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Conteúdo fornecido por Devan Stahl and Tyler Gibb. Todo o conteúdo do podcast, incluindo episódios, gráficos e descrições de podcast, é carregado e fornecido diretamente por Devan Stahl and Tyler Gibb ou por seu parceiro de plataforma de podcast. Se você acredita que alguém está usando seu trabalho protegido por direitos autorais sem sua permissão, siga o processo descrito aqui https://pt.player.fm/legal.
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The Dr. Gibb Episode

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Conteúdo fornecido por Devan Stahl and Tyler Gibb. Todo o conteúdo do podcast, incluindo episódios, gráficos e descrições de podcast, é carregado e fornecido diretamente por Devan Stahl and Tyler Gibb ou por seu parceiro de plataforma de podcast. Se você acredita que alguém está usando seu trabalho protegido por direitos autorais sem sua permissão, siga o processo descrito aqui https://pt.player.fm/legal.

In this episode we do a deep dive into the work and life of our co-host Dr. Tyler Gibb.

Transcript

0:00

Welcome to this episode of Bioethics for the People, the most popular podcast on the planet according to Grandma Nancy.I'm joined by my Co host Doctor Tyler Gibb, who if he weren't here recording right now, would probably be golfing.And I'm joined by my Co host Doctor Devin Stahl, who dutifully completes the same 5 New York Times puzzles every day.

0:27

All right Tyler, the long-awaited Dr. Gibb episode.Here we go.Here we go.I'm a little uncomfortable.I got to be honest, a little nervous about this.I I will be gentle.OK, I'll try to be as candid and non meandering as I can.

0:48

But all right, well, don't change your personality.We want the we want the listeners to know you.So first, just tell me about your current role.Where are you this morning?How do you introduce yourself?Go.Yeah, so I am currently an associate professor in the Department of Medical Ethics, Humanities and Law at Western Michigan University, Homer Stryker, MD School of Medicine, which is in Kalamazoo, MI, so kind of the southwest corner of Michigan.

1:23

And I'm also the Co chair of our department, but it's a really small department.So that sounds better on paper than it really, really is, except I get to go to a lot of meetings about random stuff.But yeah, so that's what I do here in Kalamazoo.And how did you find yourself?

1:39

You're not from Michigan, right?So how did you get from, how did you get there wherever, wherever you were?Like, tell us the trajectory.Like how did you find yourself there?Yeah.So I grew up in Indiana, kind of Northwest Indiana, just outside of West Lafayette, IN, which is where Purdue University is.

1:57

And my dad was on the faculty for his whole career at Purdue University.So that's where I grew up, but we moved here in 2015 from Los Angeles and we were in Los Angeles because I was finishing A2 year postdoctoral fellowship in clinical ethics at UCLA.

2:19

Impressive.So did you always know you wanted to be a bioethicist?No, I had, that's such a funny question because there was no such thing as a bioethicist.So I I had kind of a meandering educational journey.This may come as a surprise, but in my friend group in high school, I was the dumb jock that people made fun of for being dumb.

2:42

That is surprising.Yeah.Mostly because you were a jock.I just don't see that for you.Yeah.Yeah, there's a lot of reasons why that's strange, but yeah, my friends used to make fun of me for being the dumb one.But then at some point I fell in love with learning and knowing things.

2:58

And so in college I took a seminar class like a 7:00 AM really brutal class that all pre Med students had to take and it was just called bioethics.Wait wait wait, you were pre Med?I was, yeah, yeah, yeah.How did you go from being a dumb high school student to being a pre Med college student?

3:16

Well, life, the vicissitudes of life.Yeah, like I said, it's kind of a meandering journey, but I went to a small college after high school called Wabash College, go little Giants and tried to pursue a career in mediocre football, which didn't work.

3:34

Then I left for left college for a couple years.I was raised in the Mormon church, which also surprises some people.And I went and was a missionary in Japan for the Mormon Church for two years.And then, yeah, had a great time.

3:50

Learn how to speak Japanese, learn how to eat sushi with with the best of them.So it was a good time.Can you say something in Japanese You.Want me to to to prove that I can speak Japanese?No, I'm not going to do that.I'm going to.I'm going to.Yeah, it's.

