: put on a spinal drain. Then she got an infection.
Speaker 1: They had to go back in and cut out the infection. Anyway,
Speaker 1: this is a seven week process. We are in the
Speaker 1: hospital and it is amazing how different the experience is.
Speaker 1: When you have someone who is really kind, it feels
Speaker 1: like ten times more important than it does in normal life.
Speaker 1: Just kindness, you know, the people sweeping the room, or
Speaker 1: the medical assistance, or the nurses themselves. I mean their
Speaker 1: kindness gets a lot of people through what's a really
Speaker 1: difficult experience, because I think you're absolutely right. Anything that
Speaker 1: is going on physically with us has a mirror emotionally
Speaker 1: and mentally. There's a story we're telling ourselves about it,
Speaker 1: there's fears that we have about it, and both those
Speaker 1: actually need to be pretty well managed in order to
Speaker 1: heal and get through. And you know, in a hospital, rightfully,
Speaker 1: so they're focusing on the medicine part. But when the
Speaker 1: kindness comes with it too. Having just lived this, it
Speaker 1: makes such a difference. It almost chokes me up every
Speaker 1: time somebody does it in the hospital because it feels
Speaker 1: so important.
Speaker 3: Yeah, you said that so well. I mean, my medical
Speaker 3: schooling was interrupted by civil war in Africa, where I
Speaker 3: was born, and I began, and I wound up working
Speaker 3: as an orderly or a nursing assistant in a hospital
Speaker 3: in Ryton Valley, New Jersey for a year and a half.
Speaker 3: And I look back on that now as the most
Speaker 3: valuable medical training I ever had, because I really saw
Speaker 3: what happens to the patient in the twenty three hours
Speaker 3: and fifty seven minutes that doctors are not in the room. Yep,
Speaker 3: you know, And it's given me a real solidarity with
Speaker 3: the nursing profession because I think that that's where care
Speaker 3: is expressed. You know, I had a hernie operation Iowa
Speaker 3: a long time ago, and after my surgery in the evening,
Speaker 3: one of those classic nurses with the nursing cap, you know,
Speaker 3: she checked me out and then she said, I'm going
Speaker 3: to give you a BackRub and brought some lotion rubbed
Speaker 3: my back and you know, there was nothing biologically that
Speaker 3: that BackRub was going to do for my discomfort, but
Speaker 3: it was the most powerful thing that I ever felt.
Speaker 3: I'll never forget that. I mean it is, yeah, probably
Speaker 3: unfashionable now, but you know, that's what nursing was like.
Speaker 3: And I think physicians should pick up a lot of that.
Speaker 3: And I think I try to voice that it's almost
Speaker 3: not unethical, but it's considered like it should be talking
Speaker 3: about this stuff. But you know what you should be
Speaker 3: These are human beings. This is what they want. They
Speaker 3: want kindness, they want care.
Speaker 1: Yeah. Yeah, there's a story somewhere from your past about
Speaker 1: you're the doctor leading rounds and there's a patient who
Speaker 1: has soiled the bed. You want to share that story.
Speaker 1: I just think it sort of brings to life what
Speaker 1: you're talking about here.
Speaker 3: Yeah, I think it's not uncommon amongst physicians of our
Speaker 3: generation that we felt much more of a solidarity with
Speaker 3: the nursing profession than I think it's possible now because
Speaker 3: of all the busyness around the hospital. But you know,
Speaker 3: the patient while we were there arounding, had obviously soiled
Speaker 3: themselves and I was about to say something, and the
Speaker 3: nurse steps in and says, do you all smell poop?
Speaker 3: And she and I sort of stepped forward and helped
Speaker 3: to change the patient, which is there's a method to it,
Speaker 3: and if you have two people, that's easy and quick.
Speaker 3: And you know, after all, the patient this way, that way,
Speaker 3: and probably a lesson that my students never forgot. So
Speaker 3: you know, we took a step forward and they recoiled.
Speaker 3: But I hope that memory lingers with them as it
Speaker 3: does for me.
Speaker 1: Yeah. Yeah, it's a beautiful story of just leading by example.
Speaker 3: It's about Karen. That's how it was fresh. Yeah.
Speaker 1: So a question for you. In your book, the main
Speaker 1: character doctors tend to be surgeons, and I don't think
Speaker 1: you are a surgeon by trade? Why is that?
Speaker 3: Yeah, I'm not a surgeon, So it's an interesting story.
Speaker 3: I thought I was going to be a surgeon. I
Speaker 3: had a wonderful mentor in medical school the second time
Speaker 3: around in India, and and you know, we got to
Speaker 3: do a lot of surgery. And ultimately when I came
Speaker 3: to the United States, you know, and I loved everything
Speaker 3: in medicine, pediatrics, and just about everything. In America in
Speaker 3: nineteen eighty they had a pyramidal surgical residency structure where
Speaker 3: they took maybe ten people, you know, seven would make
Speaker 3: it to the second year, five to the third year.
Speaker 3: We had to get to the fifth year. And it
Speaker 3: was very famous that foreign graduates would be spit out
Speaker 3: at the second and third year level. And I wasn't
Speaker 3: prepared to waste my time. And I loved it in
Speaker 3: general medicine just as much. But I think surgery never
Speaker 3: lost its romance for me. And it's inherently colorful. I mean,
Speaker 3: I could and I do write about things like leprosy
Speaker 3: and the Covenant of Water. But there's something about that,
Speaker 3: you know, the act of surgery that is inherently dramatic,
Speaker 3: just like a police procedure or spycraft. You know, it
Speaker 3: gets the reader's attention. It certainly has my interest, and
Speaker 3: it's much more interesting for me to research surgical stuff
Speaker 3: and hang out with my surgical colleagues and vicariously, you know,
Speaker 3: lived that surgical life that I never chose.
Speaker 1: You mentioned leprosy there, and leprosy is a big, if
Speaker 1: I want to say, a big part. It plays a
Speaker 1: pretty big role in your latest novel. And I learned
Speaker 1: something that I did not know, which was that leprosy
Speaker 1: the reason people's flesh is falling off is not because
Speaker 1: the disease is rotting away their flesh. It's that they
Speaker 1: can't feel anything, and so they just do things to
Speaker 1: their body that eventually just causes it to I mean,
Speaker 1: fall apart or fall away. Do I have that correct?
Speaker 2: Yeah?
