“Stories are how we make sense of the world.”

Novelist and Stanford Professor of Medicine Dr. Abraham Verghese reminds us that story matters, now more than ever.

Here’s our prior interview with Dr. Verghese.

PS I mis-spoke during the show, I meant Eat, Pray, Love author Elizabeth Gilbert’s TED talk on “the muse”, definitely check it out!

Full transcript below!

Dr. Z: Hey everyone Dr. Z, welcome to The ZDoggMD Show today I have my friend and special guest, Dr. Abraham Verghese, welcome back to the show Abraham.

Dr. Verghese: Thank you for having me.

Dr. Z: So Abraham is a Professor of Medicine at Stanford and author of several books including “Cutting for Stone” which is in my opinion one of the great syntheses is that the plural of synthesis?

Dr. Verghese: I think so.

Dr. Z: Of medicine, art, humanity and your own kind of biographical details and so it’s just great to have you back on the show we talked when back a year or two ago right?

Dr. Verghese: It’s been a while in my house and this is lovely to be in your studio.

Dr. Z: So I had to repay the favor. It’s like an Indian thing. It’s like you’ll come to my house I go to your house. And I love your bow tie ’cause it reminds me so much of my dad

Dr. Verghese: Well, you know I was hoping that your listeners wouldn’t be confused you know, switching back and forth I know we look alike and so just to avoid that, I’m the guy with the bow tie.

Dr. Z: It’s a good distinguisher yeah ’cause I tried a bow tie it didn’t quite work on me.

Dr. Verghese: I should tell you I make rounds with these chief residents every Thursday and we go see patients it’s bedside teaching but the very first time I meet them, at the start of the year, the first thing I teach them men and women is how to tie a bow tie.

Dr. Z: So you show them that on the rounds.

Dr. Verghese: Yeah and then most of the time the men will wear the bow tie on their rounds and you know, we walk into the room and seeing three or four people in a bow tie the patient smiles inevitably.

Dr. Z: Ah, that’s actually really beautiful. You know, what’s interesting is it just made me think so now you’re kind of the master of the bedside rounds, touching the patient.

Dr. Verghese: I like that yes.

Dr. Z: Bringing bedside back this kind of thing which is lovely because, we’ve relied on technology for so many other things and technology is wonderful, but that human connection and so I wanna ask you this because it’s been on my mind now that everybody’s wearing masks in the hospital setting and outside of the hospital setting, but in the hospital in particularly in Stanford, I know ’cause my wife is there, she’s saying you know you get a bunch of surgical masks when you walk in the door and you wear ’em and so on how has that changed the interaction between not just you and the patient, because your face is covered but you and the team when you’re teaching?

Dr. Verghese: I think it’s been much more challenging so I have a hearing issue and I wear hearing aids and I didn’t realize how much I relied on people’s lips to tell me what they were saying and now that their lips are covered and I believe the generations after us all mumble, that’s just my opinion.

Dr. Z: I do too. My kids especially.

Dr. Verghese: Yeah so, but it’s also a challenge for the patients, you know most of our patients are elderly and often hard of hearing and you know, we’re tryna tell ’em something we are masked, they’re masked it really you know, increases the barriers to communication but that aside it’s amazing I was just attending and you know, you quickly get used to it and the body still has a lot to show you and you know, it’s there for you to see. So that part hasn’t changed very much.

Dr. Z: Well, you know, your perception of body language and the ritual around that has been very fascinating to read about and what’s interesting is you mentioned hearing aids I didn’t notice that you had hearing aids until you pointed it out now I see the very subtle hearing aids and again sometimes you almost need to tune in, in order to pick up those subtle cues.

Dr. Verghese: Yeah, yeah.

Dr. Z: Yeah.

Dr. Verghese: No I mean, it’s amazing I think hearing loss is much more common than people acknowledge. And whereas most of us as we reach a certain age we’ll never accept, not being able to see. There are a lot of people out there, when I first say I have hearing aids I often hear I’m trying to get my husband or my wife to wear hearing aids because people are picking up that their mates aren’t hearing but there’s a peculiar vanity around this which I quite understand I went through that, about you know wearing something like this, but.

Dr. Z: You know what it’s interesting ’cause with my in-laws sometimes it’s almost that the affected person doesn’t necessarily want to hear what’s being said.

Dr. Verghese: Exactly.

Dr. Z: It’s kinda like oh, the silence is bliss I’ve been waiting for this. Yeah, it’s interesting. So we’re in a strange time you know and part of the reason I was real happy to get back together with you is here you are, you’re practicing at Stanford, you’re a professor you’re teaching, you’ve finished or are working on finishing your next book but now we’re in a pandemic. And the story the sort of narrative around what we’re telling ourselves and the social contagion of fear and the social contagion of hope and all these things and I thought there’s no better person to talk about this stuff than you, ’cause you can integrate it with our healthcare audience and how we can think about it and how have you been thinking about this time?

Dr. Verghese: Well you know, to be honest I’ve been intrigued by this because you know I think stories are all around us that’s my bias, but I don’t think there’s been a moment in time when we’re more engaged in the story you know, at one level it’s the story of ourselves and you know, receptors and virus and that’s a fascinating, scientific story on its own but then it’s also the story of our own unique vulnerability based on our age, our underlying disease, it’s the story of our family you know, I have two adult boys who moved back home very poignant, beautiful, but also with it’s challenges. Yeah and then the story of our town, our beautiful State and the nation divided and you know, underlying all this and then climate change and smoke and fires and underlying all this, the big recurring theme of you know, Black Lives Matter which sort of exploded and I couldn’t help but think this was really all one story, you know all one story that had finally sort of you know, burst through the subconscious of our will if you like and manifest itself in this amazing way. And I guess at another level I’m intrigued because you know, when I first came to this country in 1974, I was living through my own peculiar story I had my medical schooling interrupted I was born in Africa in the midst of a civil war, I had to leave my medical schooling work as a nursing assistant in New Jersey for a year and a half.

Dr. Z: I didn’t know you did that.

Dr. Verghese: Yeah.

Dr. Z: So you were like a LVN or a CNA.

Dr. Verghese: Yeah exactly the whole bedpan and feeding routine and you know, I look back on it now I did it for a year and a half, but I look back on it now as the most profound medical training I ever had because I really got to see what happens to the patient in the 23 hours and 57 minutes that doctors are not in the room, you know? And it gave me a real solidarity with the nursing staff and with you know, the nursing assistant staff because they’re the ones who really are caring for the patients you know?

