One of the most mysterious and frightening entities in medicine are prion diseases — rare neurodegenerative disorders that are usually infectious in nature but involve not bacteria or viruses, but proteins. Prions are misfolded proteins that can induce normal proteins to become misfolded as well, resulting in a chain reaction that leads to irreversible brain damage and death. What makes prions alarming is that they are incurable, can incubate for decades in a person's brain without symptoms, and are usually associated with 100% mortality within months to a few years.

Sonia Vallabh, PhD was a recently-married lawyer in her early career when she witnessed her mother's baffling sudden health decline and death. Her mother was ferried from hospital to hospital, yet dozens of doctors could not figure out why she was seemingly succumbing to rapidly progressive dementia at the age of 52. It wasn't until after her death that Vallabh discovered the cause was a genetic prion disease. Subsequent testing revealed that Sonia Vallabh herself had inherited the same genetic abnormality. Determined to find a solution, Vallabh and her husband Eric, a transportation engineer, decided to retrain as biomedical scientists in a race to cure her before it grew too late. The couple now leads a prion research lab at the Broad Institute at MIT and Harvard. They are also the co-founders of the nonprofit Prion Alliance.

Over the course of our conversation, Vallabh opens up about what it was like to accompany her mother in her last months of life, the psychological toll of dealing with a fatal medical mystery, how she lives each day with an awareness of how ephemeral life is, what prion diseases are and what makes them so difficult to treat, what makes her optimistic about the future of her work, and more.

In this episode, you’ll hear about:

3:23 - Vallabh’s early memories of her mother and the devastating experience that overcame her at 52 years old

16:37 - The process of grieving the loss a parent

22:32 - What prion diseases are

25:35 - How Vallabh made the decision to undergo the genetic testing that confirmed she inherited a mutation thah causes prion disease

36:27 - Vallabh’s major career change to become biomedical researchers

45:50 - Where the quest for an effective therapy for prion disease currently stands

52:08 - Vallabh’s message to listeners on how to approach life

View Sonia Vallabh’s TED Talk on her quest to cure prion disease.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

Copyright The Doctor’s Art Podcast 2024

The second half of the 20th century saw monumental shifts in civil rights in the United States, with the end of legalized racial segregation, discrimination, and disenfranchisement affecting all spheres of life, from education to health care to housing to marriage and more.

Judge David S. Tatel is a civil rights lawyer who has contributed to key advancements in voting rights, educational equality, and disability rights. Over the course of his five-decade career, he has served as Director of the National Lawyers Committee for Civil Rights Under Law, as Director of the Office for Civil Rights during the Carter administration, and as a federal judge on the D.C. Circuit, considered the second highest court in America.

Judge Tatel also happens to be blind, due to a rare genetic condition called retinitis pigmentosa. In 2024, he published a book titled Vision: A Memoir of Blindness and Justice.

Over the course of our conversation, Judge Tatel opens up about how he has wrestled with vision impairment in both his legal career and his personal life. He discusses what it was like to be diagnosed with an incurable, progressive, blinding disease as a teenager, how he struggled to make sense of his identity as a blind individual even as his career was taking off, his philosophy as a lawyer, how his beautiful relationship with his wife and children have helped him navigate the world, and how he met his guide dog, Vixen. Judge Tatel's legacy is one of judicial integrity, a lifelong commitment to equality, and a testament to the boundless potential of individuals living with disabilities.

In this episode, you’ll hear about:

3:45 - Judge Tatel’s experience of being diagnosed with retinitis pigmentosa as a teenager

15:33 - The inspiration that led Judge Tatel to focus his legal career on civil rights

22:47 - Judge Tatel’s experience of progressively losing his vision while ascending in his legal career

28:05 - Visual elements of life that Judge Tatel misses and how he now “experiences” vision

33:12 - Why Judge Tatel regrets concealing the truth about his blindness early in his career

37:01 - How Judge Tatel’s blindness has influenced his civil rights work

44:45 - Judge Tatel’s concerns about the future of democracy in the United States

46:27 - The ways in which getting a guide dog late in life changed Judge Tatel’s sense of freedom and his perspective on blindness

49:06 - Judge Tatel’s advice to his former self

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

Copyright The Doctor’s Art Podcast 2024

Addiction is often misunderstood not just by the public, but also by clinicians. It challenges us as individuals, families, and communities. To understand addiction is to understand not only human behavior and neuroscience, but also social networks, public policies, and bioethics. Our guest on this episode, Keith Humphreys, PhD, is a psychologist who specializes in addiction and has served on the White House Commission on Drug Free Communities during the Bush administration, and as Senior Policy Advisor to the White House Office of National Drug Control Policy during the Obama administration. His research on recovery support systems like Alcoholics Anonymous and on the opioid crisis has shaped how we understand addiction recovery.

Over the course of our conversation, Dr. Humphreys shares how he became interested in addiction medicine, what happens to our brains when we become addicted, the difficulty of balancing interventions with a respect for patient autonomy, why social networks can be powerful tools in addiction recovery, possible solutions to the opioid crisis, and how clinicians can better establish trust with patients facing addiction.

In this episode, you’ll hear about:

2:36 - How Dr. Humphreys became interested in studying the psychology of addiction

4:34 - The neuroscience of addiction

9:15 - Whether addictive behavior is a matter of personal choice

16:27 - How clinicians can address patients who do not yet recognize their addiction as a problem

21:36 - What GLP-1 inhibitors can tell us about the mechanisms of addiction

26:07 - The benefits of peer support groups (like Alcoholics Anonymous) for addiction recovery

32:55 - Dr. Humphreys' work on drug policy

37:32 - The rise of the opioid crisis

43:05 - Policy models to address substance abuse

48:24 - How medical professionals who are struggling with addiction can seek help

51:25 - Dr. Humphreys' advice for clinicians on how to connect with patients who are struggling with addiction

Dr. Keith Humphreys can be found on Twitter/X at @KeithNHumphreys.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

Copyright The Doctor’s Art Podcast 2024