EP121: Exploring Medical Humanities and Physician Well-being with Dr. Dean Gianakos: Part Two

In this episode of SEE HEAR FEEL, Dr. Dean Gianakos returns to discuss his role as Chief Academic Officer at Centra Health, his interest in medical humanities, and his journey with The Pharos journal. Dr. Gianakos shares an inspiring anecdote about the poet John Stone and reflects on themes of burnout and personal growth through the metaphor of whittling. He also recounts how his curiosity led him to contribute to The Pharos, ultimately becoming a member of its editorial board. This conversation highlights the importance of noticing the small details in life and following one's passions.

00:00 Introduction and Guest Bio

00:52 John Stone's Influence and Anecdotes

02:10 Exploring Burnout Through Poetry

03:46 Involvement with The Pharos Journal

07:12 Reflections and Closing Thoughts

Dr. Dean Gianakos MD, FACP is currently Chief Academic Officer at Centra Health, a Central Virginia regional healthcare system. Wellness is important to him, and he has been chairman of Centra’s Physician Wellness Committee. He is trained as an internist with previous certifications in Pulmonary Medicine as well as Hospice and Palliative Medicine, and he has taught many family medicine residents and medical students for almost 3 decades. Dr. Gianakos is interested in the medical humanities as well as end-of-life care, the patient-physician relationship, and communication. He is currently on the editorial board of The Pharos, a medical humanities journal. He is also a writer, and he has written, “Practicing medicine can be addictive. The daily praise and gratitude from patients feed the fragile egos of physicians.” Links to a few of his articles: the lonely physician, Whittling: The Last Class, leadership.

Transcript

Christine Ko: [00:00:00] Welcome back to SEE HEAR FEEL. Today I have the pleasure of doing a part two conversation with Dr. Dean Gianakos. I'll reread some parts of his bio here, some of which I did not share for the first part of the conversation. Dr. Dean Gianakos MD, FACP, is currently Chief Academic Officer at Centra Health, a Central Virginia regional healthcare system. Wellness is important to him and he has been Chairman of Centra's Physician Wellness Committee. Dr. Gianakos is interested in the medical humanities and is currently on the editorial board of The Pharos, a medical humanities journal. He is also a writer, and I'll put a link to a couple of his articles in the show notes. He has written, "Practicing medicine can be addictive. The daily praise and gratitude from patients feed the fragile egos of physicians." 

Dr. Gianakos is going to start with an anecdote about John Stone, who wrote the poem, Gaudeamus Igitur, that I shared a few weeks [00:01:00] ago. And we're going to talk about another of John Stone's poems called Whittling: The Last Class. Can you start with your John Stone anecdote?

Dean Gianakos: John Stone was amazing. He came to Lynchburg in 2003. So this is what great poets do. They notice things. So he held a seminar for physicians. There were only four of us who attended. I escorted him to the seminar room in the hospital. And on our way there, we're in the parking lot, he stops and he said, "Dean, these ginkgo trees are just knock down gorgeous." I said, "Dr. Stone, what ginkgo trees?" I've been walking there every day into the hospital. I hadn't even paid any attention to them. Then he immediately pulled out a book of poems that he had written that he was going to give to me. And he directed me to a poem that he wrote about a ginkgo tree and then signed his name below the poem. I'll never forget that. And now I never fail to notice a [00:02:00] ginkgo tree. 

Christine Ko: I love that story. It's just so many things that we walk by every day that we just no longer or maybe never noticed, right? 

Dean Gianakos: Correct. 

Christine Ko: You wrote an article about John Stone's poem that is about whittling. It relates to burnout. Would you share some thoughts about what you wrote? And any further thinking you've done on burnout? 

Dean Gianakos: It's funny. So I wrote that article, gosh, it's been 10 or 11 years. And when you said it had something to do with burnout, of course I had to go back and read the article and the poem. Did I really say something about burnout in here? Wood is a metaphor for your life. This is my interpretation. This is someone whittling their life. There's the expression "whittling your life away", which usually tends to mean that you're idling and you're not doing anything purposeful.

Stone, I think, is trying to say, that's valuable. It's also valuable, he says it specifically in the poem, to keep moving, which I love, because in terms of [00:03:00] burnout, there are times when you are reflective. There are also times when you really need to keep moving. He says you better keep moving for the reason that life is short. He doesn't use that cliche. He says, "before a pair of pliers squeeze" your heart." You have a heart attack. So we're always you know, whittling or carving out our life, shaping our life. But he also says be careful to not shave towards you, but shave away from you. And I took that to mean shaving away from you means not to be so self centered, not to be so focused on yourself. Shaving away that your goals become other directed.