Speaker 3: In fact, I'm surprisingly even though leprosy is such an
Speaker 3: ancient disease, you know, mentioned in the Bible, it's a
Speaker 3: very recent insight. A famous hand surgeon an India, Paul Brown,
Speaker 3: he may not be the first, but he probably was
Speaker 3: the first to write about it. He was just puzzled
Speaker 3: why his patients, despite dressing their wounds, you know, just
Speaker 3: kept losing fingers and you know, losing toes. And he
Speaker 3: was driving by the place where the lepers were living
Speaker 3: and he saw a leper missing fingers, clumsily trying to
Speaker 3: flip chapati, you know, like a tortilla, and struggling with
Speaker 3: the spatula, and then finally she just sort of reached
Speaker 3: in there with their bare hands and flipped it over,
Speaker 3: and he realized that it was let proceeds primarily a
Speaker 3: disease of skin and nerves, and it's the nerve damage
Speaker 3: that renders them insensible to pain. In a sense, it's
Speaker 3: like diabetes and what happens with the diabetic foot and
Speaker 3: people getting ulcers and amputations. When you don't feel, you
Speaker 3: injure yourself. And the book that Paul Brown wrote is
Speaker 3: called The Gift of Pain. And really, in a way,
Speaker 3: pain is a gift because it protects us from noxious stimuli,
Speaker 3: and you lose that and you begin to traumatize yourself.
Speaker 3: So I always find it amazing that it was such
Speaker 3: a recent insight. We're talking about the early nineteen hundred
Speaker 3: is not when it should have been.
Speaker 1: Yeah, talk more about the Gift of pain in a
Speaker 1: broader psychological or spiritual sense.
Speaker 3: You know. One of the interesting critiques of my book
Speaker 3: book has been that all my characters seem to be
Speaker 3: good people or two good people. They're not many villains
Speaker 3: in my book. And I always sort of push back
Speaker 3: on that, first of all, because the public clearly doesn't
Speaker 3: mind that they're reading public, you know. They seem to
Speaker 3: enjoy my characters, especially like the strong heroic women. You know,
Speaker 3: heroic in the sense that it's sort of an unheralded heroism.
Speaker 3: It's the quiet heroism of people like my grandmother, who
Speaker 3: the world will never know about, but in her own way,
Speaker 3: she lived this heroic life. But I always think that
Speaker 3: my characters are not necessarily perfect people, but they are
Speaker 3: like most of us, working towards redemption. We are deeply
Speaker 3: flawed people who made terrible mistakes at times. But I
Speaker 3: think it's this wonderful human instinct to make it right
Speaker 3: to do good. And I think I have a lot
Speaker 3: of that in the book. And to me, pain of
Speaker 3: maybe your own acts of a mission or commission is
Speaker 3: often what drives you in later years to the right path,
Speaker 3: to the right action, you know. So it's not as
Speaker 3: simple as good and evil, you know. I think Lee Marvin,
Speaker 3: the wonderful actor who was well known for all his
Speaker 3: bad guy roles, was once asked, mister Marvin, why do
Speaker 3: you keep playing all these bad guys? And his answer was, Son,
Speaker 3: I've never played a bad guy in my life, and
Speaker 3: that's exactly it. You know, he would embrace these characters
Speaker 3: and the world might perceive them as bad, and so
Speaker 3: no one is inherently bad. We just sort of I mean,
Speaker 3: of course there are exceptions, but we do our best
Speaker 3: and sometimes we're deeply mistaken about what we think we're
Speaker 3: doing and then we regret it. Yeah, so I believe
Speaker 3: in that pain in that sense.
Speaker 1: Yeah, it's interesting because, yeah, most people that we might
Speaker 1: think of as doing something bad, they don't think they are,
Speaker 1: like in their mind. It makes perfect sense. And I
Speaker 1: was also thinking about what you just said about you know,
Speaker 1: your characters being essentially good. They are, And I think
Speaker 1: the more get to know a particular character or person,
Speaker 1: the more we understand their behavior, right, the more we
Speaker 1: understand why they're doing that. I mean, I'm a big
Speaker 1: believer in the hurt people. Hurt people. You know, if
Speaker 1: you're a hurt person, you're going to pass that on
Speaker 1: unless you heal it. And then if you heal it,
Speaker 1: you know, people who are healed actually help heal other people. Again,
Speaker 1: there are exceptions to everything, of course, but that feels
Speaker 1: broadly very true to me.
Speaker 3: Yeah, no, I completely agree. I mean, we've never been
Speaker 3: more divided as a nation, and especially in my field medicine,
Speaker 3: infectious disease, you know, all the vaccine anti vaccine. It
Speaker 3: takes some effort to get past the rhetoric and understand
Speaker 3: why do people feel the way they do, rather than
Speaker 3: just label them as they're the bad guy since they
Speaker 3: don't think the way I do. People have their reasons,
Speaker 3: and you know, it was just painful to watch people
Speaker 3: dying essentially because they didn't believe in vaccines, and not
Speaker 3: watching this firsthand, but you had to admire or accept
Speaker 3: the fact that this is indeed what they believed. It
Speaker 3: was part of their complexity, and you know, you couldn't
Speaker 3: condemn them, you could just be there.
Speaker 1: Yeah, I think that is one of the hardest things
Speaker 1: to do for me, is to be a person who
Speaker 1: has strong values about certain things, a strong belief in
Speaker 1: the way we should treat each other in different things
Speaker 1: when people aren't doing that, in my mind, to still
Speaker 1: see them as human that's the wrong way to say.
Speaker 1: Of course I see them as human, but to have
Speaker 1: some degree of compassion, some degree of understanding, because if
Speaker 1: we don't, we don't change each other's mind by yelling
Speaker 1: at each other. It just doesn't work. I don't think
Speaker 1: it's ever worked, and I don't think it's ever going
Speaker 1: to work.
Speaker 3: Right.
Speaker 1: We change each other's mind by beginning to understand each
Speaker 1: other and show each other things that maybe we're not seen.
Speaker 1: And there's just not much room for that in the
Speaker 1: world today.
Speaker 3: Yeah, well, that was something that I painfully realized during COVID,
Speaker 3: is that you're not going to change people's opinions by
Speaker 3: facts alone. You have to recognize that, you know, people
Speaker 3: want to hear certain things even if the facts are
Speaker 3: against it, for reasons that are to do with their
Speaker 3: own self interests that are easy to understand. You know,
Speaker 3: if you're a business person, you don't want to hear
Speaker 3: about closures for COVID, you don't want to hear about
Speaker 3: things that keep people from coming to your business, you know,
Speaker 3: so you will latch onto things that are supporting your
Speaker 3: point of view the facts, you know for a and
Speaker 3: this is what demagogues can do so well. They can
Speaker 3: tap into, you know, the desires of people, even if
Speaker 3: they are contrary to the reality that's just life.
Speaker 1: Yeah, you have a lot of dog pictures on your Instagram.
Speaker 1: You're posting pictures of people's dogs. I'm just kind of
Speaker 1: curious what that's all about.
Speaker 3: Just dogs, it's also cats. There's quite a few cats.