Dr. Z: You know what’s interesting Abraham is, this is something that had come to me later in life so when I started in my medical path I was the guy who was like, oh, the nurses, calling me in the middle of the night and it was us versus them and we know what we’re doing and they’re just there to do it and it took some eye-opening events that opened my eyes to that, ’cause they’re there like you said like you were they’re there with the patient when you’re not, they’re there when you see a patient at the supermarket.

Dr. Verghese: Yeah.

Dr. Z: You see them in their street clothes, you go this is a human being they’re not a problem to solve sitting on a bed in a gown with a bunch of nasal cannular and all that and the nurses see that all the time and so they would tell me things about the patient that would open my eyes.

Dr. Verghese: Yeah.

Dr. Z: And what’s interesting now is in the role that I have and again ’cause I like to make everything about me Abraham, we’re talking about stories, here’s my story but I try to support nurses any chance I can to incorporate their voice a lot of our audience are nursing. I get a lot of pushback from doctors who say you’re not supporting us the same.

Dr. Verghese: What a shame because I think they’re not getting it so you know long before they were encouraging us to have the nurses join us on rounds I don’t like to begin rounds if the nurses isn’t in the room because you know, of all the people assembled there they’re the ones who really know what’s going on and what we decide is going to influence what they have to do for the next eight hours so it’s hubris to you know just not consult them, not make them aware of it if you can

Dr. Z: How hard has it been for you to get them in the room?

Dr. Verghese: Not hard I mean it’s a challenge but if they can make it.

Dr. Z: Yeah.

Dr. Verghese: And if you can make it, everybody appreciates the effort and I think it’s eye opening for students to see the nice thing is right now at Stanford is that we’re training PA students with the medical students from year one. And so you know we all have to work together so if we’re gonna train together, you would think that we’d all know how to work together but it’s amazing how, even if we start together we wind up being in these very divided camps but I think, you know, team care means we all work together.

Dr. Z: How lovely I never had that experience with PA’s on the team.

Dr. Verghese: It’s new it’s a fairly new program.

Dr. Z: Oh wow.

Dr. Verghese: A couple of years now yeah.

Dr. Z: And how has it been received, how’s it working?

Dr. Verghese: You know a little resistance here and there, but for the most part I think they’re demonstrating their value, they’re very mature people who often have come after a bachelor’s and some life experience and you know very focused, very motivated, great people.

Dr. Z: Yeah you know, my experience with the PAs, when we would rotate through at UCSF when I was a surgeon when I was a surgical, rotator as a medical student, I decided to do it at my home hospital in Fresno, California that’s where my parents are and I was like oh, I can leave San Francisco and do an away rotation.

Dr. Verghese: Yeah.

Dr. Z: And the people who taught me all my procedures were the surgical PAs.

Dr. Verghese: Isn’t that something?

Dr. Z: I went back recently and did a talk and I saw them and we met and hugged and it was this beautiful it’s like you taught me everything I know about chest tubes and central lines and even foleys you know ’cause they would take me in the middle of the night and you know, they were just generous of spirit and really good at what they do.

Dr. Verghese: Yeah, the folks who are you know in one specialty, over time they can just about do it all I would say.

Dr. Z: 10,000 hours of mastery.

Dr. Verghese: Yeah exactly.

Dr. Z: Exactly.

Dr. Verghese: Anyway, I was tryna say that you know, in 74 when I was doing that, when I first came to America, the very first movie I ever saw in America was “Jaws” which took the country by storm it was a blockbuster the director no one had heard about by the name of Steven.

Dr. Z: Spielberg.

Dr. Verghese: Spielberg I think it was yeah.

Dr. Z: Something like that, no named guy.

Dr. Verghese: And then many years later as I was you know sort of delving into scripts myself, I saw a storyboard of “Jaws” and I realized, you know the premise of “Jaws” is the most ancient story in the world it’s a monster comes out of the deep preys on a population and one ordinary person is called to adventure and has to recruit special tools and allies and defeat the monster. And you know in essence it’s a retelling of the very first story ever told which is the “Epic of Gilgamesh” which is 2000 years you know BC only discovered in 1800s but it’s a 12 stone tablets cuneiform script and it tells the story of the hero Gilgamesh and the monster Humbaba and it’s been retold many many times and you know maybe 700 A.D came Beowulf another story of you know Beowulf slaying the monster Grendel. So we’ve had monster stories, you know forever. And we are living through another monster story and what I find really I mean, we have a virus it’s descended on us, picking out innocent people and we’re all forced to sort of find a way to battle this. But I think what’s most intriguing to me is there were some really powerful lessons in the many, many, many plagues stories, monster stories that we’ve had whether it’s Camus’s “The Plague” or Defoe’s “The Plague Years” or Boccaccio’s “The Decameron” or you know movies like “Outbreak” and you name it there’s just been, so many monster scripts if you like or plague scripts. And they’ve had some very powerful lessons in there that I wish we had paid more attention to. So we’re really good at the science. I mean I can’t believe that I’m alive in an era where within a week of the virus being discovered, we have the entire genome, we know the receptors we’re starting the vaccine path I mean, compare that to the HIV experience where I cut my teeth as a physician and we’re way ahead, but socially we’re back in you know, the Great Plague of London because both Camus and Defoe described it all, the people who roll up their sleeves and join the proceedings, those who are in denial, those who profit by it, those who undermine it you know, Defoe talks about the people who basically partied in the streets, you know, which is the equivalent to the bars that are ignoring all the rules. And you know, I feel like it should be a must reading that all our leaders, in addition to being savvy about science, which I’m not sure they always are, need to be savvy about the social capital, the social intelligence, we should be embracing to inform us about how to be right now, rather than you know, taking on the role of all of these characters you know? So it was all there, it was all there.

Dr. Z: We never learn from these things sometimes.

Dr. Verghese: We don’t seem to, you know.

Dr. Z: This idea of the plagues story is interesting ’cause I had Dr. Monica Gandhi on the show who just is lovely person and was talking about parallels like you’re talking with the cholera outbreak of 1832 and you had two camps, the contagionists and the hygienists and how they were going at each other often at the expense of the vulnerable poor that were the biggest victims of the cholera outbreak, same idea, nothing changed I think there’s something that’s uncovered, you said it our collective unconscious kind of comes up, whether it’s in the form of protest in the street, whether it’s in the form of pro mask, anti mask each shaming each other, whether it’s in the form of oh, how did this just happen to be during a political year?

