Episode Transcript
[00:00:00] Speaker A: Foreign.
[00:00:07] Speaker B: Hi, everyone. Welcome back to the beyond the Diagnosis podcast. Today I am joined by Dr. Raj Dasgupta. He is an expert in pulmonary, critical care, and sleep medicine. You may know or recognize him from the doctors KTLA and Larry King now.
[00:00:25] Speaker A: Or.
[00:00:26] Speaker B: Or if you're an inspire member, you may recognize his name from our Q and A's, our Ask the expert series.
Dr. Raj, thank you so much for joining us today. Could you, for those of us who don't know you, could you give us an introduction and just give us a little bit more detail about your background?
[00:00:42] Speaker A: Sure. So, anyways, hey, I'm Dr. Raj, and you know what my claim to fame is? I'm just super nice. I am Jill, ain't I? Very nice.
[00:00:51] Speaker B: You are, yes, absolutely.
[00:00:53] Speaker A: But you do want me to brag about myself. And don't worry, I have no problem with that.
I am quadruple board certified, and you're going to ask me in what so sleep medicine. But don't go to sleep during the podcast.
Pulmonary, which is the lungs, critical care, and the last is internal medicine, which I feel is the foundation of trying to be a good doctor, because I really believe in the word integrate. And when I'm not pretending to be a doctor. Just joking. I do a lot of different media things. I know you. You mentioned the doctors, and I had a show with Ann Curry called Chasing the Cures on TNT and TBS that was so super proud of it. But then that pandemic happened and it didn't get picked up the next season. I'm so sad. And I do a lot of teaching, and I do have, like, a book series, and I agreed to go on this podcast because my book series is called beyond the Pearls, and this is beyond the diagnosis. So I love the word beyond. But, yeah, I love doing these things. I love raising awareness. I love the David and Goliath story where there's a Z states that don't get enough notoriety, and I'm there to actually bring it to the forefront. And I love the fact that it's all about patient and the caregiver. So this is a good podcast for me to be on.
[00:02:10] Speaker B: Yes. And thank you so much for joining. And I, you know, in our prep calls, we had so many conversations about your kind of duality as a physician as well as a caregiver.
Your father had Alzheimer's and your son is autistic. And I want to really kind of dive into how that has kind of shaped your patient care. Right. How that has shaped how you deliver a diagnosis to a Patient. So first, how do you approach delivering a serious diagnosis to a patient?
[00:02:44] Speaker A: So I like how you said a serious diagnosis. So I think in my opinion, all diagnosis are serious because everyone's a little bit different. And I think it's easy to downplay when you're a doctor, a resident, a fellow, to say, like, hey, you've seen hypertension every day, and you don't show the empathy when you say, hey, your blood pressure is elevated. You know, I know we focused on two things on our back call, which was, hey, what about chronic obstructive pulmonary disease? What about obstructive sleep apnea? And I think the first thing I do is just say that, you know, instead of focusing on the negative parts of things, I always focus on, hey, what are our options? What are our treatments? And it shouldn't surprise anyone out there that it's all about being positive. It's all about knowing your audience. Of course. But I did want to say something. I always chuckle because there's something called press gaining scores.
Jill, you know, have you heard of those before?
[00:03:41] Speaker B: I have, but I couldn't tell you what they are.
[00:03:44] Speaker A: They're all about patient satisfaction. That's good, you know, so every year we always have these meetings to say, how can we improve our patient satisfaction? And I see doctors taking notes like, okay, make eye contact, don't speak fat. You know, and these are all great tips. You know what I mean? But if you ask me, what's the hardest part about being a doctor, is that knowing how to interact with others, knowing how to form the bond, especially when you have this much time to do it. It's not something you just read in a textbook and someone give you a review course. And that's why I'm like, I'm glad they're doing it. I hope their scores go up. But it's something that it just happens and it's innate. And that's the thing I'm most proud about, and that's the thing I try to teach the most naturally to the future generations of doctors, is to make that interaction. But. But to answer your question, it's all about, hey, what options are going to be out there? Where do we go from here? Not taking steps in the past because we can't jump into the back to the future time machine and suddenly change anything. But it's about, hey, what's our steps forward? And I got to tell you, one thing is that if you ask me, how does having an autistic son, having an Alzheimer's, how does that change Me as a person is, you know, ever since I had both in my life and I still have my wonderful son Aiden, my dad passed away in January from Alzheimer's, that I realized that life is full of uncertainty. When you ask me what's going to happen to Aiden today when I pick him up from school, I don't know.