Speaker 1: Okay.
Speaker 3: It happened by accident. A friend of mine who you
Speaker 3: to have a lovely labrador, and I actually painted a
Speaker 3: little watercolor portrait of her lab and the lab passed
Speaker 3: away and she's retained that picture. So with her new dog,
Speaker 3: she sent me a picture of her dog, you know,
Speaker 3: with the book, and just got me going. So I
Speaker 3: began to solicit and get more picks like that, you know.
Speaker 3: But I love dogs. I have less experience with cats
Speaker 3: because one of my family members was allergic, so we
Speaker 3: never had cats. But I heard somewhere some all saw
Speaker 3: that if you have a story that's about a doctor
Speaker 3: and a dog, you're in good shape. Don't ask me why.
Speaker 1: Where you say somewhere that what is it? A dog
Speaker 1: lives for you, a cat just lives with you.
Speaker 3: I didn't really invent that. I think I heard that
Speaker 3: from somebody else. Also, Yeah, a dog lives for you,
Speaker 3: a cat lives with you. But I also think that
Speaker 3: dogs are wonderful emulators of how we might be. You know,
Speaker 3: treats every goodbye as though it's forever, you know, voice
Speaker 3: when someone shows up and opens the door, you know,
Speaker 3: and they are living accelerated lives. They have a lifespan
Speaker 3: that's so short compared to ours that every day is
Speaker 3: a week for them. And boyd, they live there days
Speaker 3: fully and lot to be learned from them, lot to
Speaker 3: be learned.
Speaker 1: Yeah, we're recording this on a Wednesday, and on Friday,
Speaker 1: which is two days from now, I have to put
Speaker 1: one of my beloved dogs to sleep.
Speaker 3: It's time.
Speaker 1: Yeah, it's hard, but you know this idea of the
Speaker 1: grief being a sign of the great love, you know,
Speaker 1: and grieving a dog is easier to grieve than many
Speaker 1: different things in life because it's pretty uncomplicated, you know,
Speaker 1: Grieving a breakup, there's a lot of complexity. Even grieving
Speaker 1: a past parent, there's a lot of complexity right because
Speaker 1: of the relationship. But a dog, for me is it's
Speaker 1: an tremendous amount of pain, but it's a very clean
Speaker 1: kind of pure pain.
Speaker 3: Well, I hope you feel that we have to Friday
Speaker 3: because it may be true, but it's going to be profound,
Speaker 3: as you know.
Speaker 1: Yeah, I've put two other dogs to sleep in like
Speaker 1: the last four years, so they just all aged out
Speaker 1: in a rough timeframe. Oh, I have no doubt of
Speaker 1: what's coming. I'm already feeling it and have been for months.
Speaker 1: So I don't mean to say that like it's easy.
Speaker 1: I just mean it's a lot easier just to focus
Speaker 1: on the love.
Speaker 3: I get you. They give you unconditional love, so you
Speaker 3: can just warn them. There's no need for anything else.
Speaker 3: I get it.
Speaker 1: Yeah, yeah, Well, I have a kindle version of your book.
Speaker 1: I wish I had the hardcover because I would take
Speaker 1: a picture of my baby beansy and the book and
Speaker 1: send it to you. But if you get at I
Speaker 1: don't know. I've got the hard copy. You said somewhere.
Speaker 1: I'm fascinated by knowledge, but I'm more fascinated by wisdom. First,
Speaker 1: I guess, how do you tell the difference between the two,
Speaker 1: and what is wisdom to you?
Speaker 3: There's a lot of data these days, you know, and
Speaker 3: there's a prevalent notion that, especially in medicine, that more
Speaker 3: data is better. But I'm not necessarily sure that's true.
Speaker 3: You know, sometimes more data, I mean, it's just more noise,
Speaker 3: more in attention to the telling details that really matter.
Speaker 3: The way they manifest in medicine is, you know, people
Speaker 3: haven't really listened to the story, they haven't really looked
Speaker 3: at the patient, but they have these reams of tests
Speaker 3: and stuff that have been done in almost a thoughtless fashion.
Speaker 3: You know. So I think sometimes data is an illusion.
Speaker 3: I mean, in general, as a scientist, I think the
Speaker 3: more data is the better, but sometimes not. There's a
Speaker 3: very influential book I read some years ago by a
Speaker 3: wonderful sort of ecologist thinker at Oberlin University, David Or
Speaker 3: and it's called The Art of Design, and it was
Speaker 3: talking about the sort of dichotomy between wisdom and knowledge.
Speaker 3: And they use an example in Indonesia of a village
Speaker 3: that had their rice planting based around the temple. The
Speaker 3: temple was the center of the village. The rice was
Speaker 3: planted or around it. There were rituals about when the
Speaker 3: plant went to Harvard, when to leave the landfallow. And
Speaker 3: then the WHO or sub organization came in with a
Speaker 3: high yield American rice and you know, tremendous productivity, but
Speaker 3: they wound up not only burning out the soil after
Speaker 3: ten years but destroying the social infrastructure of the village
Speaker 3: because it was more than about rice. And so I
Speaker 3: think we do that to ourselves in many different ways,
Speaker 3: in many different parts of our society. But I can
Speaker 3: only speak for medicine, where you know, increasingly so many
Speaker 3: people are feeding off this lucrative truugh that is medical care.
Speaker 3: You know, trillions of dollars in this twenty percent of
Speaker 3: our GDP almost and we're all excavating from this, and
Speaker 3: what really matters, the human connection, is increasingly getting lost,
Speaker 3: and you know, if we don't have that, what do
Speaker 3: we have.
Speaker 1: You did a ted talk about how important the physical
Speaker 1: exam of a patient is, both for what you can
Speaker 1: find out and the healing that we talked about earlier,
Speaker 1: this being in contact with another human. And there's a
Speaker 1: couple of pictures you show in there that I thought
Speaker 1: were really telling, and one sort of showed hospital rounds
Speaker 1: and the way we have traditionally thought of them, which
Speaker 1: is a group of doctors gathered around the patient's bed.
Speaker 1: And then you showed another picture which is where more
Speaker 1: and more hospital rounds happen, which is a group of
Speaker 1: doctors gathered around a computer and the patient isn't even there.
Speaker 1: Their data is there, to your point, but they're not.
Speaker 3: You know, first of all, I want to make sure
Speaker 3: that I don't come across as a luddite. I think
Speaker 3: that we're far better off than that black and white
Speaker 3: picture of you know, I think it was from the
Speaker 3: fifties or so.
Speaker 2: Right.
Speaker 3: Yeah, But the fact is, we have so much data.