Dr. Verghese: Yeah, yeah.

Dr. Z: It’s almost like they couldn’t have decided a better time to make it difficult.

Dr. Verghese: Yeah I mean I actually think, I mean plagues transform society that’s for sure. But plagues are not sort of some outside thing that just descended into society they are an effect of our society in a sense you know, if we don’t destroy rainforests we don’t encounter these strange viruses and you know to blame this country or that country is sort of absurd this is a consequence of globalization. And plagues change society you know, the smallpox that the white settlers brought to America destroyed the Native American population or they might not have been able to colonize we might not have been here

Dr. Z: Right.

Dr. Verghese: To have this show. So similarly every place has transformed, the interesting thing as we come back to this issue of the seminal story, the archetypal story, it’s never that the story ends with the monster being destroyed and everything’s back to normal. Almost always you destroy the monster, but you have sort of a new understanding of your life and the way to go on. And the society is fundamentally changed by this sort of transition. So I think it’s naive to think we’re gonna get back to pre COVID and do all the stuff we were doing. We will never get back to pre COVID. We are going to be in a completely new place having vanquished this virus but hopefully much more savvy about the fact that more are coming, much more cognizant of the need for our leaders to be really savvy about the social ills that come with plagues and not be surprised by them you know Camus says that plagues have been happening since human history and yet every time they happen plagues and war, we’re surprised by them. You know?

Dr. Z: It’s really true.

Dr. Verghese: Yeah.

Dr. Z: What you said about the social ills that come with plague, it’s funny and now that I think back and I reframe like almost every episode I’ve done since this thing started I’m talking about the social ills that come with plague it just by a different name whether it’s the tribalism that sprung up about I’m on this side or that side, I’m on Great Barrington side, or I’m on John Snow side versus how we’re managing to really harm poor people in all of this, inadvertently or advertently it’s hard to know and how we’ve harmed ourselves in our own psychological state, whether we’re cowering in fear in our houses, wiping down our UPS packages or brazenly going out you know into a bar and without regard again they’re both extremes of.

Dr. Verghese: Yeah and I actually think that it’s you know it’s a disservice to, consider people evil if they’re not in your camp I mean actually the way I see it and this is Camus’s exact words that evil in the world comes from ignorance so I don’t think people are doing things willfully to be evil they’re just not necessarily willing to get the facts that are you know, might change their view.

Dr. Z: Now this is something that comes up a lot. I try to advocate to my audience to stop branding the other side first of all, there are sides. We have our biases and we seek to confirm them we’ll pick data that supports what we’re saying We can find it.

Dr. Verghese: Yeah.

Dr. Z: We can pick sides especially with social media, which I think is a a new twist on an old idea of polarizing into tribes.

Dr. Verghese: Yeah, yeah right.

Dr. Z: It just does it much more efficiently and more seductively because it’s addictive to score points on social media. I can go on Twitter right now pick a side, hey, I wanna open schools all right let me show you all the data.

Dr. Verghese: Yeah.

Dr. Z:  That says this is good. And then someone else will show some data otherwise and then someone will give me an anecdote someone will get emotional and the next thing you know I’m a bad guy and they’re a bad guy to me.

Dr. Verghese: Exactly.

Dr. Z: And what have we accomplished? Nothing, whereas if we both understand, no we’re coming from the righteous mind as Jonathan Haidt calls it we’re coming from a sense of morality that’s our own flavor, how we interpret the world and execute that, comes from an intention that’s good.

Dr. Verghese: Yeah exactly well said, so I think that, you know, hopefully the data over the nine months or so, will begin to sway people I mean we have data that’s just coming out, just published in Nature and I think abstracted in the Washington Post to show that the States that wear masks have had less of a problem and I think we just need more conviction like that, that you know, people begin to see that you know, the defiant masklessness has consequences you know.

Dr. Z: We talked about that with Monica as well, ’cause she’s done some of that research on mask inoculum and how it lowers.

Dr. Verghese: Exactly.

Dr. Z: Now here’s the twist on that and I think there is a misunderstanding I think among scientists who are traditionally poor communicators you’re an exception where we just assume okay we have this data, this is what it shows there’s no other way. And if we don’t listen to people who are saying yes but my small business which relies on maskless dining is gonna go under which means I don’t support my family and there’s no government assistance I mean, there was the original PPP, but there’s nothing else. And they are going to have a bias against anything that.

Dr. Verghese: Absolutely.

Dr. Z: Threatens their life and livelihood and it makes sense I think you have to say okay, I respect that so how are we gonna deal with that nuance when we have policy ’cause policy is that struggle between values.

Dr. Verghese: I think that’s where reading Camus and reading Defoe has been so helpful the recognition that, this was predictable, it’s not an aberration of our society, especially in a society like ours unlike say a very regimented society like South Korea or Taiwan, you know.

Dr. Z: Everything.

Dr. Verghese: Yeah everything we’re seeing, it was predictable what we could have done is anticipate the consequences better and have more resources, because the real issue is economic downturn. It really isn’t as much about the mass per se as people’s sense of you know, their livelihood is disappearing.

Dr. Z: Right.

Dr. Verghese: And you know focusing on that might’ve been a way to obviate this and also having good examples of people, you know wearing the mask and putting out a consistent message you know, back and forth has been really, really confusing

Dr. Z: It’s been tough you know and we’re in the Bay Area where we’ve done pretty good actually, we’ve bent the curve reasonably well Stanford never got overwhelmed.

Dr. Verghese: Yeah.

Dr. Z: And there is a lot of masking out there, there’s some you know, resistance but.

Dr. Verghese: Yeah

Dr. Z: As Monica mentioned you know, if you have 80% of the population wearing masks that may be enough to create this inoculum effect it doesn’t have to be 100.

Dr. Verghese: Yeah.

Dr. Z: But it does need consistent messaging and that’s been a problem because early on WHO, CDC and we talked about that mixed messages Fauci et cetera, and he is so adorable. It’s been tough because you and I again as scientists with science backgrounds, it’s very hard to see science either misinterpreted or abused it really hurts actually one thing that you said that I loved you said, “You know that’s where reading Camus is actually very helpful” so most scientists come on the show and they’re like you know, that’s where looking at the literature in nature and so on, but you’re actually pointing to something different, which is the humanities influence on hey, they actually figured this out they analyze this in the past from a social standpoint and you can’t have one without the other because how are you gonna get adherence, if you haven’t addressed the underlying social currents?

