This Podcast Will Kill You - Special Episode: Gabriel Weston & Alive

Episode Date: November 18, 2025

In an anatomy and physiology class, you may learn how the different heart valves work to circulate your blood, how the structure of your kidney helps to maintain electrolyte levels, and how the expans...ion and contraction of your lungs sets off a carefully orchestrated cascade of gas exchange and transport. The human body is an endlessly fascinating machine. But when you spend so much time learning about the body, you can lose sight of the fact that it isn’t a machine. It is the story of your life. In this book club installment, I am joined by surgeon and award-winning writer Gabriel Weston to discuss her latest book Alive: Our Bodies and the Richness and Brevity of Existence. In this compelling blend of memoir, science, and meditation, Weston examines different body parts chapter by chapter - what they have meant to her or her loved ones, their significance in history, and how their meanings are shaped by our scientific understanding. Weston inspires readers to take a moment to reflect on what it’s like to live in your body, feel your heart beat, your lungs expand. Doing so can help us connect with ourselves and others. Tune in for a delightful conversation! Support this podcast by shopping our latest sponsor deals and promotions at this link: https://bit.ly/3WwtIAuSee omnystudio.com/listener for privacy information.

Transcript
Discussion (0)
Starting point is 00:00:01 This is exactly right. There are already enough things charging your card every month. Dinner should not be one of them, which is exactly why Blue Apron is now subscription-free. You heard that right. Blue Apron no longer requires a subscription. You can order meals when you want them and skip when you don't without adding another recurring charge. Blue Apron meals are designed by chefs and arrive with pre-portioned ingredients, so there's no meal planning and no extra grocery trip. Order now at Blue Apron.com.
Starting point is 00:00:32 Get 50% off your first two orders plus free shipping with code this podcast 50. Terms and conditions apply. Visit blue apron.com slash terms for more information. Ever feel like your bedroom's shrinking? Don't worry. You don't have to sell your favorite things to make space. With IKEA bedroom storage solutions, think dressers, wardrobes, full closet systems, even storage boxes.
Starting point is 00:00:55 You can keep it all. Your vintage band teas, safe. Those limited edition sneakers? Plenty of room. And yes, your childhood teddy bear gets a spot too. Don't sell what you love. Store it instead with IKEA bedroom storage solutions. Shop now at IKEA.us.
Starting point is 00:01:11 Slashbedroom storage. The greatest to ever play the game. Return to finish what they started. Welcome to Survivor 50. I wanted one more shot to play the game that I fell in love with 25 years ago. I want to win against the best of the best. I chickened out at the final tribal. Season 50, it's an honor.
Starting point is 00:01:30 Light your torch. I've got some unfinished business. Be part of history. I have more to play for this time. Bigger than ever. Survivor 50. New milestone season begins CBS tonight at 87 Central. Hi, I'm Aaron Welsh, and this is This Podcast Will Kill You.
Starting point is 00:02:31 Welcome to another episode in the TPWKY Book Club series, where I get to interview authors of popular science and medicine books about their latest work. We have covered some fascinating topics so far this season, from the history of the pelvic exam to the origin of language, the world of regenerative medicine, and how everything truly is tuberculosis. If you'd like to see the full list of books we've covered in this season and past seasons, head over to our website, this podcast will kill you.com, where you'll find a link to our bookshop.org affiliate page under the extras tab. That page has lots of TPWKY book lists, including one for the book club. I'm always updating these lists, so check in regularly to see what's new or upcoming. As always, we love hearing from you all, whether it's a book suggestion, episode suggestion, first-hand account, or anything else on your mind. So please feel free to reach out through our contact us form on our website.
Starting point is 00:03:32 Thank you to everyone who has sent in book suggestions. I truly appreciate it. Two last things before we dive into the episode, and that is to first rate, review, and subscribe if you haven't already. It really does help us out. And second, we are now releasing full video versions of most of our episodes. Make sure you're subscribed to Exactly Right Media's YouTube channel so you never miss a new episode drop. How does our heart pump blood? How does our gut, digest food. How do our lungs draw in oxygen and exhale carbon dioxide? Medical training focuses on the how and the why of our bodies, the anatomy and physiology of all the parts that keep us
Starting point is 00:04:15 alive and healthy, what happens if they fail, and how to fix it. There are diagrams and charts and atlases that help instill specialized knowledge in medical trainees that they can use to heal, to relieve, and to repair. Sometimes, over the course of a career, a doctor might find themselves forgetting that a kidney is not just a kidney, it's this person's kidney. A heart in need of surgery is more than Tuesday's operation. It's the beating muscle that has faithfully kept this mother, son, friend, spouse, alive for the past 15, 30, 60, 90 years. And it's not just medical professionals that may benefit from a moment of reflection on what it means to live in our bodies. When is the last time you thought about your skeleton, the bones inside you, and how it supports us? When have you last
Starting point is 00:05:12 looked over your skin, examined the scars and freckles and wrinkles, and appreciated how it protects us and holds us together. In Alive, our bodies and the richness and brevity of existence, award-winning writer and surgeon Dr. Gabriel Weston transcends the usual boundary between doctor and patient to instill a sense of humanity in our bodies. Throughout each chapter, she explores a different part of the body, examining not just how it works, but what it has meant throughout history and how it has shaped the story of her life. The liver, with its incredible capacity for regeneration and transplantation. The brain, unfathomably complex and yet so vulnerable, as Dr. Weston discovers with her son.