4:05

Been so long.So I used to speak fairly well, like fairly fairly like fluidly, but I it's been what, 20 years now?And so in my head I'm still just as as fluent, but I'm sure it would be terrible coming out and recorded for all eternity so.Fair enough.

4:21

Yeah.So I went to came back from Japan, moved in, started going to college part time out in Utah and then kind of got re enrolled in a Community College there and then just kind of kept going and kept going and kept going until there was no more school left to go to.

4:38

So.So.So at what point were you in?Were you were pre Med at Wabash?Is that right?Yeah.So I ended up graduating from Brigham Young University out in Utah.And it was there that I obviously was trying to figure out who and what I was going to do with my life.

4:57

And I definitely spent many semesters as pre Med doing all of the pre Med classes, physics O chem, chemistry labs, like all that stuff.Yeah.And part of the requirement was this bioethics seminar class.

5:14

OK, so say more.Yeah.So 7:00 AM once a week go to this seminar and we just had readings and we were supposed to go and discuss.But the professor who was in charge of it, he didn't want to be there.None of the other students wanted to be there.Like everybody hated it except for me.

5:29

I was in the front row every week.And I was like looking around at the class.I was like, this stuff is so interesting.Like, why are you guys all not listening or why is this professor phoning it in?Yeah.So that that was my very first introduction to it.That's incredible that you were more enthusiastic about the class than even your professor.

5:46

Well, I mean, it's not that surprising, is it, that I was like, wait a second, let's talk about this.But yeah, it was a terrible class.And I thought that I thought that that is like the type of question, the quite the type of thing that I'm really interested in.OK, yeah.

6:02

So you weren't like a failed pre Med, which sometimes happens.You were doing pre Med, you were passing classes, but then you got introduced to bioethics and even though your professor wasn't great at teaching it, which is actually pretty heartening to all the bioethics professors out there, is like people can get into your topic even if you're not great at teaching it.

6:23

Obviously we're great teachers so we don't need to worry about that.But that just tells you how compelling the topic is, and it's it switched your whole career.Yeah, so at that time I was still trying to figure out, yeah, I was doing well in all my pre Med classes and you know, even O chem and there's a couple that are kind of wieder classes like that, like organic chemistry lab and stuff like that.

6:42

But no, I was doing fine.I had a couple more semesters before I finished up because that, like I said, I was doing kind of a Community College for a while and then enrolling full time and also working and stuff.So I was taking my time getting through undergrad.So I had a couple more semesters and I took a class in, I can't remember the name of the class, something in the anthropology department.

7:05

And that's what really like blew my mind.I was like, there are people who get to sit around and think about like what different cultures think about health and illness.And, and so I took a medical anthropology class and that's what I really fell in love with was this idea of different communities, different groups of people like approaching this concept about health and Wellness and disease in very, very different ways.

7:35

So from there though, you decide not to be AMD, but you decide to be a JD.So how did you, so you know from Jock in high school to oh, should I be a physician or should I be a lawyer?Like how did you then get into the law?

7:52

Yeah, yeah.So part of my struggle in life is that I am trying to make up for things that I did in a previous life.So lots of, lots of trying to make up for kind of adventurous adventures earlier in life.

8:08

So when I was in this, this spot when I was taking these anthropology classes and falling, falling in love with like this idea, like this big, big picture, big concepts of like health illness, like healthcare systems.I went to West Africa for two summers in a row with a medical anthropology professor just to do research about.

8:30

So it's called medical pluralism or basically the idea that there's different healthcare systems existing within the same community.And so we went to West Africa and did research looking at the difference between like traditional healers, like traditional herbalists and different healers called like bone setters or priests.

8:50

And that was existing at the same time in the same community with like Western biomedical, like British trained hospital system.And so looking at the, the interaction between those 2 is what we really spent a couple of summers doing research on which I loved.

9:06

And I think if I were not married and did not have children, I would have pursued a medical anthropology PhD program and just been like, you know, doing field studies and living and, and doing that.But as happens to all of us, not all of us, to the lucky of us, I fell in love, got married, and then the idea of dragging my family along to West Africa to do field studies became less and less, not, not less appealing, but like less practical.