Dr. Verghese: I mean it’s the most amazing paradox so we have incredible science and yet because we have resistance socially, the impact of that science has been quite diminished I think and you’re seeing it at the highest levels of government so I think that this is you know this is why we’re humans, and this is why I might even say, that we’re likely to keep repeating these experiments you know in different formats, but human beings being what they are this is always gonna be tricky.

Dr. Z: ‘Cause there’s something you said in the beginning that I think is gonna trigger people who I know get triggered by this which is you said, “We’re not going back to the same normal, post COVID.” A lot of people are so anxious that they feel like we are never getting out of this mess life is always gonna be screwed up and this and this and this, but your point is.

Dr. Verghese: No that’s not what I meant.

Dr. Z: Exactly right tell us what you meant because it probably agrees with what of my interpretation is

Dr. Verghese: You know, it’s like, you’re never going to be back in the same innocent world where this began.

Dr. Z: That’s right.

Dr. Verghese: Hopefully we’ll have a lot more provisos to anticipate the next thing coming down the pike and there will be one.

Dr. Z: Yeah.

Dr. Verghese: But also I think you know I’m just speaking personally now I feel like I’ve had many months to sort of be alone a lot of the time. And even when you’re at the hospital at some level you’re alone with your mask and you know, in your own room not the cubicle full of office stuff that you’re used to and in that time has come an ability to sort of appreciate what is precious about this life you know. I mean what is precious? What is it that we value the most? And I think it’s going to change people in that sense I think my relationships are much more poignant than they ever were. I think my sense of how much time I was wasting doing things that I shouldn’t have been doing it shouldn’t have taken COVID for me to jettison those things, you know? So I think that’s what I meant, we will be a new society just as after the Black Death, you know feudalism was over the serfs had power you know, that’s an extreme example but in some way we simply cannot be the same society that is naive.

Dr. Z: And that’s exactly what I was thinking is it’s actually a hopeful message. It’s saying.

Dr. Verghese: Very much so.

Dr. Z: This is what we’re learning from this, later then talking about well we also tend to repeat our mistakes. So I think though as we progress one interesting thing about humans is we can actually train critical thinking and self-reflective skills in people, we just haven’t yet. So this idea that we can watch our minds, we can see when an impulse arises that comes from a place of our own bias and watch it and go, okay, what if I let that go and listen to all the data and actually analyze it critically? What if I can apply critical thinking to the latest conspiracy theory and go through and go oh, does this actually pan out? And those are tools we don’t give people but they’re available they’re on offer and if we taught our students that, if we taught our kids that if we started to come out of this in a way that changed the way we critically think while respecting that we are fundamentally emotional story-driven unconscious creatures.

Dr. Verghese: Yeah, yeah.

Dr. Z:  That would be helpful.

Dr. Verghese: I mean, I think Santayana said years ago that people who don’t understand history are forced to repeat it in a sense I think we’re always repeating history I mean we would never have a war after the first one if we’d learned anything you know, there shouldn’t have been a WW2

Dr. Z: Right.

Dr. Verghese: But I think it’s you know, unfortunately it’s one element of our being alive our each having our own opinions that we will have conflict and, you know an advanced society might have the tools to self-reflect and get themselves out of it but very often not the loudest voice wins and you know so I think this is sort of what history has shown us and we may be condemned to repeat it but in different forms not quite as obviously as the previous form.

Dr. Z: You know it makes me think of Steven Pinker and his ideas that in general, we’re progressing in general society’s becoming more rational, a little more scientific a little more enlightenment values but I think one thing that Pinker leaves out, and this is my own editorializing is that if we became more spiritual and I don’t mean that in a dogmatic religious way I mean, if we actually focused also on well, what’s our meaning and purpose connection what’s our true identity in the world? What are we? I think that would then empower a better understanding of how to behave wisely in the world in settings like this, because I think the next pandemic this pandemic is a rounding error on what can actually happen with an airborne aerosolized virus with a high ARO and mortality that’s quite high across age groups. And I think this was a warmup. So when the next one comes we’d hope that we can wisely go, okay we need to behave very systematically right now upfront rather than drawing out half measures.

Dr. Verghese: Yeah. No, I think you’ve said it in fact one of the things that I think will make us change after this virus or during this virus will be the sheer impact of the mortality I mean there will be a point I mean it’s become a cliche to read about, oh, I was against this until my father got COVID and died or all I couldn’t understand, you know so people sometimes need personal trauma to really come around till then it’s an abstract mask versus no mask or you know virus versus no virus. So unfortunately we’re reaching that pain point very rapidly we have 1,300 something healthcare workers who’ve died. To me that’s you know, that’s the number that really I ache for because these are courageous people who showed up to work every day and whatever their opinions on the virus they had to come to work and they came to work.

Dr. Z: Let’s talk about that a little because in the early days of this that was a real stand that we wanted to take here is like hey, you guys in leadership and across leadership, whether it’s political whether it’s hospital, whether it’s administrative whether it’s supply chain had warning for this to the degree that you did you have one job which is to keep us staffed and safe and okay and you didn’t do it so we’re gonna hold this accountable like we are not gonna forget this when the pandemic’s over ’cause we’re gonna come do our jobs, we’re gonna show up, which is what we signed up for, but we didn’t sign up to be abandoned and on the front lines and so it became very important in those 1,300 lost lives the lost on the front lines. You know, reporting is so powerful what’s also a good hopeful story on that is that it is now 1,300 and not 13,000 because we realized in hospitals, if you wear a mask, if you wash your hands if you do the right precautions, you are a relatively safe.

Dr. Verghese: Yeah in fact you know, we’ve had a scattering of employees who have become positive.

Dr. Z: In Stanford.

Dr. Verghese: But especially of late, almost all of them have been outside the hospital.

Dr. Z: Right.

Dr. Verghese: So paradoxically, I feel safer in the hospital because you know, everybody’s gowned and tested also.

Dr. Z: Yeah.

Dr. Verghese: Patients are tested too but even so I mean there are patients who slip through the cracks who were negative at the admission, but positive later.

Dr. Z: Sure.

Dr. Verghese: And no one knew. And you know, so I had to go through one of those, but even so all of us were fine. So I think, you know, we’re fortunate in health care, but it doesn’t diminish the sense of heroism that I sort of see in the young hospitalists who, you know, were there from day one when the hospital was not advocating masks for everybody and you know, they sort of took a lot and my heart’s really go out to them and I’m so proud of them.

