In cancer and palliative care, patients who have a strong working relationship with their doctor have been shown to experience greater wellbeing, quality of life, meaning, and peace. For many physicians, who they are as a person and how they connect with their patients is one of their primary instruments of healing. But it can be a delicate instrument. Encountering intractable suffering day after day can take its toll – and finding the delicate middle ground between taking on too much of a patient’s suffering and abstracting it all away is one of the great balancing acts of doctoring.

Our guest on this episode is Dr. Keri Brenner, psychiatrist, palliative care doctor, and clinical associate professor of medicine at Stanford. Dr. Brenner attended Yale School of Medicine before completing her residency in psychiatry and fellowship in palliative medicine at Harvard. She is a nationally recognized leader in “PalliPsych” initiatives that integrate psychiatric, psychological, and psychotherapeutic principles into serious illness care.

Over the course of this episode, Dr. Brenner shares how her time volunteering at Mother Theresa’s home for the dying in Kolkata led her to a deep study of suffering and eventually to medicine. We discuss the doctor’s role of accompanying patients through hard times and the folly of trying to impose a silver lining onto another’s suffering. Finally, we explore strategies for how physicians can be a healing presence for their patients without being overcome by the pain they witness.

In this episode, you’ll hear about:

3:00 - Dr. Brenner’s path from volunteering at Mother Theresa’s Home for the Dying to becoming a psychiatrist and palliative care doctor.

13:38 - What Dr. Brenner has learned about the phenomenology of suffering

26:09 - How Dr. Brenner approaches her work when many of the challenges her patients face cannot be fixed

32:15 - Practices and perspectives that can help physicians be attuned to the suffering of their patients

53:43 - The care that palliative physicians provide to other doctors

59:18 - Finding the emotional balance between empathy and over-identifying with patients

1:06:30 - Keri and Tyler reflect on a shared experience with a palliative care patient

1:14:20 - Dr. Brenner’s advice for infusing more presence into patient practice

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