When you ask me, is my dad going to walk out of the house? You know what I mean? When he was with us and alive, I don't know. And I think is that that's what medicine is for many individuals. You don't know what the future has in Stol, whether you're talk about breast cancer, whether you're talking about obstructive sleep apnea or just carrying a diagnosis that your lipids are too high, you need to be on Crestor or something. You just don't know. And I think that because of that, I approach every interaction moment here, being present for myself, for my patient, for the people I train. And I think that was the biggest influence of having those two people, disease states part of my life.
[00:05:57] Speaker B: Yeah. No, and that makes perfect sense. And it sounds like you're saying, be a human when you're delivering this news. Be human. Right. Be empathetic, be yourself.
Rather than the clinician is just reading it off of the chart. Right. Because the patient, this is the first time they're getting that news and they're kind of going to be blindsided by it. Right. They might. Of course, they don't know one once bad news. Right. So what patterns have you observed in the past patient process when they're processing that diagnoses, you know, and how can clinicians sort of bridge that gap and that emotional support need for the patients?
[00:06:38] Speaker A: Oh, this is the toughest question. That's like solving the Rubik's Cube, you know what I mean? And I think number one is going to be what we don't have, which is. Which is time. Time is the most important thing in our lives. You know, it is precious for the patient and for clinician and to sometimes form that trust, that bond. You know, it's just, it's so hard when already by the time the patient sees us, there's a lot of levels, frustration, trying to make the appointment, get the appointment, the parking's not paid for, then they see you. Then next thing you know, I don't have the imaging available to us. And I'll give examples. You know, there is a disease state I represent for Inspire called sarcoid. And it is a rare diagnosis. Rare, unless you have it, of course. And to see someone who specializes in it, it takes a while to make that appointment and even fine to navigate through the medical field. And how frustrating is it that there are misdiagnosis along the way. People who kind of knew it was because they attended a few medical school classes, but they don't really know then you have to go to another place. So I really feel that it's about like finding the right doctor, which is tough in itself because there's so limitations. What insurance do you have that really has the time and knows how to really form that bond with you because it meshes well with how you approach life and approach that disease state. For example, one of my favorite people in the whole world was my father in law who passed away. He had glioblastoma, which was a tumor of the brain. And he was went to a university setting to actually help out with his multidisciplinary care. And his oncologist was a really young person. I swear he just graduated. And I was kind of like, you know, dad in law, is this the right person for you? And he looked at me and he just said he makes me happy when I walk in there. He actually gives me hope when I go in there. And it wasn't about, you know, scrutinizing did he read the latest journal articles and they're offering things and this guy was smart. But it's just amazing what what people want, what people need just to march forward in any disease state. So the where am I going with this? Is that when we talk about doctors now, the, the playing field has changed, you know what I mean? I think that being part of university is great and I love that I was part of that system for the most super longest time. But maybe the university setting it are for those more the uncommon diseases you do need multidisciplinary. But when you have something that you know is what we call the bread and butter of any subspecialty, that having some that you could go to close to your home that has the time to do things that really feels that they are well versed in that disease state, that's where things are opening up. And that's where we talked about things like direct care, whether we talk about concierge medicine. And it really has a role. The only thing that sucks about it is that it's not everyone can get it. But I think that that is a need that is getting filled right now because of the fact that it's hard to form those bonds because of many of the time Constraints.
[00:09:51] Speaker B: Yeah, yeah. And that's definitely felt not only through the clinician, but the patients as well. Right. The patients are waiting for these.
[00:09:57] Speaker A: Yes.
[00:09:57] Speaker B: But the physicians are overworked and you're, you have so many patients and you're trying to make sure that you give that standard of care to everyone.
Of course, it's really tough. And I don't think that the everyday patient really takes that into consideration. I don't think that they understand the volume that you're all seeing. Right.
[00:10:16] Speaker A: And yes.
[00:10:17] Speaker B: How that impacts their time with their physician and their treatment plans.
And so, so, so to kind of switch gears into your care role. Right.
[00:10:27] Speaker A: Yeah.
[00:10:28] Speaker B: So this is the other piece of this. I think that.
And I, by no means I'm speaking for all patients, but I would think that the everyday person would assume that you as a physician, as a clinician would be better able to navigate the healthcare system and caregiving. Than anybody else. Right. But why don't you share your experience with your father and your son and how that kind of altered your perspective of navigating that system as a caretaker?
[00:10:58] Speaker A: I think my example I'm going to lead off with my son.