9:37

But then having fallen in love with the idea of these big ideas and teaching, I kind of came to the realization that I didn't want to be a doctor for a person, right?I didn't want to be somebody's doctor.But I wanted to look at these issues of health and illness and the ways that systems and our communities and our politics and our laws influence people's health in either good ways or bad ways.

10:03

And so one Ave. into that is looking looking at it through the legal lens.And I think like a lot of kids who grow up who are maybe a little bit smart mouthed and and can talk back to to to adults and hold interesting conversations with grown-ups.

10:19

I was always told that I should go to law school and that would be something that would be good for me.Does it translate?Is it the case that if you're a smart mouth kid, you're good?You're good in law school.No, not unless you turn into a smart mouth lawyer.But I didn't really turn into a smart mouth lawyer.

10:35

Yeah.So then that was kind of a big realization.And then I was looking at graduate programs rather than medical programs because I wanted to, I really wanted to be a professor.Like I, I like the, I like the life, I like the interaction with students.I like wrestling with big complicated topics and reading and writing and doing that stuff more than I I thought that I would enjoy being a a person's doctor so.

11:01

So you're living the dream.Well, kind of.It's also probably a lot of revisionist history going on into this story as well, right?Yeah.So then started looking at graduate programs.And a really wise professor of mine said that for, he said for you, Tyler, he said, I think law school would put you in a competitive advantage when you're trying to find a job.

11:26

And also it's a good fall back plan.You can do a lot of things with a law degree.It's not cheap, it's not easy.It's not it's not quick.But for me, that was kind of my practical side winning out a little bit where I thought, you know, what if this professor thing doesn't go well, which is kind of a, it's a kind of a crapshoot.

11:44

I mean, getting a job as a professor, especially if professor of like ethics or philosophy or religion, I mean, it's hard.And so I thought, boy, I'm going to have to provide for my family at some point.And so having a backup plan doing law, I think was kind of the practical choice.

12:04

Yeah, that makes total sense.And I was not on my radar when I was like, yeah, I'll do an M division and APHD.It was like not as marketable.You were.It makes more sense to like if you're going to have a fall back, the law is a fall back.Although when you graduated from law school, wasn't that right at the point when even getting a job as a lawyer was becoming much, much more difficult?

12:26

It was the worst, Yeah.So I was, I was looking almost exclusively at dual programs.So PhD and or a JD MA program is because I wanted to have that opportunity to teach where just a straight JD program wouldn't allow that as easily.

12:44

And so I found this program at Saint Louis University, which apparently nobody had ever done before, and it existed on the books.And so I applied to the law school and got accepted.And then I deferred for a year and then applied to the PhD program.

12:59

So I so I matriculated.I entered Saint Louis University, having already been accepted to both programs.I didn't realize you were the first.Wow.So you were the trailblazer JDPHD at Slew?Yeah, there were a couple other folks in my cohort.There were three of us who all started at the same time in the pH, in the JDPHD dual program.

13:20

But they after law school, they continued a little bit, but they ended up just kind of relying upon their law degree.And I think they're doing very well.I don't have a lot of contact with them, but I'd like to.Kelly, Shane, reach out.So, so, yeah.

13:36

So you were the first to graduate with both of those degrees.And OK, for those who are unfamiliar, how long does it then take?Is it any quicker to do them at the same time?Yeah, so I, I started law school in 2007 and then the way the program works is you finish the law degree with the with the dual credits and then you go on for the PhD program.

13:57

But SO started in 2007 and I left Saint Louis in 2013, so 6 years.Yeah, that's faster than so a law degree takes three years, and a PhD can take anywhere from four to seven years. 7 is still the average.

14:12

Yeah, yeah.And then when I left, I went to UCLA to do the postdoctoral fellowship, and that's where I finished writing my dissertation.And so I graduated in 2015 with the PhD, but I was mostly done by that point, so.That makes sense.I didn't realize you were still writing the dissertation.