Starting point is 00:06:03 The womb that nurtures and provides and that has been used to control women for millennia. A profound blend of memoir, science, and meditation, alive is a beautiful, absorbing book that honors what it means to be human with our incredible yet not infallible bodies. I really loved chatting with Dr. Weston, so we'll just take a quick break here before getting into the interview. Dr. Weston, thank you so much for joining me today. Thank you so much for having me. I'm absolutely thrilled to be part of this podcast. Oh, thank you. That means it means the world. Well, in your latest fantastic book Alive, you take readers on this really, thoughtful and captivating tour through the human body. You weave together your personal experiences and
Starting point is 00:07:17 reflections with the history and the science of the body parts that you explore. So tell me, how did this book take shape? I mean, I think first and foremost, it just came from this place of, and this is why I called it alive, this sort of sense that as doctors and medical students, that the anatomy that I was taught at medical school and as the basis for my surgical training, had this kind of dead quality to it. So, you know, physiology always felt like it was a kind of experimental sort of specialty. And pathology, of course, had all the fantastic, wonderful illnesses that are so exciting. But there was something about anatomy, which I had expected that I would love,
Starting point is 00:07:59 that just seemed really kind of inanimate and almost like the way it was taught was inanimate as well. And basically, I got to this point sort of 25 years into my, surgical experience where I started realizing that actually the facts of anatomy are not as inert as we were led to believe, and also that many of those facts don't really apply to women or people of colour. But then I think even more than that, I had this feeling as a doctor who was herself getting older and going through lots of life's experiences, that actually the way that we live in our bodies is so ever-changing and so kind of like not just a progress. You know, you have times in your life where you feel like you're going backwards and where everything has collapsed in on
Starting point is 00:08:49 itself. And I just sort of thought it would be really interesting to try and write a book that was almost like an alternative anatomy that would allow me to explore some of these kind of spaces that I didn't feel I saw anything of when I was learning myself. Yes, and I think that is what What is one of the things that makes this book so valuable is being able to see the body parts and read about these body parts, not just in the way that you are exposed to it in a medical class or even in history class, but it's this bigger picture, this complete, more beautiful picture. And each chapter kind of goes into a different body part. You've got gut, lungs, kidney, genitals, heart, and so on, many more.
Starting point is 00:09:32 And I'm curious how you decided on this organization, especially the order of the chapters? I mean, I was very keen that the book should start with a post-mortem, because I thought, in a way, like, the dead body and the first chapter of the book is called dead, that in a way is my start point as a surgeon, as a kind of medical student that once was, as I was saying before, this kind of sense that the anatomy I was taught was dead. And I thought, if I can begin the book, not just with a dead body, but actually with a kind of language that feels very cold and clinical, then that will be a kind of start point from which the rest of the book should be almost a coming alive of not just the body itself, but my way of kind of integrating my understanding of the body.
Starting point is 00:10:21 When it came to the actual like organs and which ones to go first and stuff, I mean, in a very sort of light way, I had all of the piles of organs on the floor at one point. And I remember kind of noticing that a lot of the organs have got memory. of my own body in them. And I sort of thought, I wonder if I could just very lightly arrange them in order of my age. So, for example, I think I remember
Starting point is 00:10:46 a nasal fracture from when I'm a child in bone, which is the first organ. And then obviously, womb is an organ I wanted to put later so that I could examine childbirth, menopause, all that kind of stuff in there. So there is some sense in which these organs are kind of telling the story of my body,
Starting point is 00:11:06 But, you know, it's not super visible. So it was more like a kind of scaffolding for my sake rather than the readers. Throughout your book, you share many personal stories with the readers. You give them a really intimate glimpse into some of the most challenging times of your life. And I was wondering whether that was difficult to be vulnerable in that way or to put so much of yourself out there. I mean, it's such a great question. And what I find really difficult, actually, is not vulnerability. and it's not telling the truth of my experience of the body.
Starting point is 00:11:40 I think my difficulty is, I think in medical literature, I don't mean like textbooks, but more kind of popular medical literature, there is a lot of sentimentality that attaches to the way that people write about the body. You know, it's a hard thing to describe without sounding slightly psychopathic, but I slightly feel particularly as women,
Starting point is 00:12:04 that there's this sort of expert, that if we're writing, for example, about childbirth or motherhood, that there should be a kind of softness to the way that we do that, when in fact, many of my experiences of, certainly of motherhood have not been soft, fuzzy, nurturing ones. They've been ones that have been kind of full of confusion and sometimes rage and exasperation and even regret at times. And so I think what I wrangled with was not the sense that there was any thing. that I didn't want the reader to get to see about me, but that I wasn't wanting to write in a sentimental way
Starting point is 00:12:43 or in a way that I felt for me would not be true. And so it did mean kind of departing from a lot of the sort of medical writing that I have read, particularly written by women, where I feel sometimes there's this expectation of, you know, what these feelings ought to be, around death and birth and reproduction and love and all those stuff. So I think always kind of as a feminist writer, I'm very keen to to have myself be an example, maybe of a slightly like monstrous female who doesn't always feel all of these nurturing feelings that I think
Starting point is 00:13:25 there's still such a great expectation that we should have. Let's take a quick break. And when we get back, there's still so much to discuss. Dinner shows up every night, whether you're prepared for it or not. And with Blue Apron, you won't need to panic order takeout again. Blue Apron meals are designed by chefs and arrive with pre-portioned ingredients so there's no meal planning and no extra grocery trip. There, assemble and bake meals take about five minutes of hands-on prep. Just spread the pre-chopped ingredients on a sheet pan, put it in the oven, and that's it. And if there's truly no time to cook, dish by Blue Apron meals are fully prepared. Just heat them in the oven or microwave, and dinner is ready.