Christine Ko: Okay. I'm going to move on to a slightly different context. You are involved with the literary journal, Pharos. Will you talk a little bit about that? 

Dean Gianakos: I was an intern in internal medicine at Georgetown. I'd been up all night and I got off early. This [00:04:00] particular day, I decided I'm gonna go for a run and really explore the campus. And so I run by this office, Kennedy Institute of Ethics. And I say to myself, Oh, this is interesting. This is on the campus, which is at least several hundred yards, maybe further, from the hospital. I said, what is going on in this office? Because I was already beginning to experience ethical dilemmas, as an intern at the hospital. So I decided, you know what? I'm just gonna knock on the door. And this lovely woman answered. I said, I'm curious what goes on in this building. And she says, please come in. The director of the program is in. It's Dr Edmund Pellegrino, who was at that time one of the most renowned physician ethicists in the world. She shuffles me into the his office, and all of a sudden we're in a we're in conversation. He said, Dean, are you familiar with the journal? Cause I started talking, telling my interest in William [00:05:00] Carlos Williams and the humanities. Are you familiar with The Pharos? I said, no, I don't know anything about it. So that's how I discovered The Pharos. Okay. Fast forward, maybe 15 years later. I'm now teaching at Lynchburg family medicine residency as an internist, former pulmonologist and critical care doctor, loving my career. I said, now's the time maybe to explore even deeper my interest in medical humanities. And so I wrote the editor of The Pharos. His name was Ted Harris. I asked him, would you be interested in having someone review essays for The Pharos? And a wonderful thing happened. He said, yes, with one exception, I'm going to be sending you poems to review. So I decided, okay, I'll dive in. I know a little bit about poetry, not much. He sent me a poem once a month. I would spend a lot of time critiquing the poem. And after three years [00:06:00] of diligent work, I got this wonderful letter. We would now like you to join the editorial board of The Pharos for your tremendous contributions. I was completely humbled. And the activity itself had been enjoyable to me. The activity itself that had so much meaning for me. 

Christine Ko: I love all your stories. That one's great because it shows, in reality and the real world, it's not always true, but your story does really support the idea that you follow your passion, you follow what you enjoy doing, and then you will be rewarded and find success, whatever that means to each individual.

Dean Gianakos: I'm gonna tie it back to your question about whittling, the last few lines of the poem: to find a truth that's good enough for you, that's resonates with you, that's authentic, that is your own personal journey that you've spent a lifetime finding.

Christine Ko: Whittling: The Last Class, that poem, the [00:07:00] exact lines are, " There's plenty of wood for everyone and you, go ahead now. May you find in the waiting wood, rough and spoken, What is true, or nearly true, or true enough."

Dean Gianakos: Another favorite question. Okay. What do you think about what I'm saying? That's one of my favorite questions. What do you think about what I'm saying? You can comment on anything. 

Christine Ko: I mean, you've given me a lot of food for thought. And that's partially one of the reasons why I enjoy doing the podcast is since I edit and look through the transcript and listen to it more than once when I'm putting it together. It really makes me rethink over and over again. What are the things that are more crucial if I'm whittling things down? In terms of what I think about what you've said, in broad strokes, is I find it very inspiring. You've been a physician for decades, right? Maybe because of your interest in poetry and the humanities and writing and your work with The Pharos: you're an [00:08:00] intern, and then, 15 years later, you work on a poem a month. And then three years later, you become part of the Editorial Board. I find it inspiring that, seemingly to me as an outside listener to your stories, it does show an overall curiosity, right? Overall curiosity to see where your physician work, your interest in literature, poetry, where does that take me? When you reached out to the editor, I think you said his name was Dr. Harris at the time. He'd said, no, not essays, poems. And you were like, okay, fine. If you were a little bit more closed minded about it, if you thought, no, then all the poems that you would have read wouldn't have been read, and the eventual position on the editorial board wouldn't have happened. It just seems to me your whole life is permeated by curiosity to see where your job takes you, where your work with a patient takes you, where the Uber driver's story that day takes you. And I'm thinking probably helps prevent you from [00:09:00] getting burned out.

Dean Gianakos: Christine, that is just an amazing summary of our interview. What a thoughtful interviewer you are and a pretty amazing listener to absorb that. And then communicated it back to me. Thank you. Thank you for that.

Christine Ko: You're welcome. Thank you for spending the time.