Speaker 3: But what it has done is that come at the
Speaker 3: expense of our being at the pet side. It's almost
Speaker 3: as though the patient is an afterthought. I got into
Speaker 3: some hot water for writing a piece in the New
Speaker 3: Journal of Medicine where I said that the patient was
Speaker 3: merely an icon placeholder for the real patient who was
Speaker 3: in the computer, and I called it the eye patient.
Speaker 3: That's where I got into trouble because you know, like
Speaker 3: your iPhone, your iPad, I called, you know, the iepatient
Speaker 3: gets wonderful treatment all across America. The real patient often wonders,
Speaker 3: you know, where the heck is everyone? When are they
Speaker 3: going to talk to me? When are they going to
Speaker 3: tell me what's going on? Just to make clear, I
Speaker 3: think my generation allowed this to happen on our watch.
Speaker 3: We allowed the sort of creep of the computer and
Speaker 3: the taking us away from the bedside, and it's been insidious,
Speaker 3: and I'm just so pleased to see the new generation
Speaker 3: pushing back hard. But you know, we have to find
Speaker 3: the right balance. We need the data, we need all
Speaker 3: these tests, but not so many of them. But we
Speaker 3: also need the sanctity of listening to that person examining them,
Speaker 3: because the patient wants to feel that you've located the disease,
Speaker 3: not on some X ray somewhere, not on a biopsy report,
Speaker 3: but on their body. And I think it's by talking
Speaker 3: to them and by examining them that that process happens.
Speaker 3: You know, I don't want to commit myself to some
Speaker 3: sort of radiation and chemo based on some report somewhere.
Speaker 3: I want to feel like a human being I trust
Speaker 3: gave me the news and located it on me, and
Speaker 3: you know, together we entered this journey.
Speaker 1: Yeah. I mean, I think data is, to your point,
Speaker 1: is not a problem. Actually it's a good thing. However,
Speaker 1: we can only process so much information about any one thing, right,
Speaker 1: And we see this in information overload, right, just broadly
Speaker 1: in culture. Is I just get so much that I
Speaker 1: don't even know what's important anymore. None of it actually
Speaker 1: sinks in none of it actually becomes actionable, none of
Speaker 1: it changes me or who I am. It's just more
Speaker 1: and more and more. It's like the opportunity cost, right,
Speaker 1: the opportunity cost of all that data is other things
Speaker 1: that I could be giving my attention to you, and
Speaker 1: like you, I tend to be a pretty firm believer,
Speaker 1: Like we got to find a middle ground on all
Speaker 1: this stuff.
Speaker 3: Yeah, it's actually a very interesting time in medicine talking
Speaker 3: about data because of AI. I mean, we have AI
Speaker 3: algorithms that can look at test X rays and you know,
Speaker 3: they're rapidly learning and getting better and better machine learning
Speaker 3: and you know, so on, so that they're calling diabetes
Speaker 3: on X rays. They're calling out things we didn't think
Speaker 3: an extra could tell us. But they're actually processing massive
Speaker 3: amounts of data and you know, we actually can now
Speaker 3: know what it is. They were looking for a fair
Speaker 3: degree of accuracy, they're making predictions. So I think that
Speaker 3: we have already reached our data limits. And you know,
Speaker 3: if you have a chart this thick, which is not
Speaker 3: uncommon for you know, many patients with multiple diseases, sometimes
Speaker 3: we're missing patterns and I think AI can help us
Speaker 3: extricate some of those, but what I hope most of
Speaker 3: all is right now, we are the highest paid clerical
Speaker 3: workers in the hospital, spending so much time on the
Speaker 3: computer entering data for billing purposes, and that's what we do.
Speaker 3: And if AI could remove that and should be able
Speaker 3: to nature language processing, should be able to capture what
Speaker 3: we're saying and fill the chart out, I'm hopeful that
Speaker 3: finally we can spend more time doing what we want
Speaker 3: to do, what we're supposed to do, and that is
Speaker 3: talk to people, be with them.
Speaker 1: You said somewhere that few doctors will admit this, but subconsciously,
Speaker 1: in entering the profession, we must believe that ministering to
Speaker 1: others will heal our woundedness. And it can, but it
Speaker 1: can also deepen the wound. I'd love to know, if
Speaker 1: you're open to sharing, do you have a sense of
Speaker 1: what your woundedness was that drove you into medicine, And
Speaker 1: I'd love to hear a little bit about how the
Speaker 1: practice of medicine can both heal that and how it
Speaker 1: can also make it worse.
Speaker 3: Yeah, I think that many of us, not just in medicine,
Speaker 3: but in life. You come out of childhood and unless
Speaker 3: you're really fortunate, you can feel not okay. And I
Speaker 3: had no particular reason to not feel okay. I had,
Speaker 3: you know, lovely parents and great siblings. But for whatever reason,
Speaker 3: you can feel wounded. I think that that's maybe it's
Speaker 3: not universal, but it's pretty uncommon, and very often I
Speaker 3: find that people view medicine this noble thing that you
Speaker 3: enter to in a sense absolves you, and you know,
Speaker 3: sort of allows you to take on this mantle that
Speaker 3: makes your inadequacies, your woundedness go away, and the double
Speaker 3: edged sword there is that. Too often you can, you know,
Speaker 3: get this illusion that somehow, since I'm ministering to people,
Speaker 3: nothing can happen to me. The phenomenon of addiction amongst
Speaker 3: physicians comes from just that kind of humorous the sense
Speaker 3: that you know, I prescribe these medications all the time,
Speaker 3: but since I know so much about them, if I
Speaker 3: pop one, it's not going to hurt, you know. And
Speaker 3: one of the most memorable things I ever heard was
Speaker 3: a neurosurgeon who you know, was in one of these
Speaker 3: rehab places and had been caught. His addiction was such
Speaker 3: that he was visiting patients and stealing drugs from their
Speaker 3: medicine cabinets. And he talked about the time that he
Speaker 3: had never used a paint pill, had no occasion to.
Speaker 3: He had gone to a colleague for some back pain,
Speaker 3: and you know, with anybody else that colleague might have said, well,
Speaker 3: how's your marriage, how much are you drinking? How much
Speaker 3: wead are you smoking? But with a fellow physician, he
Speaker 3: just gave him some town all with codeine, and physician
Speaker 3: took it and he said, I felt this huge weight
Speaker 3: that was on my chest just slide up. You know.
Speaker 3: So you have these in obsessive, compulsive types, hard working
Speaker 3: types willing to put up with the sacrifice medicine needs,
Speaker 3: and there's sort of a cumulative injury that takes place.
Speaker 3: And you know, perhaps if they had dealt with their
Speaker 3: woundedness early on, not take an undismantle prematurely, they might
Speaker 3: have prevented this. But I don't know that for a fact,
Speaker 3: But that is my sense that were often wounded, maybe
Speaker 3: a little more so than other people in other walks
Speaker 3: of life. I don't know, And medicine heals us and
Speaker 3: it certainly does. You know, on my worst day, I
Speaker 3: walk into the hospital and there are things I see
Speaker 3: that make my troubles feel like well, forget that.
