Explore every episode of the podcast Palliatively Speaking

This conversation explores the challenges and strategies involved in helping clinicians, particularly surgeons, improve their communication and decision-making practices to provide better patient-centered care. Dr. Gretchen Schwarze, a vascular surgeon and medical ethicist, and Dr. Amy Zelenski, an education researcher, discuss how their collaborative work aims to shift clinicians' mindsets and behaviors around informed consent, prognostic communication, and shared decision-making. They share how surgeons often struggle to move beyond a "fix it" mentality to meaningful improvements in patients' lives. Dr. Schwarze advocates reframing the surgeon's role as assessing whether an operation can help the patient achieve their goals, rather than just fixing a problem. With background in theater, Dr. Zelenski discusses the power of improv-based strategies like the "two-minute rant" and other techniques in cultivating empathy and empowering clinicians to respond rather than react to what is happening in their surrounding environment.

Guest: Stephanie Harman Guest's guest: Shireen Heidari In this episode, Dr. Stephanie Harman, a palliative care physician and leader at Stanford, takes us through her remarkable leadership journey. From founding Stanford’s Palliative Care clinical program to establishing a leadership development program for women in medicine, Dr. Harman shares invaluable insights into the challenges and triumphs of building successful programs for the next generation. Dr. Harman shares how she draws on her expertise and experience as a palliative care provider to drive her leadership initiatives, emphasizing a process-oriented approach over outcomes and placing a strong focus on cultivating communication skills in leadership programs. A central theme of the conversation is mentorship—Dr. Harman shares how she was guided by leaders like Dr. Bob Arnold and how she now pays it forward by supporting and advocating for junior faculty and empowering them to thrive and succeed in their careers. Dr. Shireen Heidari, the program director for the Stanford University Hospice and Palliative Fellowship, joins the conversation to discuss the role of narrative medicine, emphasizing how writing can help process the emotional intensity of palliative care. Together, they explore the importance of communication, the lessons learned from working with seriously ill patients, and the need for ongoing mentorship to cultivate purposeful leadership in palliative care.

Guest: Arif Kamal Guest’s Guest: Christopher Jones Dr. Arif Kamal, an oncologist, palliative care physician and Chief Patient Officer at the American Cancer Society (ACS).  Kamal reflects on his work in oncology and palliative care, emphasizing compassion in cancer care, the role AI assistive intelligence will play in enhancing the role of humans in healthcare, and the importance of a supportive community to help you weather career setbacks. Dr. Kamal discusses how palliative care principles, like understanding a patient’s needs and values, can be integrated into routine oncology care and how this could become easier as the field of medicine incorporates the assistive intelligence aspects of AI that can assist with generating differential diagnoses and treatment considerations.  He advocates for the role of compassionate care such as considering first, who is our patient before determining what the treatment approach should be where healthcare providers prioritize understanding who the patient is before focusing on medical conditions or treatments. We discuss the future impact of AI in enhancing decision-making in oncology and he calls for a shift in how care providers are incentivized, promoting compassion as an essential component of high-quality healthcare. Dr. Kamal discusses the role of mentors in his life, career setbacks, and personal experiences that shaped his path, highlighting resilience and the importance of finding supportive communities. We welcome his guest, Dr. Christopher Jones, the editor-in-chief of the Journal of Palliative Medicine and the clinical vice chair for Duke Palliative Care.  They discuss operationalizing palliative care interventions, the human side of medicine, the challenges of burnout and the importance of creating a balance between professional responsibilities and personal well-being.

Dr. Debra Lotstein, a pediatric palliative care physician and leader at UCLA reflects on her journey into pediatric palliative care, sharing how an early experience as a resident shaped her understanding of end-of-life care.  She shares a defining moment in her career when she realized that focusing solely on advanced, life saving medical interventions can overlooks what truly matters to a patient or family.  We discuss the emotional and cognitive challenges of working with seriously ill and dying children.  She tells how she “reads the room”, builds trust, and helps families navigate uncertainty.  She reminds us that pediatric palliative care is a team sport where members bring unique skills to the bedside but also support each other through tough cases.  Dr. Lotstein’s deep sense of purpose and commitment to her patients and families is evident and led her to advocate at the policy level locally and nationally to improving palliative care systems of care for children.  Her reflections offer insight into the emotional depth, ethical complexities, and profound rewards of working in pediatric palliative care. Dr. Debra Lotstein is joined by Patty Everett, the mother of Ryan, a young man with severe disabilities. Their conversation delves into the emotional and logistical challenges of caring for a child with complex medical needs and how palliative care provides critical support. Patty recounts how Dr. Lotstein guided her through many of the most difficult decisions of her life regarding carin for Ryan, breaking down the process step by step in a way that felt manageable and compassionate. We discuss the role of concurrent hospice care, which allowed Ryan to receive both standard medical treatment and palliative support simultaneously. Beyond the personal aspects of their work together, the episode highlights their shared commitment to policy advocacy, including testifying at the California State House to ensure continued palliative care access for young adults transitioning out of pediatric care.  We can see how relationships forged in difficult circumstances can lead to connection and action that may help shape the future of palliative care medicine.