Starting point is 00:14:04 And here's the exciting news. Blue Apron no longer requires a subscription. You can order meals when you want them and skip when you don't without adding another recurring charge. Order now at Blue Apron.com. Get 50% off your first two orders plus free shipping with code this podcast 50. Terms and conditions apply. Visit blueapron.com slash terms for more information. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel. like they've been through something. That's why O'Keefe's working hands hand cream is such a relief. It's a concentrated hand cream that is specifically designed to relieve extremely dry, cracked hands caused by constant hand washing and harsh conditions. Working hands creates a protective layer on the skin that locks in moisture. It's non-greasy, unscented, and absorbs quickly. A little goes a long way. Moisturization that lasts up to 48 hours. It's made for people whose hands take a beating at work, from health care and food service to salon, lab, and caregiving environments.
Starting point is 00:15:08 It's been relied on for decades by people who wash their hands constantly or work in harsh conditions because it actually works. O'Keefs is my hand cream of choice in these dry Colorado winters when it feels like my skin is always on the verge of cracking. It keeps them soft and smooth, no matter how harsh it is outside. We're offering our listeners 15% off their first order of O'Keefs. Just visit O'Keefscom. This Podcast and code this podcast at checkout.
Starting point is 00:15:36 A timeless wardrobe starts with pieces that are built well from the beginning. From the fabrics to the fit, everything needs to last beyond one season. And that's how Quince approaches design. Quince has all the staples covered, from 100% organic cotton sweaters to premium denim made with stretch for all-day comfort and luxe cotton cashmere blends, perfect for the changing seasons. The quality shows in every detail, the stitching, the fit, the fabrics. Every piece is thoughtfully designed to be your new wardrobe essential, and each piece is made with premium materials in ethical trusted factories and priced far below what other luxury brands charge. I recently got a pair of Quince's Bella Stretch Wide-Legg jeans, and they are now in constant rotation.
Starting point is 00:16:20 They are so comfortable, the fit is amazing, and they come in a bunch of different washes, so I'm about to go order some more. Refresh your wardrobe with Quince. Go to quince.com slash this podcast to get free shipping on your order and 365 day returns, now available in Canada too. That's Q-U-I-N-C-E dot com slash this podcast to get free shipping and 365-day returns, quince.com slash this podcast. Welcome back, everyone. I've been chatting with Dr. Gabriel Weston about her book, Alive, Our Bodies, and the
Starting point is 00:17:07 richness and brevity of existence. Let's get back into things. I'm sure that that also filters into not just your role as a writer, but also your role as a surgeon and how you are expected to be or think or feel about your patience or about your own self. I think so. And I think, I mean, in a way, one of the things I find most beautiful about the body as a writer, as a doctor, but also just as a human walking around as a woman is, you know, if you have a thought, it is very likely that most other people are having that thought to you. Like you're going to have thoughts and you're going to think you're the only person in the world
Starting point is 00:17:46 that is having those thoughts or desires or you're going to think that you've just thought something that is the most shocking thing that you could even ever imagine someone thinking. It is highly unlikely to be that shocking. And the body as well, I feel like the way that we experience kind of life's big changes and events through our bodies, it's like if the body is, kind of telling you, I feel disgust or I feel desire or I feel fear or I feel longing, it's okay. And sometimes we might have those feelings in odd circumstances. And I like putting that on the page. But I absolutely have, I just have an aversion to doctoring and writing that is
Starting point is 00:18:32 about telling people what they're experiencing in that moment. So yeah, that's a big thing. for me. Your background is not necessarily. You didn't start out your career, your adulthood, with designs on becoming a doctor. Can you tell me a little bit about your atypical journey? Yeah, yeah. So, I mean, in the UK, we have this crazy system where when you're about 16, you have to choose three subjects that become the only three subjects you're going to study at school, and then usually you choose one of them to go on and do at university. And I gave science up when I was 13, as soon as I possibly could. So I had to keep one science for what we call GCSE,
Starting point is 00:19:13 which is a kind of 15, 16-year-old style exam. And then after that, science disappeared from my life. That was a great relief to me. And I had a year out, then I went off to do English and philosophy. English was always the thing that I was good at, so it seemed like the obvious choice of thing to read at university.
Starting point is 00:19:33 And then when I was at uni, I just started kind of discovering that whenever someone was sick or someone like fell off a ladder or broken arm or it was around the time that ER was on TV for the first time. That's how old I am now that it came, it came on around that time that I was doing my English degree. And I noticed that I was much more than usually interested in all of this stuff. And not from the point of view of I did not have an overarching desire to help people. That was not the impulse. The impulse was just pure untrammeled fascination, like kind of not okay style fascination. And then completely by happenstance,
Starting point is 00:20:19 one of my friends who was a math student, his dad came to visit us up in Edinburgh and his dad was a surgeon. And this was back in the day where, you know, there were no mobile phones or anything like that. And he had these old school photo albums in his car. filled with photographs that he or his scrub nurse had taken when he was operating. And I remember everyone else went out clubbing and drinking. He and I stayed in alone. And at the end of that evening, he said, next time you're in London, give me a call, you can come to my operating theatre.