Speaker 1: Yeah, I mean you could probably say, largely speaking, a
Speaker 1: huge amount of the psychologists and therapists out there are
Speaker 1: coming from a similar place. The wounded healer is an
Speaker 1: archetype for a reason. I mean, I do the work
Speaker 1: I do because of those things. You just said something
Speaker 1: there that I thought was really interesting, and it comes
Speaker 1: from your latest novel, The Covenant of Water. But it's
Speaker 1: talking about addiction and one of the characters goes through
Speaker 1: a period of opioid addiction, and you've got a line.
Speaker 1: I'm just going to read it. It does show a
Speaker 1: certain understanding to me of addiction, and in it they
Speaker 1: talk about the black pearl, which is just the opium, right,
Speaker 1: it's the opium that they get. Some might imagine the
Speaker 1: black pearl is the source for such inspiration, but that's absurd.
Speaker 1: The ideas are always there, but pain is the padlocked door,
Speaker 1: the stern gatekeeper locking them inside. The little pearl merely
Speaker 1: frees them, and the pen does the rest. They're talking
Speaker 1: about creativity and how that person sees opium as a
Speaker 1: source of creativity, and I think what you point to
Speaker 1: that's so true there is that I'm not sure that
Speaker 1: it puts anything into us creatively. As a musician, I
Speaker 1: had a strong belief in the creative abilities of drugs, right,
Speaker 1: And I think more importantly is they got past the
Speaker 1: pain in the padlocked door, and once that opened, then
Speaker 1: the ideas are there and they can flow. But this
Speaker 1: consciousness that is always sort of reducing and pain tends
Speaker 1: to reduce consciousness, right, mental or physical, It tends to
Speaker 1: shrink our world. When that sort of opens back up,
Speaker 1: we find oh there's a whole lot there.
Speaker 3: Yeah, but it's a slippery slope, as you know, because
Speaker 3: I think many drugs can unlock the gates so that
Speaker 3: you can your creativity, can express yourself. But then, you know,
Speaker 3: then you get to the point where there's a sense
Speaker 3: that I need the drug for the creativity. And you know, yeah,
Speaker 3: for the most part, smoking a joint might make you
Speaker 3: feel like your guitar playing is awesome. But if you
Speaker 3: ever but it's later, it's not quite as awesome as
Speaker 3: you thought at the time.
Speaker 1: You know, I've got lots of recordings that are a
Speaker 1: testament to that.
Speaker 3: My goodness, you know, I do think that our daily
Speaker 3: life is so full of gated and censored ways of
Speaker 3: looking at the world. We miss so much. We miss
Speaker 3: so much about yes, the sound of things, the feel
Speaker 3: of things, And I think a lot of times what
Speaker 3: drugs do is slow us down in a way that
Speaker 3: we should be able to accomplish from time to time
Speaker 3: without that. You know.
Speaker 1: Yeah, I am absolutely not, in any case advocating that
Speaker 1: you start doing OPIM so you become more creative. It
Speaker 1: turns bad for most of us. It doesn't work out well.
Speaker 1: But I thought that the insight of that pain gets
Speaker 1: opened up was a deep insight. And to your point,
Speaker 1: I think there are ways there. I've learned ways to
Speaker 1: get there. They're not as snap your fingers right as
Speaker 1: smoking a joint, but they also don't have the tremendous
Speaker 1: downside that for me, any sort of mind altering drug has,
Speaker 1: which is basically the ruination of my entire existence. It's
Speaker 1: pretty high price to pay to crank out a crappy
Speaker 1: three chord progression that you think sounds good at the time.
Speaker 1: When you put it in those terms, it's coming. Ah,
Speaker 1: this is not a good deal.
Speaker 3: You know. What was the most impressive thing to me
Speaker 3: about learning so much about addiction and I actually use
Speaker 3: it a little bit of it in the Covenant of
Speaker 3: water is the power of you know, the the AA circles,
Speaker 3: and you know, they managed to repopulate the isolated world
Speaker 3: of the addict, and they forced them to give up
Speaker 3: their secrets. But there's a line in Covenant and I
Speaker 3: thought you were going there where the mother observing her
Speaker 3: son in solid recovery, says, you know, and part of
Speaker 3: that is he goes to church prayers every evening, and
Speaker 3: she says, if there wasn't a god, he would invent one,
Speaker 3: you know. And I think that came straight out of
Speaker 3: my admiration for what, you know, addiction circles and A
Speaker 3: and A all those things do so well, you know,
Speaker 3: they restore, you know, sort of a higher consciousness that
Speaker 3: is so beneficial to that individual. I'm all for it.
Speaker 1: Yeah, that idea, if there wasn't a god, he'd invent
Speaker 1: one is a really tricky idea. Because I got sober
Speaker 1: at twenty four from a heroin addiction. I stayed sober
Speaker 1: about eight years, and I ultimately went back out and
Speaker 1: I never went back to the heroin, but I went
Speaker 1: back to drinking. And part of the problem for me
Speaker 1: was that I had built my spiritual foundation on something
Speaker 1: I didn't actually really believe in that I had invented
Speaker 1: I needed to have a higher power. I was told
Speaker 1: this is what it could be, and I just tried
Speaker 1: to believe in something I actually didn't And so when
Speaker 1: I came back, I was like, all right, I can't
Speaker 1: do that again. But I also do recognize the concept
Speaker 1: that believing in something greater than me is important for
Speaker 1: my recovery. So what might that be for me? What
Speaker 1: might that look like? And that can be a really
Speaker 1: beautiful journey if you embark on it in a truly
Speaker 1: wholehearted and curious way.
Speaker 3: Yeah, my thesis is that the higher power is us.
Speaker 3: It's within us. You know, I've never subscribed easily to
Speaker 3: that sense of external God or higher power. People make
Speaker 3: assumptions about me because of the nature of the book
Speaker 3: and the community, which is a very religious community that
Speaker 3: I'm you know, this proselytizer Christian, and you know I
Speaker 3: am a Christian. I love the tradition of our community.
Speaker 3: But my sense is all these things are within us,
Speaker 3: you know, in the sense that we're finding that higher power,
Speaker 3: we give it different labels, and these are metaphors for
Speaker 3: the two wolves that you're feeding and how you keep
Speaker 3: them in balance is all it is, is my sense,
Speaker 3: and we have different language for it.
Speaker 1: Yeah, So, given what you've just said there, some of
Speaker 1: the people in the book have a very strong faith.