Dr. Z: That’s just lovely.

Dr. Verghese: Yeah.

Dr. Z: Lovely sentiment. And you know I have to say ’cause I’m doing a talk for a physician group in Long Island next week, virtual talk and I got on a phone with their leadership and you know they said, listen, the reason we wanna have you come and talk is because these were the people there, you know they’ve suffered trauma, they’ve lost colleagues we forget that they’ve lost patients in a way that they can’t go to the funeral they can’t say goodbye they can’t see the family. it is such a deep trauma and so in New York people are quite aware of what this thing can do now since everything is local and even the IFR the infection fatality rate is locally variant, right? Because how much communal housing is there? Multi-generational housing what’s the healthcare infrastructure like it changes so somewhere in the middle of nowhere, central part of the country, rural town, you’ve not encountered it you haven’t felt it, even the healthcare professionals are denying that it’s a thing because they haven’t seen it.

Dr. Verghese: Exactly, yeah.

Dr. Z: And this is natural human response.

Dr. Verghese: And it brings us back to a story I feel like you’ve seen them and I’ve seen them in a profusion of personal narratives from nurses and physicians and others in the front line I think we have a human, you know, human sort of, compulsion to tell stories because stories are how we make sense of the world. Stories are how we communicate to our children from their very earliest days, we were telling them stories and they sort of begin to understand the world and the metaphor of story so I think it’s important for us to dissect the story where we are dissecting right now it’s important for individuals to sort of frame the story. And that might be a year from now to sort of frame the story of their COVID experience. What was it for them? What does it really mean? And you know, what is the epiphany? It might not be clear right now. And this is why I say it’s not just that the virus went away but those young house staff in Long Island are never gonna be the same. Long after the virus went away this will be a seminal experience of their lives the HIV experience was a you know, a life-changing experience for me to take care of those young men in that era, it informed everything I did.

Dr. Z: Monica said the same thing about her HIV experience because she has ward 86 in San Francisco General and said you know, how do you talk about public health? Things like masks, how do you talk about condoms? You don’t say “You know you better wear a condom you’re a bad person that’s gonna backfire.” There’s a way to do it back to the story thing you know, the narrative, the story it’s the fundamental human driver you don’t see dogs telling stories to each other although we may not perceive it.

Dr. Verghese: Yeah.

Dr. Z: Maybe they do it in a body language way in a way that we don’t perceive, but humans do it and it actually drives so much of what makes us good doctors and nurses because and this is where again I have a beef with the EHR it’s turned a story, which our note used to be it used to be just telling a story to ourselves like, hey this is what’s going on with Bob today, you know, he played tennis, the CD4 counts 12 but he’s having trouble. Now it’s like a boiler plate ransom note cut and paste.

Dr. Verghese: Yes indeed.

Dr. Z: It’s not a narrative anymore and I worry about that when we ran our clinic we actually had to build our own EHR with our partners Iora Health which unfortunately had the name Iora Clinical Information System or ICIS, which this was pre ISIS. And they wanted to change the name and I’m like, “Don’t change the name they’re the ones who suck, just keep it.” But the idea is it was narrative based. So it told the story of the patient and the story of each of their problems. So congestive heart failure had its narrative.

Dr. Verghese: Right.

Dr. Z: And it started with this idea that he was using a lot of pillows.

Dr. Verghese: Yeah.

Dr. Z:  And wasn’t able to keep up with his grandkids you know?

Dr. Verghese: You know, Bob Wachter says about the MRE, he says that we should have a big box at the bottom of every note that says and now what are you really thinking? Because with all the cuts and pastes, you know you can easily miss what are they really thinking? You know? What about this note is different from yesterday?

Dr. Z: Exactly.

Dr. Verghese: Hard to tell.

Dr. Z: Bob wrote a great chapter in his book about that actually, that was really well done he really nailed the problems with the EHR and again, you don’t wanna be a Luddite about it you’re not saying don’t use technology.

Dr. Verghese: Exactly.

Dr. Z: You’re saying wait, we’re humans you know, the other thing, I don’t know if we talked about this the last time we talked, but the idea of story language writing they’re tied together. So I have this theory and it’s based on other people’s work, that there’s a cognitive effect of writing with your hand when you’re listening to a patient or whatever that is not replicated by typing a note and that cognitive effect is lost in an EHR for better or for worse we don’t know the effect of it, but I know this when I was doing hospital medicine at Stanford, I would go into the patient’s room with a clipboard and I would take notes on them and when I’d hear, we talk about story, when I hear the story from the primary who was admitting them direct or from the ER doc, I would write the aspects of the story in my hand, then I would talk to the patient I’d write in my hand, I would make that little box with the labs I circle what I thought was important then later at night, I go to the computer and I pull up a template and I’d fill in the parts that I thought was important but without that writing, I wouldn’t have known that patient.

Dr. Verghese: No I think that’s well said in fact I have the saying that I write in order to understand what I’m thinking.

Dr. Z: Oh, that’s well said.

Dr. Verghese: You know, so I might write an essay I might be commissioned to write an essay for something an op-ed and you know, I can take a walk on the beach say and you know formulate my thoughts but there’s something magical about the act of you know putting your rear end in the chair and sitting down to write the muse only comes to you when you’re doing that. And I often find that in the act of writing, I sort of break through into an understanding a sort of a meta understanding that I don’t think I could have ever have gotten by just walking and thinking so there’s something magical about writing I mean it doesn’t have to be in my case, just using a pen but the act of writing out a thought, as opposed to articulating it or thinking it.

Dr. Z: Yeah.

Dr. Verghese: Takes you somewhere different and I am a big believer in that.

Dr. Z: This is fascinating ’cause I find the muse and this idea of creation to be fascinating the flow state that you can attain. when you’re open.

Dr. Verghese: Exactly.

Dr. Z: To this source of creativity when I went to your house the last time I saw and if we didn’t show all this on the video but you know, you had a setup where on the wall were these beautiful drawings and a kind of a connection of a web of the characters of the book you’re working on now, and it was visually laid out but then there were words and it was dense and it was beautiful to behold because I saw a glimpse into how you accept the muse a little bit and it’s different for everyone, right?

Dr. Verghese: It’s different from everyone I think you know, I sometimes feel that I’m dreaming my way through this novel, but at a certain point the novel is surreal that every morning I have to you know, reenter the dream and looking at those figures and I sort of give myself permission to reenter that world but you have to be disciplined. Somerset Maugham said famously he said, the muse strikes every morning but I have to be in the chair at 9:00 a.m. thankfully you know there was something he said that pointed out that you still need the discipline of being there and doing it you know.