Starting point is 00:20:51 So I did that. I was about 21 back in the day where you could just rock up to someone's operating theatre with no credentials. and I just literally walked into this room and it was like I was having some kind of religious conversion. I mean, I was just beside myself with excitement. And I went a couple more times after that. And then I kind of thought, I don't really see how I'm going to make, be able to make surgery a hobby. I don't think that's going to be a kind of socially acceptable thing for me to be doing in my spare time.
Starting point is 00:21:28 So after a little kind of while of arming and owing, I just thought I think I'm going to have to go and be a doctor. So I had to go back because I had English, French, and Latin A-levels. And I had to basically do all the science A-levels that would get me a place at medical school. And then into medical school I went. And the crazy thing was that apart from that early year where I had to do all the science and it was so difficult for me, really the rest of it was kind of fine. It's like I loved it.
Starting point is 00:22:01 And I had this amazing feeling that most of the other medical students didn't have of like a kind of glorious sense of the glamour of being a medical student who would come from a background where it didn't seem like that would ever be possible. And so I never quite lost my sense of the kind of, in loveness with the persona of this new person that I was. And in a way, I think I still have that now. It's like when I go into the operating theatre now to do, you know, very small surgery with, you know, very low risk and kind of nothing to write home about
Starting point is 00:22:39 when I put my scrubs on, I just still feel that's very cool. You know, I've never lost that sense. And so I think there's a lot to be said for that, you know, for kind of whatever it is that makes you keep loving it. And I really do. I mean, even despite our NHS being in the most kind of powerless state, the actual business of being a doctor who gets to handle people's bodies is just a joy, isn't it?
Starting point is 00:23:10 It's just like intimacy of the most extraordinary, beautiful kind that life has an offer. You write about the human body with such care, And with such lyricism, it shines through along with your endless curiosity about the human body and about your own ability to express your stories. And I wanted to kind of get into a few specific parts of the body that you covered in your book, starting with bone. So in your chapter on bone, you talk about the common misconception that bones are these static, unchanging things when really they are very dynamic. Can you talk about how our use, of the skeleton as the symbol of death
Starting point is 00:23:54 really contradicts the true vitality of bones? Yeah, I mean, skeleton's so interesting, isn't it? Because it's like lay people, you don't have to be a doctor, like we all know what skeletons look like. Kids know what they look like. They wear Halloween costumes with skeletons on the front of them.
Starting point is 00:24:09 And you can go for a walk in the woods and see a bird skeleton. And most of us have touched bones, you know, whether we're eating a chicken wing or whatever. We have a very kind of established sense of what bones are. And yet when you see bones inside a body that is alive, they're not like that at all. So for this book, I went to, there's an amazing orthopedic
Starting point is 00:24:35 hospital just outside of London called the Royal National. And I went there and saw an amazing surgery where a guy was basically removing a tumour from a woman's thigh bone. And he had to kind of take an enormous length of her thigh out in order to take this tumour out. And when they were sawing through the femur, I was just so struck by the cross-section of this biggest bone in the body that it was filled with marrow and it was filled with blood vessels and it had this kind of live, yellowy-looking periosteum. And it just, I looked at it and I thought it's just not at all the way you would think bones are. And then, of course, when you look at the physiology of bone, you realize that bone is kind of
Starting point is 00:25:21 changing itself all the time. So the bones that you have today, you wouldn't have had 10 years ago. Every year, 10% of our bones are being remodeled by a process of, you know, osteoclasts removing old bits and osteoblasts putting in new bits. So I think even this kind of symbol of death, when you look closely at it inside the living body, which obviously most people don't get to do, You just see that it's alive in a way that's really counterintuitive and really beautiful. It's like instead of the ship of Theseus, we have the skeleton of Theseus. You know, the bones that we have now are not the bones that we started out with. They've just been continuously remodeled throughout our entire lives.
Starting point is 00:26:07 And in your chapter on the womb, you take readers on journeys through the inner workings of this amazing organ. and the ways that it's been used to dismiss or harm women, as well as your own experiences in childbirth, both as the one giving birth and as the one observing childbirth. Did any part of this chapter feel especially meaningful or challenging to write? Yeah, I mean, like you say, it's such an incredibly sort of dynamic organ, the womb, when you think it sort of begins as something the size of a small pair,
Starting point is 00:26:44 and then if you're pregnant, you know, it occupies your entire abdomen. So it kind of, it presents itself as something to write about, almost like the most beautiful kind of metaphor for changeableness. And that really appealed to me. And then it kind of, you know, it kind of intersected with really, in a way, the main drive behind this book is this kind of philosophical desire that I have all the time with the body to somehow occupy that. space between being in a body and observing a body.