His name is aiden. He's currently 10 years of age. And there's the autism spectrum. Right. And then there are. People are very high functioning and God bless them, but that's not my boy. And it doesn't take away about how much I love him, but he's like moderate to severe. It's his communication, it's his behaviors. You take him out, he doesn't mean to, but he'll let out a big yell in public, you know, I mean, and it never gets easy, you know what I mean? Because you can't explain everything to everyone. When we take him out, he always wears T shirts that say I have autism there because people just don't know, you know what I mean? And you always want to look at the good in people. But you know, when, when we found out about the diagnosis early in life, we're so lucky, you know what I mean? That was like around 2 years of age of now. A little bit younger, you would think it'd be like, oh, just send me to the autism person that can navigate. How do we do this with our insurance? What options do we get? And how do we get some care for him and how do we get speech? It's not that easy. And it's almost like to navigate certain disease states like speed, special needs. You need a whole master's in college just to do it. And I gotta tell You. There's never a magic number, or if I want to figure something out, oh, let me just call the number. And someone picks up, like, hey, let me help you today. It's always getting transferred and getting transferred, and then there's always new people that don't know the system, that they don't know what to do, and they'll call you back. It's really frustrating, and it was very humbling being on that part of things where for the longest time, I always been surrounded by amazing staff. And I get to go in there and say, I'm Dr. Raj. Let's get that pre auth for me, and let's do this and call me back when they do this. It's not like that. You know, I am really just a number. And you do this because it's someone you love and care for. And I could only imagine you mean what other people who have special needs, you know, children are going through.
And I got to make sure I mentioned this, is that, you know, I think that the way they represent autism, I mean, I'm always glad about raising awareness and for people to know this, but, you know, I think that sometimes they don't. You know, for example, I feel bad even saying this. Sesame Street, God bless Big Bird and Ernie and Burton. Those people. I owned all the toys and books and stuff, but they. They have a little person with autism there, and I think it's great. But, yeah, why doesn't she like having a breakdown and maybe pushing other people and, you know, and can't go to the bathroom and soiling her pants? Why don't they have that on Sesame Street? You know what I mean? Why don't they show what a lot of people are going through? And I feel sometimes it gets, you know, misrepresent, which is like other disease states. They only show the main things out there, and sometimes they don't show, I mean, the sadness because it doesn't make a good commercial. And the last thing I've learned is that when it comes to chronic disease and I think especially special needs and Alzheimer's, what about us? What about not the doctor? What about the caregivers? You know what I mean? And I'll say for sure, for sure. When it comes to Alzheimer's, it's a million times worse on the caregivers than it is on the patient. I say that with my own dad having it, you know what I mean? But even with autism, you know, it's kind of like we have two other kids. My wife and I are both doctors, you Know, one thing that my advice to this podcast, to everyone out there, is that when I represent a doctor, no one cares about my personal life. They came to see Raj because they want to see Dr. Raj.
When I do a podcast or TV, no one cares about the fact that my dad to walk out of the house, my kids having a breakdown in school, and they're texting me while during the interview, they don't care. You got to be who you are. And that's what having, you know, disease states such as an Alzheimer's, such as autism taught me, is that you have to be in the moment because you don't let those things in your personal life ruin things that you're doing at this time going forward, you know, because me doing my job is actually going to help me be a better parent and a better son to my father and to my son. So it's all together, and you just find a way to go forward, be positive, and definitely, I'll tell you one thing. I am so patient now, Jill. I'm the most patient person in the whole world.
[00:15:21] Speaker B: It is interesting how, I mean, and I do think that all children will humble you and make you a little bit more patient, but it is, you know, you have extenuating circumstances.
I understand. And I think going through that experience, you're definitely going to transfer that to your patient care and kind of say, okay, let me take a step back. This person's very upset. This person needs a little bit more time that you don't have, but you're going to take it because you recognize that this is a challenge for them, particularly for caregivers as well. Right. And I think the caregiver point of view is so important because no one talks about it. Right. We talk about patients. We always talk about patients. We always talk about. It's the patients and physicians. But then there's this gray area of caregiving, and. And I don't know that caregivers have a tremendous amount of support. So it's wonderful to hear from a physician who has lived it. Right. And you understand how challenging it can be and carrying that into your patient care, I think that's. That's really, really admirable and something that I think all physicians should consider. You do have to consider multiple points of view, and it's different when it's a lived experience, but just kind of taking that step back and thinking, okay, what is this person going through? Right? Let's. Let's think about that. And so.