Dr. Z: What you said is important Vinay Prasad and I talked about this a little bit this idea of the diligence, the work, the 10,000 hours of training are necessary but not sufficient.

Dr. Verghese: Exactly.

Dr. Z: To channel this muse and we call it a muse you can call it creativity, you can call it.

Dr. Verghese: Right brain.

Dr. Z:  Right brain I like to even think of it now, in terms of that I’ve learned in meditation, which is when you silence the mind you are nothing but this empty potential and that potential is constantly creating.

Dr. Verghese: Absolutely.

Dr. Z: It’s creating thoughts, it’s creating images it’s creating stories, it’s creating connections and if you close your mind to it or you’ve never trained your mind to accept, I forget who it was that she did a TED Talk that was beautiful “Eat Pray Love” the author of that did a TED Talk where she talked about this being in the path of this tornado that’s coming and if you’re not up early enough to stand in the path of it, it’s not gonna hit you.

Dr. Verghese: It’s not gonna hit you yeah. No, I think it’s actually profound and I think coming back to something you said about giving people the tools to question things if your mind is never silent I mean, we are almost addicted to our phones you know. we can’t sit on the.

Dr. Z:  Not almost.

Dr. Verghese: Without you know flipping through and at some point we’re missing an essential dialogue with ourselves so we have this apparent reality of who we are and who we present to society and we actually begin to think this is really who we are and only through quietening the mind as you’re doing through meditation, do you begin to appreciate that you know, that is all just the front of you. That is all just the reactionary part of you and if you don’t quieten the reactionary part, you’ll never get to you know the real you who might have an opinion about this entirely different from all this chatter out front. So, you know I often think a great meditation technique is not my invention is to ask yourself who is the person behind this watching you chatter away and that’s where you wanna get and it’s very hard to get there.

Dr. Z: I’m gonna take it one level deeper, that’s the self inquiry of who am I, who am I really watching here? Right? And that’s a witness in consciousness everything’s arising, it’s a witness but you know what’s crazy is there’s one level further which is what’s witnessing the witness in other words, even the witness is an appearance in something further back and even more empty of content but more infinitely creative and accessing that, so just a quick side when I do my shows, I prepare by reading about something, by thinking about it, by walking around and going, how do I believe about this based on this data and what I think, and what do I wanna say but I can’t really say what I wanna say, then I just go live I press the button I look at that lens right there and I get into a state where the mind empties and I’m just talking and for better or for worse so sometimes it’s disjointed and crazy and sometimes it’s exactly what I really meant. The real I is just coming out and it’s wonderful, but to be able to do that and have people occasionally appreciate that.

Dr. Verghese: I think when you get back there all the way back there to that beta state, when you come back out you have this tremendous empathy and love for everything you see, you know half the conflict that we’re dealing with is, you know the inability to really be in the other person’s shoes or have love for them or empathy if we can’t awaken that in the soul of people all the other stuff falls apart. And how do you awaken that? I think you remind them of you know the existence of that inherently in their lives, in their families and help them extrapolate from that. Not easy to do, not easy to do.

Dr. Z: Oh, you’re getting at the heart of this when I said earlier I said what we need back is a kind of a non-dogmatic spirituality.

Dr. Verghese: We need love.

Dr. Z: And we need love that’s what it is. Now people will go, oh couple of bald Indian guys talking about love like this is basically guru central they’re missing a bigger piece, which is loving kindness this willed compassion, this idea that you can recognize suffering, you can recognize common shared humanity and you can have a burning desire for that other person, no matter how other they are to be happy at peace and full of love themselves that comes from recognizing that primal state.

Dr. Verghese: Exactly.

Dr. Z: That we all share you and I share that same exact state.

Dr. Verghese: You know, what else we share which might be the real epiphany of this COVID is that we’re all mortal you know a rose is a beautiful thing only because it withers and dies if roses stayed at the way they were forever they would be weeds they would be a nuisance and similarly I think a human life is so poignant and for many of us, we managed to live most of our days not even imagining that we are mortal. And yet I think with COVID has come a sense of you know time is precious so when we get through this, anything you wanted to do, do it. Anything you wanted to say, say it, don’t waste time on hate, you know enjoy the fruits of your love and your labor. That’s the message.

Dr. Z: Oh, I wish more people would get that message especially online you know, like you said, we’re addicted to our phones we don’t have that space to be with ourselves, you know they say, I forget who said this and I forget the exact quote but it’s something to the effect of you’re never really gonna have things together I’m paraphrasing until you can be alone in a room with yourself for hours at a time.

Dr. Verghese: Yeah.

Dr. Z: And not necessarily with your thoughts, your thoughts are just appearances with your real self and that means not being fully addicted to this, not constantly being plugged in and then recognizing this idea and I think this is our opportunity. This idea of mortality so again, I keep talking about Monica Gandhi because she had a real effect on me at the end of our second interview she said, “Oh, by the way, I lost my husband,” and she’s my age. “Lost my husband he’s a cardiologist to cancer month before the pandemic struck and I have two young boys” that are my kids’ age. “My understanding of mortality is acute. This pandemic you either live through it as if you’re constantly afraid of that mortality and you’re living in fear or you recognize that we are all going to die and you live as if that’s the case.”

Dr. Verghese: Exactly.

Dr. Z: And I thought it was beautiful. And this can teach us that, right? But I tell you there’s so many of my people who watch the show who messaged me and say, “I’m so racked with anxiety I’m so afraid, I’m afraid to leave my house I already had generalized anxiety or panic or whatever trauma and now this has made it that much worse.” How do you think about that?

Dr. Verghese: Well you know I have advice for you know, a lot of my colleagues and my staff and we talk about this a lot we have a very sort of robust, you know circles where we discuss all the things that are going on but my advice is, remember such a thing as the magic of reading you know, there is something very special that happens when you read a book you take those little signals on the page that we call words, and in your mind they create this movie and you escape to this very, very beautiful place, but it’s not just an escape, it’s an education you know, “A novel is the great lie that tells the truth about how the word lives.” That’s a great quote by Dorothy Allison so you know you read to your horizons you’re stuck in the house afraid to go out, okay don’t go out, but take up the “Love in the Time of Cholera” by Gabriel Garcia Marquez, travel to Macondo or wherever you know I think that these are the ways we sooth ourselves put the phone away. Especially at that time at least an hour before bedtime, put it away, try to get in better shape, try to eat better, but do it in a forgiving way don’t beat yourself up if you don’t have that ice cream so I think there’s a lot of need for us to forgive ourselves, be kinder to ourselves the place where love begins has to be with us you know loving ourselves.

