"The Doctor's Art" is a weekly podcast that explores what makes medicine meaningful, featuring profiles and stories from clinicians, patients, educators, leaders, and others working in healthcare. Listen and subscribe on , , Amazon, , , and .
In this episode, Henry Bair and Tyler Johnson, MD, explore the themes of storytelling, pain, rage, and cultural competency with , who grew up and went to medical school in Pakistan before completing residency at Harvard Medical School and fellowship in cardiovascular medicine at Duke University Medical Center.
Today, he is an assistant professor at Harvard Medical School and the associate director of the Heart Failure Program at the VA Boston Health Care System. A prolific writer, he contributes regularly to the New York Times, Washington Post, and others. He is the author of three books on medicine for the general audience, most recently 2022's , which examines the nature of pain not only as a physical, but also a historical and cultural, experience.
Over the course of our conversation, Warraich compares his medical experiences in Pakistan and in the U.S., discusses why he strives to incorporate palliative care into his cardiology work, and offers an impassioned critique of how modern medicine fails to address patients' suffering.
In this episode, you will hear about:
- 2:10 How Warraich went from thinking of his medical training as an "arranged marriage" to loving his career
- 7:03 How Warraich stays connected to his patients and his work despite the intense pressure and responsibility he experiences on a daily basis
- 13:22 What drew Warraich to cardiology and end-of-life care
- 17:33 Warraich's reflections on the gaps in the care of patients with heart disease and how he now strives to reform the practice of cardiology
- 22:06 A discussion of how the medical culture of Pakistan differs from the U.S. and how they can be shockingly similar
- 28:49 How Tom Brady, the football quarterback, inspires Warraich to stay connected to the emotional core of his practice
- 35:37 Why it's important to stay in a field if you care about it, especially if you hope to change and improve it
- 41:38 Warraich's reflections on the nature of pain and how he hopes to change our cultural conversation around it
- 45:17 How acute pain and chronic pain are very different processes and how we can address suffering as a subject and deeply personal experience
Following is a partial transcript (note errors are possible):
Bair: You've written so much about death, dying, heart failure, and pain. So there's a lot there that we can explore. But first, can you tell us what initially drew you to a career in medicine?
Warraich: When I was growing up, I was pretty undifferentiated, and if I had to pick, I was probably a writer and a storyteller before I kind of knew what I wanted to do with my life. I somehow ended up in medical school almost by accident, if you believe that. When I finished college, I had applied for medical school, dental school, and engineering school.
And in the end, I ended up picking medical school, not because of any fancy, inspired reason other than the fact that that college is probably the best institution for an education in Pakistan. And it would keep me closer to my friends as well. So, you know, I ended up in medical school with very poor reasons, and it really held me back in a pretty significant way because, you know, medical school is no joke.
Unless you're inspired, unless you have a purpose, it can really be a pretty daunting place. And so my first few years in medical school were really a struggle from an academic perspective, even though my writing was really flourishing and I was able to really see life and my environment in a way that I hadn't done before. But the medical school experience itself was really, really hard until I began to find the reason, until I, you know -- almost like an arranged marriage. I began to sort of pay a lot more attention to medicine than I had in the past. And it was only when I got past some of the superficial nature of what we do as physicians and as clinicians that I really fell in love with medicine. But it wasn't something that was pre-planned. It was almost by accident, but something that I am very lucky to have experienced now.
Johnson: That's a very interesting metaphor, that it was an arranged marriage for you. But once you discovered a reason to love medicine, what was it that you discovered?
Warraich: I think it was, for me, the most fascinating piece about medicine has always been that any random day in our lives is probably one of the most important days in the lives of our patients, and that we kind of get dropped into these really important situations for patients, where they're oftentimes scared, oftentimes unsure, oftentimes just confused about what's going on. And they look to us for guidance. They look to us for not just technical guidance, but really moral guidance and ethical guidance.
And that, to me, is something that still never gets old. And, to me, as someone who was always interested in exploring spaces or exploring people or exploring new worlds, medicine is an opportunity to explore a new world every time you meet a new person, and the responsibility that is placed on us, no matter what our specialty is or no matter what you're doing, is just so immense, but also very rewarding. And I think it is because of those interactions that I have with patients that really brought me in and pulled me into medicine and then keeps me glued to this day.
For the full transcript, visit .
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