Starting point is 00:27:19 You know, like, where that's the mystery, isn't it? It's like when you're a surgeon, you're standing at the operating table, you have your hands inside someone's body, but your own heart is beating, your lungs are working, your hands are warm because of blood running through them. I'm so struck always by that kind of, like a desire to be and know at the same time, which never feels possible. It's always like a hologram
Starting point is 00:27:46 that you have to kind of flip from one side to another of. And so when I had my, so my first two children I had vagina the second two at the same time by C-section because they were twins, which was also kind of cool because I thought I get to kind of experience
Starting point is 00:28:00 all the ways that the womb can give birth to children. And I just thought it would be really interesting to get in touch with the obstetrician who delivered my babies by C-section, which I did about six months after they were born. I mean, I think she probably thought I was crazy, but she was very accommodating. And I just sort of said to her,
Starting point is 00:28:21 like, I really, I want to see what you did to me. I want to kind of be on the other side of the line, like having lain on that table with my womb open and you pulling my twins out, I want to stand there next to you with my scrubs on, seeing you do that to someone else. And so in the womb chapter, I'm really exploring that kind of,
Starting point is 00:28:42 very female again. I think it's a very existentially deep part of being female, this way that our bodies are the thing that life is enacted on, but it is also self. It's like if we are to express agency, it's through our bodies. And yet the second you hit puberty as a girl, you're suddenly aware that the world is objectifying you. And so
Starting point is 00:29:12 I felt like the womb was a really, really exciting organ to look at some of those things through. And then just as the icing on the cake, I also, for the BBC, went to Sweden to see a womb transplant being performed. That was just kind of mind-boggling in a wonderful way as well to see, like, in adjoining operating theatres, you know, a mother's womb being carried down a corridor in a dish to be put inside the pelvis of the daughter who had been gestated in that womb herself. Just so cool, you know, just like those moments again where I'm kind of maybe thinking to myself, in this moment, I should be having a sentimental reaction, but actually I'm just blown away by how exciting it is and how kind of existentially deep it is. And, you know, so that that was really like a terrific
Starting point is 00:30:11 experience as well. I don't have the words. It is the coolest thing. And it is also, you know, earlier you mentioned, and I wanted to circle back to this, earlier you talked about how it wasn't like you went into medicine because you wanted to help people or because you had this like altruistic. This is what I was put on this earth for. You love the huge. And I feel like that is the expectation to feel that way, to feel like I went into medicine because I want to save the world and make the world a better place. And I feel like it is, it is challenging then, or is maybe viewed as sometimes not acceptable to say, I really just thought this was fascinating. And I wanted to do this. I mean, I definitely feel sometimes when I was a junior surgeon that I would be so excited in an operation. I'd kind of think,
Starting point is 00:30:58 I'm glad I've got a mask on because then they, you know, they're not going to see how excited I am. I mean, obviously there is a limit to how much a patient wants to see that on a person's face. But we would prefer all of us, I think, to have our doctors really into what they do. And I definitely think for writing about the body, like, there are lots and lots of places to get facts about the body. And I think it's, I still feel that it's very political writing the truth about the experience of being inside one. I still feel that that is something women can keep. writing truthfully about their experiences of being inside their bodies till the cows come home and it will not be enough, you know. There's a deficit. Let's take a quick break here. We'll be back
Starting point is 00:31:51 before you know it. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel like they've been through something. That's why O'Keefe's working hands hand cream is such a relief. It's a concentrated hand cream that is specifically designed to relieve extremely dry, cracked hands caused by constant hand washing and harsh conditions. Working hands creates a protective layer on the skin that locks in moisture. It's non-greasy, unscented, and absorbs quickly. A little goes a long way. Moisturization that lasts up to 48 hours.
Starting point is 00:32:26 It's made for people whose hands take a beating at work, from health care and food service to salon, lab, and caregiving environments. It's been relied on for decades by people who wash their hands constantly or work in conditions because it actually works. O'Keefs is my hand cream of choice in these dry Colorado winters when it feels like my skin is always on the verge of cracking. It keeps them soft and smooth, no matter how harsh it is outside. We're offering our listeners 15% off their first order of O'Keefs. Just visit O'Keef's company.com slash this podcast and code this podcast at checkout. Hello, hello, I'm Malcolm Gladwell, host of the podcast Smart Talks with IBM. I recently sat down
Starting point is 00:33:08 with IBM's chairman and CEO, Arvin Krishna. And I asked him, how can companies use AI to its fullest potential to create smarter business? My one advice to them. Pick areas you can scale. Don't pick the shiny little toys on the side. For example. If anybody has more than 10% of what they had for customer service 10 years ago, they're already five years behind. If anybody is not using AI to make their developers who write software 30% more productive today,
Starting point is 00:33:47 with the goal of being 70% more productive. Yeah. So we are not asking our clients to be the first experiment on it. We say you can leverage what we did. We are happy to bring out all our learnings, including what needs to change in the process, because the biggest change is not technology. It's getting people to accept that there's a different way to do things. To listen to the full conversation, visit IBM.com slash smart talks.
Starting point is 00:34:14 Texting privacy policy and terms and conditions posted at textingterms.com. Texting enrolls you for occurring automated text marketing messages. Message and data rates may apply or apply or stop, opt out. Visit ISSA online for details. Excuse me, what do you do for a living? Weight tables. You like it? Not really.
Starting point is 00:34:32 Do you work out? Every day. Best part of my day. Would you like to get paid to work out? Are you kidding me? How? With ISSA, you could become a certified personal trainer in as little as six weeks. Once you're certified, you can start your own business.
Starting point is 00:34:45 Work at a gym or just do it as a side hustle. Some trainers are making as much as $100 an hour. A hundred bucks an hour. Yes, please. But how do I even find a job as a trainer? That's the best part. There's such a huge demand for personal trainers that ISSA guarantees you'll get a job. I'm in.
Starting point is 00:35:00 How do I get started? Just send them a text. Get your free personal training evaluation kit today. Just text gym to 3232.32 right now. Get certified in as little as six weeks. and ISSA guarantees you'll get a job. Text Jim to 32 32 3232. Text Jim to 32 32 32 32 32 32.