Dr. Z: It’s the hardest thing you know they have these meditations Metta loving, kindness meditations, and one of the last targets you target you target people that you love really closely and you wish them well and feel this sense of love and it’s a kind of a visualization. And then you turn that ultimately on yourself.

Dr. Verghese: Yeah.

Dr. Z: And that is the hardest thing because well you know so much unworthiness and self hate.

Dr. Verghese: Exactly.

Dr. Z: And regret and all this and turning that beam a spotlight on yourself when you feel it finally and you go no, you know what I’m doing the best I can if I actually forgive myself, I can be better to others. How can I forgive others if I can’t forgive myself?

Dr. Verghese: Exactly.

Dr. Z: I’m holding myself to this impossible standard.

Dr. Verghese: The same with fear, I mean, we are all fearful of this, we’re all fearful of what it’s going to do to our families, to our lives, to our livelihoods. And courage is not the absence of fear, courage is that you somehow go on despite the fear. I cannot go on, I must go on I go on, you know, and every time you do that, you build that muscle, you are proving something to yourself despite the fear you’re still going on.

Dr. Z: It’s like a resiliency muscle.

Dr. Verghese: This too shall pass this too will pass.

Dr. Z: Exactly oh, you said something about story and reading. I have a question do you think that listening to an audio book is the same different interchangeable?

Dr. Verghese: So I’m actually enjoying listening a tremendous amount I do a lot of listening, and I think it’s a different experience for the listener I mean, I’m enjoying it in a very different way, this made me much more conscious as a writer technically of the realization that this is probably gonna be read aloud as often as it’s going to be read. And I think as a writer it’s always good practice to read your work aloud because something that looks good on the page you know, might be off there might be an alliteration that you didn’t intend or a little you know rhythm being off, but I’m much more conscious of it now. From the listener’s point of view I don’t think it makes any difference reading versus listening I do find myself a little, more patient with these long expositions in a novel, for example only because I have no choice I can’t quite skip ahead because I don’t know what’s ahead, whereas on the page you can sometimes see oh, you know, here is, Melvin is gonna go on about a whale blubber for the next 15 pages.

Dr. Z: It’s gonna suck, but when you’re listening to it.

Dr. Verghese: When you’re listening, you have no choice and sometimes as a consequence you sort of get a deeper appreciation of how worthwhile it was to keep that in there.

Dr. Z: I recently rediscovered your novel “Cutting For Stone” on audio book and there’s a gentleman with an Indian accent who reads it and the way that he says the names even “Sister Mary Joseph Praise”, Sister Mary Joseph Praise and it becomes like a mantra almost and your listening to it and it just draws you into the story in a way that’s different than reading. They both have their value, but I think that it’s fun to experience both. You know you mentioned, “Beowulf” early on and Grendel and in high school I wrote my senior English thesis for AP.

Dr. Verghese: Seriously?

Dr. Z: On “Beowulf” and its parallels to “Lord of the Rings” and how Tolkien had actually been a “Beowulf” scholar as well as a linguist and invented all these languages that aren’t typical paradigm of the monster the other comes into the village and as Sauron is the same thing or evil that comes in and how the call to adventure which you said, you know, you’re called then and the hero comes through and now to see my nine-year-old old pickup, you know I read her the “Hobbit” during the pandemic and she was like, “That was good, what’s this big thick book you have?” “Well that’s the combined “Lord of the Rings” it’s this thick I don’t think you’ll wanna read that because it’s a lot of names.” “Can you read it to me?”

Dr. Verghese: Wow.

Dr. Z: Oh wow all right let me crack this thing open, you know an unexpected party, you know, long expected party go back and she is riveted to the story.

Dr. Verghese: Wow that’s a good sign, that’s wonderful.

Dr. Z: It’s really great and it’s this imaginary but the themes are so important, this theme of evil coming in and how do you respond to it? Power and the seduction of power you know.

Dr. Verghese: Yeah yeah.

Dr. Z: Very timely.

Dr. Verghese: Somewhat living the story right now for all the angst that we’re going through. You know, these are the times when, you know if they say in writing that a character is never fully defined until the character makes a decision under pressure. So these are character defining moments for all of us as a society, we are under tremendous pressure and the next action we take individually is really what defines us, so you can describe a character and his height and his weight and his color and you know, all the pretty things he says but it’s only when he’s faced with a crisis and he has to make a decision character is defined by decisions made under pressure. That’s us.

Dr. Z: That’s a good way to think about it and you know we have to add to that is, I think there are a lot of people who regret decisions they’ve made under pressure or have made decisions that they don’t feel comfortable with now that was not the decision I should have made I think the first step is to forgive that.

Dr. Verghese: Forgive yourself.

Dr. Z: Because you made the only decision you could have made in that moment with everything that you had in that moment you made the decision you made now.

Dr. Verghese: Right.

Dr. Z: What are you gonna do next?

Dr. Verghese: Exactly.

Dr. Z: That’s what matters.

Dr. Verghese: And there is only this moment and the next day there isn’t a past, there is only this moment there’s only us here now and you know, I think too often we’re watching commentary on TV, which I rarely watch you know, I was just amazed how much of it is about the past and about a future and so little of it is about the now this moment, you know?

Dr. Z: Again you’re hitting on these very timeless, spiritual themes of there’s only the eternal now moment and yet so the past is a tracing and the future is an anticipation in now, everything is happening now you know, there was a guy I saw recently talking about his experience using a drug called 5-MeO-DMT that’s derived from a toad. And he said that on this drug your ego dissolves, I’ve never done this drug. Ego dissolves and you’re left in an eternal present moment as everything and he said, he realized he came back and he said, “Wow, I’ve been this eternal now here and now forever imagining worlds forever here and now here and now if the dinosaurs happened here and now the big bang happened here and now forever, it’s me doing it”

Dr. Verghese: Wow.

Dr. Z: And that resonated with me in a way that I almost I was like, “Oh my gosh, that feels weirdly right,” and also terrifying weirdly and again, it gets to that point if you live in the now you can be more mindful of what a future now would look like.