14:27

So but this talk about the fellowship because that's a full time job.So how were you writing your dissertation with this full time job with a family and children to take care of?Yeah, I have a Good Wife.That's that's how I answer that question.It was hard.

14:43

I do not recommend it.I was just in Saint Louis at ASPHA couple of weeks ago and meeting with a couple of current JDPHD students and was talking about my experience.It I I would get up early in the morning and write on my dissertation.Then the kids would get up, we'd do the morning stuff to school, go to the fellowship, do that all day, come home late, have dinner, bath time, put the kids to bed, and then I would go right until in the morning.

15:12

So it was, it was rough, but we finished it.You know, our advisor said it can't be good until it is.And mine got to the is point and never got past that.So, yeah.So graduated from UCLA, their fellowship program, which is excellent.

15:30

If anybody is looking for clinical ethics training programs specifically, you can't ask for much better than UCLA's program.And then went on the job market, interviewed a bunch, and then landed here.

15:46

We've kind of talked about it that in other episodes, but you and I were looking for jobs at the same time and both ended up here in Michigan for a while.Yes.And my guess is the JD did help you because we were up for all of the same jobs and you got your job 1st.And I think they were like these, these are both stellar candidates, but this one has a law degree and that one has a divinity degree.

16:07

And on the whole, JD is just going to be a little bit more impressive to most job positions.JD wins there.Yeah, I, I tell people that I did the, I did the PhD.So doctors, when I'm in the room, they have to call me doctor.They call me doctor, but I did the law degree, so they actually listen to what I'm saying.

16:27

So yeah, yeah, it's, it's helpful.Every once in a while I'll say, okay, putting on my lawyer hat.Actually did that in a meeting just recently.But I don't usually, I don't lean into it very much.I never took the bar, so I'm not barred.I can't practice law but I can play one on TV and podcasts apparently.

16:46

Yeah, Yeah, you can.Just, you can say things like, you know, putting on my lawyer hat, right, which gives a certain kind of cachet to what you're about to say.Yeah.But you can say that like putting on my what pastor hat.Yeah.Putting on my chaplains hat.I could say that depends on who your dog you do, I suppose.

17:03

Yeah, yeah, yeah.So you did this.So the fellowship, you're like doing intensive clinical ethics.And so you have then tons of experience.But actually, as I remember, at Saint Louis University, you led Ethics Committee meetings.I remember going to meetings that you had at the hospital where you would sort of help run ethics too, right, Which put you in a good position to get this fellowship, which are also really competitive.

17:26

Super competitive, yeah.There's not enough good high quality fellowship training programs, I don't think postdoctoral training in clinical ethics.So towards the end of my time at Saint Louis University, again, thinking about jobs, thinking about children, supporting my family, it became very clear to me that I would best be able to support my family by working somewhere in clinical ethics because clinical ethics pays better than a, you know, entry level humanities professor at some university, right?

18:00

And so just looking at the job salaries, I was like, I need to get more training, more experience in clinical ethics.And at the time, Saint Louis University's program wasn't didn't have much of A clinical ethics emphasis.And so Erica Salter, who's now the chair of the department there and directing the PhD program, she had some contacts and she and I worked together to help kind of weasel our way into some brown bag lunches in the hospital, meeting with ICU residents and having conversations about cases.

18:29

And I think that's kind of where it it came from.And what what was interesting for me is the law is interesting to know.And it's interesting to be able to like, you know, refer back to and read and understand.But I think the most benefit that came from law school was being able to quickly think on your feet in a public space about really detailed things, right?

18:51

And so being able to sit in a meeting and and read a policy quickly and interact with people who are in crisis and be able to have those kind of conversations, that's a skill set that I think law and lawyers have that's different than a lot of other people in clinical ethics.So.

19:07

Yeah, totally worth the half $1,000,000 you paid for that skill set.Well, it wasn't that.Yeah, Well, maybe, yeah.And so I, I really kind of fell in love with clinical ethics, particularly because it reminded me of when I was working in the, the legal aid office and working for the law clinic in, in law school where where, you know, clients would come into us with some sort of crisis.