Starting point is 00:35:17 Jim to 32 32 32. Welcome back, everyone. I'm here chatting with the wonderful Gabriel Weston about her book Alive. Let's get into some more questions. So skin is an incredible organ. I mean, again, like they all are out, I'll say this about all the organs. But I really appreciated how your chapter encouraged readers to see skin, not just as the thing that holds us together, not as a barrier to the outside world. And you talked about some of the
Starting point is 00:35:59 things that skin can show what it can reveal, as well as what it can hide. I was hoping you could just elaborate a little bit more on that. Yeah, I just so I think again, like with all of these organs, I'm always sort of after something literal, you know, what does the skin do? What is its function as our biggest organ? And I guess its main function is letting sunlight in and heat out in the most basic way, but it's kind of, it is a barrier and a protective barrier, but it's also like a filter because your skin doesn't work well. And if it's completely impermeable, it wouldn't be doing the things it has to do. But also I got, of course, thinking about skin more symbolically as the thing that marks out where I end and the world begins, which is again kind of going back to the more
Starting point is 00:36:47 philosophical sense of like, what is a self? Where are we inside ourselves and where do we touch the outside world? And we do that through our skin. So it was a chapter that I felt was kind of a really interesting chapter to examine themes of time through. So one of the things I did in this chapter was kind of take a bit of a like a spread of members of my family from at the time my twins were like toddlers right up to my parents in their 80s and have these kind of moments where I'm stopping my usual physiological inquiry into the skin to just look at the skin of these loved ones, you know, of my little kids and my teenage kids and my middle-aged husband and my elderly parents. And then I also have this amazing opportunity to visit one of the immigration
Starting point is 00:37:41 removal centres near one of our airports in London. So these are kind of like, hidden places with no signposts and basically it's where tens of thousands of people who don't have their asylum papers are left often for years while those papers are processed and I managed to get access with a GP who goes in there to kind of assess some of these asylum seekers claims for asylum and managed to go in with her and have this fascinating day where I realized that this particular young man who we were seeing, that his job and the job of the GP who'd come to visit him was to document all of the scars on his skin, which were his evidence that he had come from a place where he had been traumatized and tortured. And so it's this really fascinating,
Starting point is 00:38:34 like turning on its head of how we usually want our skin to be particularly, again, women aging, we want our skin to be sort of perfect, like the perfect, flawless canvas. And yet here was this young man at pains to show all these kind of traumatic blemishes, because he knew that if we could document enough of them, and if he could get them to match the story that he was telling us, that that might be the ticket for him to be able to stay in the UK. So that was a kind of way of acknowledging the complexity of skin as a political organ without like treading on ground that didn't feel like my ground to tread on. It sort of runs parallel in some ways to some of the challenges that people face and the range of challenges that people face when seeking health care in general.
Starting point is 00:39:32 And one of those being communication and being able to adequately receive care and attention and explanations from their physician. And this is something that you touch on in your chapter on the kidney, some of the ways that doctors just aren't always the best communicators. Why do you think communication still poses such a challenge and there is still so much room for improvement? So I think in the UK, the primary difficulty is one of the resource of time. So in our NHS, which is, you know, free at the point of access and kind of on its knees now as a system, which is just totally overrun with need and insufficient resources to meet those needs. I genuinely think that if hospitals and medical schools could take whatever paltry funding they have that they're diverting into community. skills courses and just somehow enable that to manifest itself as a couple more minutes per consultation for each doctor, a lot of the communication problems would disappear. So I think, you know, if you can imagine, like if you were trying to talk to your partner about being
Starting point is 00:40:49 unhappy in the relationship or, you know, talk to one of your kids about their drug problem or whatever, if someone said you've got 10 minutes to do that, you know, it would be absolutely impossible and yet that's what doctors and nurses are expected to do with highly complex patients who they've never met before. It's just totally extraordinary. So I think time is one thing. I think the other thing is we have such an embedded kind of distance in the way that we're taught as doctors, the kind of ancient ways of treating patients from on the other side of a desk, from above. If you've got through medical school,
Starting point is 00:41:31 you're someone who's really good at learning facts. You're probably someone who's come from a pretty advantage background with all the assumptions that go with that. And I just think there's still such a distance between doctor and patients so much of the time. And that's a really complex thing to fix. But I think certainly in my own experience,
Starting point is 00:41:54 I think having become a patient and perhaps more importantly, the mother of a patient, I have just really experienced now how awful it feels to be in a doctor's room or in a hospital where you're terrified, you feel like no one is listening to the thing that you need them to know. And this kind of awful sense that you somehow have to kind of behave yourself in order not to irritate the people who you need
Starting point is 00:42:27 to look after you. And I think a lot of those problems are probably quite British problems and quite entrenched in the fact that our healthcare system doesn't involve any exchange of money in the way that it does in other places. So it's almost as if any motivation for a doctor to be nice to a patient that might have anything to do with patronage or reputation, that doesn't exist. here. And so in a way, all you're left with is these very overworked, exhausted healthcare providers who are just going to get paid what they're going to get paid regardless. And I, yeah, I just,
Starting point is 00:43:11 I think the dual problem of this kind of culture of superiority combined with real-time deprivation is the problem of communication between doctors and patients. And I think it's also not helping by some of the, as you kind of touched on, this entrenched way that physicians see patients where we've incorporated more quantitative tools to assess a patient's condition or, you know, we have these scans, we have blood tests, we have all of these ways to look at the individual parts of a patient that can sometimes then make a doctor lose sight of the person as a whole, not just as a patient or as a patient's body part. What role do you think? that plays and how can we maybe strike a better balance between using these quantitative