[00:16:35] Speaker A: And let me just say one more thing on that. I Had this amazing mom and she's still with us. And you know, because you know, I'm Asian, I did the Asian thing. I, my mom moved in with us and I want to give a shout out to my wife who's so patient and so wonderful. And you know, during, you know, the last couple years, my dad had Alzheimer's. My mom, who's this tiny 4 foot 11 Filipino who's very skinny, had to take care of my dad because of the fact that, you know, one thing we need to do better in health care is inform, you know, patients what are the options, what insurances you need, what is end of life care, what are all these things? And you know, my, it just turned out that my dad needed to be at home. My mom is, wanted to take care of him and it was only her and him. And I remember at nights she wouldn't even sleep at night because he was, you know, forget it. He went to the bathroom and getting up and getting up, my mom would be sleep deprived. And it's just to show that you, that's why I like inspire. We need to have a place where people can share their stories so they could find other people what they're going through. And you know, no one gave my mom a medal, no one gave her a trophy for being best wife ever during the hardest parts of life.
So it really just shows that one thing we all could do better is, is recognizing those caregivers that bring the patients to the office, that bring them to the hospital. I mean, I'm sure they all have a special story.
[00:18:00] Speaker B: Yeah, no, absolutely. And I, it's, you're right, they don't, not only do they not get credit, but it's a tremendous sacrifice, you know, and it's a lot of, it's a lot of work for some caregivers. It is a full time job. I have a friend who, who she quit her job to take care of both of her ailing parents. And it's, it's taxing and it's, you know, this is like prime time for career growth. Right. And, and she kind of was like, I have to have to take care of them. I can't do both. Right. And, and that is, that's mentally taxing. Right. So yes, you need to find that, that community support and you know, what else would you recommend? Is there any other sort of advice that you give not only to caregivers and patients but clinicians as well if they're navigating something like a challenging diagnosis?
[00:18:46] Speaker A: Yeah, I always feel being a good communicator and you know, who you communicate with the best. And I think for me, it's my wife, and I'm blessed that she is also a clinician. But I think it's just nice to have someone just express your inner feelings with, even if they're like, sometimes a little bit on the dark side.
It's because all of us are going through this and there's so many taboo things not to say and not to complain about, or whether you feel like crying or yelling. You know, there's always something. So you always need to communicate. And, you know, everyone has a different way that makes them feel better. And always know in your job, if it's not going to be at home with your wife or loved one, whoever, it's going to be that. What are your. What are your resources? You know what I mean? Make sure you don't fall into the big D depression. Which is real, you mean? And you always need to take care of yourself. And taking care of yourself, of course. Mental, but physical, too. I could tell you during the hardest times with my son and my dad, I forgot to go to the gym, you know, I mean, you'll catch me eating horrible things because I was so busy. But there always has to be a place where you take care of yourself or else, you know, things are going to start falling apart and no one's going to believe me on this when they have their own hard lives. I meet so many people. I'm so. And I hear stories. I just admire so many people. But you're right. When you're in this stage of our lives, you, Jill and me right now, you know, you just can't take the foot off the gas because you have hard stuff in your personal life because this is the prime time. And I think this is where it was really hard for me because I felt like I was ignoring my son, my dad. I was just not doing a good job as being in any of my roles. But, you know, I would just say this, that if people love you, whether they have dementia, whoever it is, is that they want you to be the best you could be. And I think that, you know, focus on the task at hand. Always try to push forward and communicate and let someone know what you're feeling. It really does help out quite a bit.
[00:20:47] Speaker B: Yeah, that's great advice. And you're right, you're no good to anyone else if you're not good to yourself. Right? You kind of remember that you're not doing anybody any favors if you are suffering and not trying to work through it and help yourself. So that's. Yes, that's a great point. And I didn't even think about it, but you're absolutely right.
And you know, Doctor, thank you so much again for, for being here.
For our listeners who want to learn more about you or. Or find information that you share, where's the best place for them to go?
[00:21:18] Speaker A: Omg, this is my favorite question.
So, you know, right when we finish this podcast, this wonderful host, Chill, is going to be on my podcast. It's called the Dr. Raj Podcast. And when you look it up, up, you'll see my face do this.
That's me. So you could look that up. I'm definitely on social media, whether it's gonna be Instagram or.
Don't laugh at me, TikTok. Trust me, I'm not gonna dance over there. But that's what the young people like is TikTok. And yeah, just go to Google and look me up. And I hope I meet everyone out there. I do stuff for inspire because we have a lot of things in common, which is patients, caregivers, disease states. So you'll catch me on some inspire stuff, too.
[00:22:00] Speaker B: Excellent. Thank you so much, Dr. Raj. It was a pleasure having you on, and I'm looking forward to recording your podcast next.