Speaker 1: It's a prominent thing that stands out. Why did that
Speaker 1: feel like it was relevant or had to fit in
Speaker 1: there if it's not so much in alignment with you
Speaker 1: and your beliefs.
Speaker 3: Well, actually it is in ligne with me, in the
Speaker 3: sense that I was writing about this particular community from
Speaker 3: which I come, which is a Christian community in India,
Speaker 3: but not Christians converted by you know, the Portuguese and
Speaker 3: the fourteen hundreds, or the Brits in the fifteen hundreds.
Speaker 3: These are Christians who have traced their anxioustry to Saint
Speaker 3: Thomas the Apostle, arriving in fifty two AD. So it's
Speaker 3: an old Christianity, and it still has vestiges of the
Speaker 3: Hinduism that they embraced before they became Christians. And I've
Speaker 3: always been struck by people's sort of great joy in
Speaker 3: their ritual and their satisfaction in it, and how well
Speaker 3: it informs their life. I've been envious, to be honest,
Speaker 3: you know, I think I've always felt that my Hindu
Speaker 3: friends when they visit the temple and you know, the rituals,
Speaker 3: they never quested it the way I think I did.
Speaker 3: It was just something they did and gave them great comfort.
Speaker 3: And I think that quality of Christianity I've always found
Speaker 3: admirable in my parents, my grandparents, and in my case,
Speaker 3: my brother and I'm a older brother and I both
Speaker 3: had to say sit through these services that we didn't
Speaker 3: quite understand. They were in this language Syriac, you know,
Speaker 3: so it's for a child, It just made no sense
Speaker 3: at all, and we were growing up, you know, in
Speaker 3: a very different environment than my parents, so we both
Speaker 3: drifted away from that, and I find myself gravitating back
Speaker 3: to the ritual. I mean recently I went to a
Speaker 3: church in Fremont where they have the same service in
Speaker 3: Syriac that I heard as a child. I still don't
Speaker 3: understand a word of it. Nobody does except a priest.
Speaker 3: But you know, the hair on the back of my
Speaker 3: neck stood on end because it felt so familiar, and
Speaker 3: there was something rich about seeing, you know, this community
Speaker 3: around me. So you know, I think it really doesn't matter.
Speaker 3: Like Pascal said, you know, is there a God? Isn't
Speaker 3: there a God, is it this particular God. I think
Speaker 3: it's much more about the ritual and finding the best
Speaker 3: that's in us, whatever means you choose to do that.
Speaker 1: Yeah, I'm with you. I am envious often of people
Speaker 1: who have a certain type of faith, the underlying belief
Speaker 1: that they're a plan for everything, and that you know,
Speaker 1: like and that when I die, this in X, Y
Speaker 1: and Z is going to happen. I mean, it's an
Speaker 1: enormously comforting belief. I mean, if I could, I would
Speaker 1: certainly be like, sign me up. But I just can't.
Speaker 1: That doesn't mean, though that I haven't been able to
Speaker 1: find a deep and rich spiritual life. You know, for me,
Speaker 1: that path has largely been Buddhism and Zen Buddhism, but
Speaker 1: a variety of different things. You know, it's been the
Speaker 1: mystical traditions throughout all the faiths, you know, Hinduism and
Speaker 1: Christianity and Judaism and Buddhism. There's a mystical element which
Speaker 1: is about an experience right of some sort of connection.
Speaker 3: Well, that's really well said. I mean, so my misunderstanding
Speaker 3: perhaps of the Higher Power in AA was you know,
Speaker 3: my sense that it was really trying to step away
Speaker 3: from the finding that very closely and just leaving it.
Speaker 3: As you know, when I meditate, which I tried to
Speaker 3: do from time to time, one of the things I
Speaker 3: use is to ask myself, who is the one observing
Speaker 3: my brain chattering away that I'm trying to quiet down? Yeah, well,
Speaker 3: to me, that's the higher power, and maybe that my
Speaker 3: higher power is now my God, the Trinity, Jesus, all that,
Speaker 3: whatever it is, doesn't matter because it's that quiet observing
Speaker 3: part that's my chattering brain go on, yeah, you know,
Speaker 3: and lets me have this false control that I have,
Speaker 3: but it's not always right what I'm doing. And so
Speaker 3: that's what I thought. But you've just articulated something more
Speaker 3: profound than that. So that's really interesting for me.
Speaker 1: If you'll allow me to give you a little AA
Speaker 1: history because it's very interesting. Actually. So AA came out
Speaker 1: of something called the Oxford Group, which was a group
Speaker 1: in the thirties which was very very Christian, and it
Speaker 1: was largely a very Christian organization, right, I mean I
Speaker 1: got sober in nineteen ninety four in Columbus, Ohio. I mean,
Speaker 1: when people talked about God, they meant Jesus and God, right,
Speaker 1: like that version of it. But way back in nineteen
Speaker 1: thirty nine when they wrote the Big Book, they had
Speaker 1: the wisdom to use the word higher power and tack
Speaker 1: something onto the end of the third step, which was
Speaker 1: we turned our will in our lives over the care
Speaker 1: of God as we understood him. And those four words
Speaker 1: I think probably have saved countless lives because it gave
Speaker 1: the freedom and it came right from the part of
Speaker 1: AA's text. It gave the freedom to define those things
Speaker 1: in the way that you understand them. Now. Again, different
Speaker 1: groups are going to emphasize different things, but I don't
Speaker 1: think I would have gotten sober if those words weren't there.
Speaker 1: I think it would have been too big an ask
Speaker 1: for me. But I could say, Okay, what's my understanding
Speaker 1: of it? And so AA in its most pure form
Speaker 1: absolutely encourages that. Just depending on the group you're in
Speaker 1: and the community you're in and all that you know,
Speaker 1: there may be more or less openness to that. But
Speaker 1: I think there's a whole lot more openness to it
Speaker 1: today than there ever was. Right, I mean, AA is
Speaker 1: a different place than it was thirty years ago, forty
Speaker 1: years ago, I don't know, a long time ago. I'm
Speaker 1: not quite sure how old I am, but old.
Speaker 3: Enough two sense that is just as powerful today as
Speaker 3: it was, you know when doctor Bill and.
Speaker 1: Bob Doctor Bob and Bill Wilson. Yeah, I don't know
Speaker 1: that I can answer that, because it's something I've sort
Speaker 1: of drifted away from to some degree. But at its heart, yes,
Speaker 1: I think the fact that there are a lot of
Speaker 1: other options besides twelve step programs in today's recovery world
Speaker 1: is an unequivocally good thing, because it's not the right
Speaker 1: thing for everybody. But the core thing that they got
Speaker 1: figured out right from the very beginning was that one
Speaker 1: alcoholic talking to another healed both of them. And that
Speaker 1: power exists as strongly as it ever did when that happens.