Starting point is 00:44:03 tools, not just as something that's shaping the entire narrative? Yeah, it's really tricky, isn't it? I mean, in an area like, for example, psychiatry versus neurology, I mean, that's quite interesting. Those two specialties were the same specialty until the late 19th century, early 20th century. And then as neurology became, I guess, a more sort of objectifiable form of medicine. It kind of split off. I mean, interestingly, Freud, I think was a neurologist to begin with and then became a psychiatrist. And once he started, you know, developing ideas of a kind of psychological and psychiatric self, those two things split. And now we're in a situation where, as you say, the quantitative tools that have gone so far with neurology
Starting point is 00:44:51 have given people with neurological conditions a kind of status in a way that is very, very different from the continuing stigmatized, low status of psychiatric patients. And I think it is really interesting that, you know, if you think the brain is the site where schizophrenia, bipolar, depression, you know, all that stuff is coming from that and the brain tumors and all the neurological stuff and yet I know from my own experience, one of my, my son had a brain tumor. You know, it was an awful time, but you couldn't imagine a situation where people would be nicer than a children's hospital with a brain tumor. But by comparison, I have a very close family member who's been very acutely psychiatrically well for a long time. And I've walked through that path
Starting point is 00:45:50 with that family member. And all there is is stigma and low status. You know, it's, and that is because, I think, because there isn't a scan that shows what the problem is in a way that kind of makes it easy to delineate. And also, I think when we can't find, it's the same with all these conditions where there's a little controversy over whether the condition
Starting point is 00:46:14 is a so-called functional condition or an organic condition. There's something that kind of, of brings out the kind of nasty playground thing in us that is to do with kind of this idea of a person faking something or like, why are they saying they have these symptoms when there's nothing to correlate them with? And so I think there is that problem in psychiatry that because it's all in someone's head, so to speak, we can't, we can't kind of corroborate it. in the ways that we seem to need to.
Starting point is 00:46:54 You mentioned this really terrifying medical ordeal with your son, and you begin that chapter on the brain by asking, did I think being a doctor would protect me? Yeah. And you discuss some of your roles as mother, as surgeon, as patient yourself. How did those roles intersect during that time? Yeah, I mean, it's so interesting. I tried very hard because a friend of mine who first came to see us in the emergency department
Starting point is 00:47:26 when we first realized that my son, he'd had headaches and then they did a scan and they discovered he had a math, quite a large mass in his brain. So in that awful early stage of realizing something was wrong, a friend of mine who was an ED doctor said to me, just be a mother here. Like, that's my one piece of advice to you is don't try and be a doctor, just be a mother. And I kind of tried to do that, but I also feel, in all honesty, that there were certain moments in that journey where the fact that I was a surgeon helped me advocate for him in a way that I think actually did make a difference. I mean, I'll never be able to say whether it was a life or death difference, but there were definitely a couple of junctures where I was able to say to
Starting point is 00:48:14 a system that was not acknowledging how serious something was, you know, that I'm saying this to you as a mother, as a surgeon, and with this other surgeon friend of mine who's my kind of backup plan guy. So there was a weird braiding of mother with surgeon in that time. And I think if the healthcare system had been perfect, I would not have needed to be a surgeon at all. And I certainly, I was astonished by my lack of curiosity, like, about the actual surgery my son had and about the particular, he ended up when they finally found out what it was because they thought he had something called a medulla blastoma to begin with, but he actually had a cavernoma, which is an abnormal cluster of blood vessels in his brain. Once we knew what it was and that he was going to have surgery, I amazed myself with how, like, I did no research. I didn't go on Google. I didn't look anything up. I said to my family and friends, I don't want anyone telling me anything outside of what the surgeon looking after him tells me. Like, here's my source of information, and that's all I want. So I really did the opposite of what I do as a writer and a doctor in other circumstances,
Starting point is 00:49:34 which is to cast my net as wide as I can, you know. But it was a very, I mean, we were very lucky because he came out of that surgery. He's recovered. He's fine. It's given me a lasting feeling for any patient who is in a situation where they are completely terrified. And I don't think I'd realize before that happened to me, you're not in your right mind when, you know, I mean, never mind that you're not sleeping. You're like you're in an altered state. And the way that I am with patients now, when they're in the early stages of discovering something very.
Starting point is 00:50:14 shocking is completely different than it was before in view of that. So, you know, I'm grateful to have learned that. And I sometimes feel, I feel a little bit ashamed of the young doctor I was. I don't think I was harsh, but I think I was very disconnected, almost as if by being a doctor, I was, I don't know, I had some kind of, I mean, I can't ever have actually been that stupid is to think that that was going to protect me. But in a weird way, I think I did think it was protecting me. Throughout your book, you also discuss, you interspersed correspondence with some of your physicians and recollections about your own heart condition.
Starting point is 00:50:54 And you end the book with a chapter on the heart. Would you mind sharing a bit about sort of the journey, sort of how you decided to intersperse those and then why you decided to end with the heart? Yes. So all the way, as you say, all the way in between the organs, I have these little things. I have these little fragments of clinical evidence in a way from my own heart condition. I've got mitral valve regurgitation. So one of my heart valves doesn't work properly.
Starting point is 00:51:20 And it's getting worse. And at some point, I'll need to have open heart surgery for that. So that was all kind of happening while I was writing this book. And really what I wanted to convey by interspersing these little kind of emails from doctors or little kind of moments of almost like. clinical text is present to the reader this very profound textual difference between what happens when we tell a story and everything is perfect and has jeopardy and it has a kind of narrative arc and it goes up to a crisis and then it kind of falls away and wraps itself up.