Dr. Verghese: Exactly, yeah. In fact, I have a through-line in my novel, that is the past is unreliable, only the future is certain. And I mean, there’s some truth to that, the past is unreliable because we make of our past whatever story we want, you would think well I know this happened and this happened, oh yeah well, but the spin you put on it is all yours. And only the future the fact that it’s gonna unfold is certain, the past is unreliable.

Dr. Z: That’s brilliant actually, it makes me think again of this idea that if we’re just here and now we’re inventing the past every second.

Dr. Z: Every second.

Dr. Verghese: We are.

Dr. Z: We’re recreating it.

Dr. Verghese: Yeah.

Dr. Z: Based on some tracing we have in now about you know, it’s really crazy everything we’ve been through every life experience, all our training every patient we’ve seen, we’re recreating it now you know, it happened in a now we think but man, and that really reframes it in any second you can be a new person in any second, the story that you tell yourself can be different.

Dr. Verghese: Absolutely, yeah.

Dr. Z: Yeah.

Dr. Z: How do you think about the narrative I? The person who is, the subject of your story your internal storytelling of who you are I mean, how do we construct that?

Dr. Verghese: Well, I think the narrator is constantly changing you know, the narrator’s struggling to find himself, the narrator’s too often relying on the past to frame the future you know so I think we’re all searching but it’s part of the wonderful quest, I mean sometimes I just marvel at this business of being alive and I think you know, do dogs and cats have these sort of existential moments where they wonder well, what am I doing in this role? Am I supposed to be working on this? Or is this what I should be doing? Not that I would trade places with them for a moment but by the way, dogs are just great examples on how they treat each parting as though it’s forever.

Dr. Z: Right.

Dr. Verghese: And they treat each coming back of yours as though you’d been gone for years it’s a quality that I think we could easily embrace. It’s a bit of that in the now kind of thing

Dr. Z: The now moment right? You know, I feel like the bigger the brain you have the more baggage you have of self-referential thought.

Dr. Verghese: Exactly.

Dr. Z: We create a narrator in our mind that we refer to this little mini me in our head and the dogs maybe don’t have that or they have a very rudimentary version, right? Dolphins maybe have a more advanced version of it.

Dr. Verghese: Much more.

Dr. Z: Yeah it’s interesting dogs too and cats, the way they die is interesting. You don’t see that they’re you know terrified and that they’re self referentially you don’t get that sense you get the sense that they’re accepting this moment.

Dr. Verghese: You know there’s a scientist in a UCSD by the name of Ajit Varki you might know his work but you know he postulates that, humans are the only creatures pretty much who are aware of their mortality and still manage to go on.

Dr. Z: That’s true ’cause how can a dog know.

Dr. Verghese: I mean, you’ve only, they see elephants have memory and seem to mourn their young but by and large, most other species actively says though you know, they have no awareness of their mortality. If they did it would probably cripple them. We have awareness. And yet we manage to go on, in fact, I think it’s the reason we make our lives what they are and so special because we are aware that you know life is a terminal condition. And I was Doris Lessing said, Whatever you’re gonna do, do it.”

Dr. Z: Yeah.

Dr. Verghese: Don’t wait.

Dr. Z: We’re this instantiation of being a human is exactly that fascinating sometimes I’ll sit and think about that in meditation, that I’ll look at bird sitting outside my window and I’m meditating and I often do eyes open meditation. So I’m taking in things trying to be nonjudgmental and just perceive, and I’ll see a bird and I’ll imagine me as the bird is in the moment looking around and then I’ll come back in my body. And it’s just this multilayered like.

Dr. Verghese: Yes.

Dr. Z: Oh, there’s a narrator there are thoughts floating there’s anticipation, there’s distraction and underneath it all is this being, this sense of I am like, I am here.

Dr. Verghese: Yeah.

Dr. Z: I’m having an experience and how incredibly rich and complex it is and then we’ll take a patient and reduce them to a one line.

Dr. Verghese: A one-liner.

Dr. Z: A one-liner you know.

Dr. Verghese: 37 year old with chest pains.

Dr. Z: Right or 27 year old drug seeker.

Dr. Verghese: Yeah.

Dr. Z: You know the labeling and the more malignant sort of one-liners that you can put on people, you’ve reduced to this complex suffering to drug seeker.

Dr. Verghese: Yeah.

Dr. Z: Yeah, yeah.

Dr. Verghese: What a strange time this is you know but the blessings are just this getting to talk to you, getting to, you know think like this, so I don’t know that we have this luxury at any other time to think about the spiritual in the context of medicine quite the way we’re doing right now, it is a special time.

Dr. Z: It highlights those silences between what we do and say.

Dr. Verghese: Yes, yeah.

Dr. Z: When everything is poignant yeah. Man Abraham, what a joy. Such a joy.

Dr. Verghese: Treat for me, thank you.

Dr. Z: Really a joy. Thank you for being with us.

Dr. Verghese: You’re very welcome aren’t you glad I wore the bow tie.

Dr. Z: You know what?

Dr. Verghese: Without that, there’d be so much confusion here.

Dr. Z: I wouldn’t be able to edit it because I’d get confused as to who was talking. Guys. I don’t know what to say I say, share this video and we’re gonna try to have more conversations these are the conversations I think that, they matter for me. So even if they don’t affect even another person, they affect me in a way that makes me more whole in the moment so thank you.

Dr. Verghese: And you know what we did we were entirely in the now.

Dr. Z: I think you’re right.

Dr. Verghese: The whole time.

Dr. Z: You know, can I tell you something? So doing this I mean you’ve see the studio, there’s a lot of stuff here there’s nobody helping me so a lot of times I’m looking at the box there to make sure it’s still recording, I’m watching the screens up there to make sure that we’re still framed right nothing is glitching ’cause stuff glitches and my mind is multitasking in all these different ways while trying to talk and be focused during this conversation I don’t think I did that. Just like, tell me more. Tell me more about “Beowulf.”

Dr. Verghese: That’s how I felt.

Dr. Z: That’s really lovely. Thank you for doing all you do and thank you for bringing this humanity back to what I think medicine always has been which is this art and science combined, it’s a distinctly human venture.

Dr. Verghese: Thank you for what you do. ‘Cause you take our narrow world and you make the whole world see it so thank you for that. Very precious.

Dr. Z: And after this, we both send each other a $10 check for blowing smoke up each other’s butts. You gotta love it because it’s honest and authentic. My brother thank you again and we out peace.