Speaker 1: In my belief right, it still is there and it
Speaker 1: is so healing to both people that I do believe
Speaker 1: it has that power, that that magic is still contained
Speaker 1: in it.
Speaker 2: Wonderful thing.
Speaker 1: I don't know where I saw this. I don't know
Speaker 1: if it was a New Yorker story or as I
Speaker 1: prepare for people, I just pull stuff from all over
Speaker 1: the place, and I'm like, Okay, I don't don't quite
Speaker 1: know where I got it, but there's a beautiful story
Speaker 1: you wrote somewhere about learning to say I love you
Speaker 1: to your mother. Would you share a little bit about that.
Speaker 1: It really was a beautiful story.
Speaker 3: Yeah. You know, my parents and our tradition is one
Speaker 3: of where you know, they were incredibly loving parents. They
Speaker 3: did so much for our futures and our education, but
Speaker 3: you know, expressing their emotions in this ancient Christian culture
Speaker 3: wasn't a strong suit for them, so it was not
Speaker 3: something that they felt the need to say. And I
Speaker 3: had a interesting relationship with my mother and my rebellious
Speaker 3: teens and later on, but in her old age, in
Speaker 3: her nineties, my mom moved to pal Alto, and you know,
Speaker 3: I would see her every day or every other day,
Speaker 3: and when I didn't see her, I would call. And
Speaker 3: one time I was in the car with my partner, Carrie,
Speaker 3: and I was speaking to my mother on the car phone,
Speaker 3: and at the end of the call, I said okay,
Speaker 3: and Carrie was nudging me say I love you. You know,
Speaker 3: she was mouthing and I said, I said I didn't
Speaker 3: because it just felt unnatural. I knew my mom would
Speaker 3: be embarrassed. But it happened again another time we were
Speaker 3: in the car and she's sitting there, and so she
Speaker 3: MoU would say I love you, and so I said
Speaker 3: I love you mom. My mother gave an embarrassed giggle
Speaker 3: and said thank you. But by then I was committed
Speaker 3: so that I kept every time I said goodbye, when
Speaker 3: it was on the phone, I would say I love you, mom.
Speaker 3: And then she gravitated to One day she said to
Speaker 3: me after a phone call, I haven't heard the magic word,
Speaker 3: so I hadn't said I love you yet, and then magically,
Speaker 3: at one point she said I love you too. It's
Speaker 3: pretty profound, you know. And my father is ninety six
Speaker 3: now living in Boston with my brother, and he gets
Speaker 3: on a treadmill twice a day he manages you know. Wow,
Speaker 3: he's very frail, but he at least he gets some walks,
Speaker 3: which is huge. But I've been saying this to him.
Speaker 3: I don't think i'll ever get him to say that back.
Speaker 3: It's just he's a strong, silent type. It's never in
Speaker 3: his nature. But I don't need for him to say
Speaker 3: it back. I realized that what this was about is
Speaker 3: I needed to say it.
Speaker 4: You know.
Speaker 3: I love the man for all, you know, for all
Speaker 3: his complicatedness and my complicated relationship with him at this
Speaker 3: stage in his life. What am I holding back? I
Speaker 3: love your dad? Why not?
Speaker 1: Yeah, that's a beautiful story. And I just loved the
Speaker 1: idea of your mom kind of giggling and asking to
Speaker 1: hear the magic words, and you being willing to just
Speaker 1: continue to sort of say it even though she wasn't
Speaker 1: saying it back, and not taking that personal, and just
Speaker 1: sort of recognizing, like, you know, Okay, that's what it is.
Speaker 3: It's just a.
Speaker 1: Lovely little story. I want to talk about another line
Speaker 1: from the Covenant of Water that you wrote. It's a
Speaker 1: character describing themselves and a challenge, and it says, I
Speaker 1: understood my failing, my human limitation. It is to be
Speaker 1: consumed by one fixed idea, then another and another. But
Speaker 1: in nature, one fixed idea is unnatural, or rather the
Speaker 1: one idea, the only idea is life itself, just being living.
Speaker 1: Share a little more about.
Speaker 3: That, Yeah, I mean, I think that came straight out
Speaker 3: of my own experience, you know, I think, and I
Speaker 3: witnessed this a lot in the professionals I mentor, and
Speaker 3: I although I think the younger generation is doing a
Speaker 3: much better job of balancing things than we are, you know,
Speaker 3: It's like I got to get into college, the right college,
Speaker 3: and then I got to get into medical school, and
Speaker 3: I got to get into the right residency program. And
Speaker 3: it's like, you know, these fixed ideas, and meanwhile, life
Speaker 3: is going by. And if you want to use the
Speaker 3: example of you know, living each day fully as though
Speaker 3: this was your last, then you really aren't doing that.
Speaker 3: You're spending eighty percent of it on this fixed idea.
Speaker 3: I mean not to say abandoned your training, but I
Speaker 3: mean allowing yourself to be open to the randomness of
Speaker 3: life while you pursue this one idea. But it's not
Speaker 3: the only idea. There are many ideas, and I wish
Speaker 3: and it's the kind of wisdom that you wish for
Speaker 3: when you were twenty, but you wouldn't have listened, unfortunately,
Speaker 3: So it just comes with time. But I purposely had
Speaker 3: a character in there who I gave that succession of
Speaker 3: fixed ideas and comes to a point where it has
Speaker 3: cost him and he feels like in pursuing the fixed idea,
Speaker 3: he neglected important things around him. And I think that
Speaker 3: happened to me. I think that I have great regrets about,
Speaker 3: you know, my marriage and my kids and how much
Speaker 3: time I might have spent to them, And you know,
Speaker 3: I'm in the business of trying to find redemption for
Speaker 3: myself and with them. And you can't waste too much
Speaker 3: time on what you did or didn't do. You just
Speaker 3: have to do it now. And it's part of that
Speaker 3: I love you stuff with my dad. My mom passed away,
Speaker 3: but I'm so glad I said that to her.
Speaker 1: Yeah. I was having a conversation yesterday with someone that
Speaker 1: sort of mirrored this a little bit, and he was
Speaker 1: talking about how he was in a phase where he
Speaker 1: was being very productive at work and he noticed correspondingly
Speaker 1: being irritated with the people around him. And I was like,
Speaker 1: I understand that, because to me, that productivity can be
Speaker 1: my focus narrows down to one fixed idea. This is
Speaker 1: the only thing that's important, getting this thing done or
Speaker 1: making this thing happen or this accomplishment, and anything that's
Speaker 1: outside of that is simply an inconvenience and an irritation. Yeah,
Speaker 1: and yeah, when I came back across that line of
Speaker 1: yours as I was preparing, I was like, that's speaking
Speaker 1: to me.