Starting point is 00:51:59 And on the other hand, the totally unshapely, inconclusive, disclosive, disclosive, disclosive, orientating experience of being a patient in the middle of a clinical story whose end you cannot predict. So someone who reviewed my book said something like they felt that these fragments in between were kind of a bit of a letdown because they didn't rise to a sufficient conclusion. And I thought to myself, well, no, like, they're not meant to. Like what I'm trying to do in a way is almost destabilize my own narrative by saying, okay, I've just written this chapter on the breast or the skin or the liver. And when you get to the last sentence, you will feel a sense of satisfaction that I have closed that chapter.
Starting point is 00:52:51 But here's the reality of me being in this body where there's just these few facts and there's all this space and all these questions that are not answered. And it doesn't go anywhere. It's like it doesn't end with me telling you what happens because here I am. I don't know what's going to happen. Like my valve is still flapping around there with blood going in the wrong direction. And I don't know. I don't know what the end of the story is. And that's my experience of being in a body.
Starting point is 00:53:20 And that's the way that I chose to tell it. So of course, at the end I then thought, I need a heart chapter as well to talk about some of the issues around. really interesting new stuff to do with how kind of stress and emotion actually manifests itself in the tissues of our body, or the really shocking statistics around women and heart health and how badly served we are currently in terms of our cardiology. So I thought at the end of the day, I better provide that chapter because there is all this really interesting stuff. and if I just leave these fragments, it's like too big an organ to ignore. So I guess at the end it was like starting with a dead body and hopefully ending with this kind of integrated sense of an organ that is a pump,
Starting point is 00:54:10 but also the feeling center of ourselves. It touches on, again, this theme of honesty, of this is the reality, you know, sort of this, how you said, there is no narrative arc to this, to your story. There is no narrative arc to any of our stories. if there is one, we've constructed it artificially. And that's fine, but that's not necessarily the reality. And I'm curious how you feel this honesty is or is not being accurately portrayed or
Starting point is 00:54:41 acknowledged in science communication these days or how we can all do better about incorporating honesty into science communication. I mean, that's such a big question, isn't it? And I guess it just really depends on sort of what area we're talking about. I mean, I think the introduction of AI and machine learning has been really, really interesting in this regard. Because now that AI is doing such a good job of data gathering and kind of synthesizing data in a way that, you know, we used to have to do for ourselves just a few years ago, I think the lovely thing about that is it kind of puts more of an onus on each of us to actually, when we are communication, about science, to be doing it in a way that is not a way a machine could do, you know, in an authentic way, in a disruptive way, in a way that doesn't feel nice or comfortable, because the
Starting point is 00:55:34 machine can do that stuff. So I prefer the messy truth. And I prefer it in, I prefer it in lectures, I prefer it in books, I prefer it in movies, I prefer it in people. I'm not interested in the airbrushed version. But I am not like, I don't think I'm in the mainstream. there. I think most people do prefer the polished version. So I don't know what we do with that. Well, I'm excited to see what you do next. And Dr. Weston, I just want to thank you for taking the time to chat with me today. This was so fantastic. Honestly, it was an absolute thrill for me, Aaron. Thank you. A big thank you again to Dr. Gabriel Weston for taking the time to chat with me. If you enjoyed today's episode and would like to learn more, check out our website, this podcast
Starting point is 00:56:39 will kill you.com, where I'll post a little. link to where you can find alive, our bodies and the richness and brevity of existence, as well as a link to Dr. Weston's website where you can find her other incredible work. And don't forget, you can check out our website for all sorts of other cool things, including but not limited to transcripts, quarantini and placebo-rida recipes, show notes and references for all of our episodes, links to merch, our bookshop.org affiliate account, our Goodreads list, a first-hand account form, and music by Bloodmobile. Speaking of which, thank you to Bloodmobile for providing the music for this episode and all of our episodes.
Starting point is 00:57:17 Thank you to Leanna Squalachi and Tom Brifogel for our audio mixing. And thanks to you listeners for listening. I hope you liked this episode and our loving being part of the TPWKY Book Club. A special thank you, as always, to our fantastic patrons. We appreciate your support so very much. Well, until next time, keep washing those hands. Voyages presents with love from Alaska. Alaska isn't complicated. It just needs to be done right. Waking up to glaciers, spotting wildlife from the deck, spending the day hiking, kayaking, or
Starting point is 00:58:21 exploring, and then coming back to a beautifully designed ship with epic food and a drink waiting. This is Alaska, the best way. Award-winning adults-only Alaska cruising from Virgin Voyages, sailing from Seattle. Explore sailings at virgin voyages.com. There's a difference between liking a house and actually getting it. Redfin is built to make up that difference and close the gap between finding and owning the home for you. Redfin agents close twice as many deals as other agents. So when you find a home you love, you're not a step behind when it comes to making an offer. That means less watching great homes disappear and more focus on the one you'll call home.
Starting point is 00:59:01 Redfin helps turn saved listings into real addresses. Get started at Redfin.com. Own the dream. Comcast business helps retailers become seamlessly restocking, frictionless paying favorite shopping destinations. Thank you for shopping. It's how nationwide restaurants become touchscreen ordering, quick-serving eateries, and how hospitals become the patient-scanning, data-managing, health care facilities that we all depend on. With leading networking and connectivity, advanced cybersecurity and expert partnership,
Starting point is 00:59:33 Comcast business is powering the engine of modern business, powering possibilities. Restrictions apply.

There aren't comments yet for this episode. Click on any sentence in the transcript to leave a comment.