Speaker 3: And you know, medicine was terribly seductive that way, because
Speaker 3: if you were the intern who never left the hospital
Speaker 3: was always there. You know, that was a great thing.
Speaker 3: Nobody stopped to ask you if your marriage was coming
Speaker 3: apart as a consequence, or if your relationships were suffering. Yeah,
Speaker 3: you know, And I think that sort of false honor
Speaker 3: in doing this work because the work was noble, allowed
Speaker 3: many people to get off the hook when they should
Speaker 3: have been called for bad behavior. We have a lot
Speaker 3: of dry drunks whose behavior is awful even if they're
Speaker 3: not addicted. Yeah, and I think that's where the new
Speaker 3: generation is much more wise about balancing their lifestyle, their
Speaker 3: relationships and the way that we were not So you
Speaker 3: were asking about the woundedness and the flip side was
Speaker 3: using work as an excuse to not deal with any
Speaker 3: of your issues totally.
Speaker 1: I mean, I think I have had workoholism tendencies in
Speaker 1: my past, for sure. I think I'm kind of past
Speaker 1: them to a large extent, but I certainly recognize that
Speaker 1: because you're praised for it. You're praised by always being
Speaker 1: the one at the office, always being the one doing
Speaker 1: the extra thing, and it is an easy escape because,
Speaker 1: particularly if we're good at what we do and we
Speaker 1: enjoy what we do, that's easier than the complication of
Speaker 1: a relationship that might be struggling in children who are
Speaker 1: difficult to deal with, And I don't know what to
Speaker 1: do with these kids. For three hours, all they're doing
Speaker 1: is yell. I mean work is like, oh yeah, I know.
Speaker 1: I'm just kind of right in my groove. People are
Speaker 1: approving of me, and it feels easy and I can
Speaker 1: just do it exactly. It's a pretty seductive path. But
Speaker 1: I do think most people will hit a point where
Speaker 1: they will recognize that they paid a price for that
Speaker 1: that they didn't realize they were paying very much. So
Speaker 1: you quoted Kafka somewhere who says a novel is the
Speaker 1: ax that breaks the frozen sea. Inside. I was wondering
Speaker 1: if you could just talk for a minute about the
Speaker 1: role fiction is played in your life. You know, why
Speaker 1: has fiction been so important to you?
Speaker 3: Yeah, By the way, that quote, the novel is the
Speaker 3: acts that breaks the frozen sea is Kfka. It's a
Speaker 3: beautiful metaphor. And you know, I always find it fascinating
Speaker 3: that we raise our children and we were raised by
Speaker 3: stories by nurse three tales, by you know, biblical stories
Speaker 3: by Enid blytton whatever, it is we were raised on,
Speaker 3: and then when we've become serious adults, we somehow feel like, well,
Speaker 3: no more fiction for me. I'm a biography memoir kind
Speaker 3: of person. And yeah, I always feel that's a tremendous loss.
Speaker 3: John Falls, who wrote The French Lieutenant's Woman, used to
Speaker 3: say that if you don't have that practice of taking
Speaker 3: the little signals on a page week words and using
Speaker 3: them to make a mental movie in your head, you know,
Speaker 3: your imagination the writer's words, a part of your brain atrophies,
Speaker 3: and especially in medicine, I meet a lot of my
Speaker 3: serious colleagues who don't read fiction, and I always feel
Speaker 3: it's a great loss. I think that Camu said that
Speaker 3: fiction is the great lie that tells the truth about
Speaker 3: how the world lives. You know, I think we find
Speaker 3: ways to be When fiction resonates for us, it's because
Speaker 3: it tells us something we already into it as being true.
Speaker 3: Proost said that the reader is not so much reading
Speaker 3: the book as is reading themselves as they read the book.
Speaker 3: And so, you know, you find instructions for a living.
Speaker 3: You find handholds by these seminal books that have changed
Speaker 3: the course of your life, and in my case, one
Speaker 3: book brought me to medicine, and you know, I can
Speaker 3: sort of make my life, you know, categorize it by
Speaker 3: the milestones in terms of the books I read. I
Speaker 3: think that fiction is a powerful instrument and we aren't
Speaker 3: reading in enough of it. This is not just self serving,
Speaker 3: but I really think that we sort of lose a
Speaker 3: creative aspect. It's much easier to watch movies and watch TikTok,
Speaker 3: and you know, I'm just as guilty as that. But
Speaker 3: the act of taking that digital signal, using your imagination
Speaker 3: to create the characters who will look nothing like the
Speaker 3: ones they cost when you go see the movie. Finally,
Speaker 3: but that is an important piece I think of living.
Speaker 3: It's greatly satisfying, and it's getting harder to convince younger
Speaker 3: people to do that because, Yeah, I'm hoping the pendulum
Speaker 3: swings back, there'll be this tiredness over TikTok and whatnot,
Speaker 3: and they'll come back to the elemental joy of reading fiction.
Speaker 1: Well, that is a beautiful place for us to wrap up.
Speaker 1: You and I are going to have a brief post
Speaker 1: show conversation afterwards where I'm going to ask you a
Speaker 1: couple questions about lessons that you've learned and fears that
Speaker 1: you've had to overcome. Listeners. If you'd like to get
Speaker 1: access to the post show conversation AD free episodes and
Speaker 1: support something that you love, you can go to one
Speaker 1: you feed dot net slash join and find out more
Speaker 1: about becoming part of the community. Abraham, thank you so much.
Speaker 1: The book was astoundingly good. I really liked it, and
Speaker 1: it's the book that as I started to prepare and
Speaker 1: I went back into it, I was like, I like
Speaker 1: it more. The more I think about it, you know,
Speaker 1: like the more I contemplate everything that happened, I'm like, God,
Speaker 1: this is really good. So I love the book. Thank
Speaker 1: you for coming on.
Speaker 3: It's an honor to talk with you, an honor.
Speaker 5: Eric.
Speaker 3: Thank you so much for having me.
Speaker 6: If what you just heard was helpful to you, please
Speaker 6: consider making a monthly donation to support the One you
Speaker 6: Feed podcast. When you join our membership community with this
Speaker 6: monthly pledge, you get lots of exclusive members only benefits.
Speaker 6: It's our way of saying thank you for your support. Now.
Speaker 6: We are so grateful for the members of our community.
Speaker 6: We wouldn't be able to do what we do without
Speaker 6: their support, and we don't take a single dollar for granted.
Speaker 6: To learn more, make a donation at any level, and
Speaker 6: become a member of the one You Feed community. Go
Speaker 6: to oneufeed dot net slash join The One You Feed
Speaker 6: podcast would like to sincerely thank our sponsors for supporting
Speaker 6: the show.