19:33

And we had to quickly understand where what they were talking about, what the law was, and then give them some sort of meaningful advice that would help them in their lives.And oftentimes it really made a big difference.And so it's a lot of the same skills that I think really good lawyers have, just in a different setting and be able to do that with people who are in crisis about medical decision making or, you know, end of life decisions or something like that.

20:00

Mm hmm, right.So you do the two year fellowship, you're set up well to be a clinical ethicist.I also didn't realize you like forged the path of the practicum at slew.So I have you to thank for lots of things besides just being my.Friend, it was Erica Salter.I'm sorry, Erica Salter.So then you get this job in SO and your job is kind of hybrid, right?

20:21

So you do clinical ethics for the hospitals and you teach the medical students.So talk about that.Yeah, It's really a great situation because so our medical school is fairly new.I mean it's been around since just before I got here.So we are kind of developing all of the curriculum and the clerkships and like everything as we were going.

20:40

But at the same time, we had two really strong hospital system partners here in Southwest Michigan.And they both had identified a need for kind of expert level clinical ethics support for their committees and their consultation services.And so I was hired in to not only help with the curricular needs of the medical school, but also to meet these two hospital needs, which has turned out really great.

21:03

I spent about 1/3 of my time doing clinical ethics and then maybe 1/3 doing research and writing and admin, then a third doing teaching.So it's, it's perfect.I I love my job so much.So what kinds of things do you do with the Med students?So you got to build the curriculum, which is really cool.

21:21

So as somebody who was there in the Med school from the ground up and you have the most beautiful Med school building and lots of fireplaces and water features.That's how you know it's nice.It's just a stunning medical school, but you got to like be there from the ground up building curriculum.So what kinds of things were important to you as you thought about what?

21:38

What should Med students need to know about clinical ethics?Yeah, and so one, one of the one of the best parts of my job is my my colleague, the other Co chairs Mike Redinger said.He's a psychiatrist and obviously a physician, but comes from his undergraduate Notre Dame.

21:57

So kind of has that Catholic ethics, Catholic healthcare approach, as well as just being a great person to work with.And so the two of us together were able to kind of dip our feet and, and dip our toes into a lot of different areas because there was just kind of a vacuum of infrastructure.

22:17

So for example, we said, you know, we would love to teach as much as we possibly can.And as a result, we've been able to have our ethics and humanities and law type of curriculum material interspersed throughout all four, four years of the curriculum.

22:33

So one of the first lectures that we give to our medical students is about professionalism and what it means to be a doctor and how that has kind of changed historically, but also what it means today and how social media impacts that.So that's like day one, not day one, but week one.

22:49

It's like professional identity formation.And then all the way through like one of the last sessions that we do with the students is again, kind of like here we are like four years later, like what have we, what have we done?What have we accomplished?And so a lot of like like virtue development type of professional development type of ideas, we talk a lot about being about trust and trustworthiness.

23:11

But then we also have have a lot of fun.There's a session that I get to do with the 4th year students where we, we do a mock malpractice trial.I was.Just going to say I got to witness this and it was so fun.Yeah, it's, it's great.I don't know of a lot of other places, I don't know maybe any other places that do a mock trial with fourth year medical students.

23:29

But it's based upon the Terasov case, which is we did an episode a couple of weeks months ago about the Terasov case.I don't want to spoil it in case there's any medical students listening, but it's a good time.Everyone dresses up.There were a lot of fun outfits, There were a lot of fun accents.

23:46

Yeah.People decided accents were a good idea for the smoke trial.I loved it.Yeah, yeah, yeah.Lots of costuming pre pandemic, we got to go to the local courthouse and actually the probate court judge that actually does a lot of the like the competency hearings and stuff locally.

24:05

He allowed us to use his courtroom and but as our student body grew, we outgrew the space that was available.So we just do it in here in the building.We set it up and, you know, students are the bailiffs and the jurors and the witnesses and the judge and, you know, to wear robes and gavels and all kinds of stuff.

24:24

It's a lot of fun.So that's the, so the third of it is the the clinical ethics, which you talked about 1/3 of it's the teaching.And so talk about the other third, which is your research, like what is really exciting to you to research and write on?Yeah.So there's, I guess there's a wide variety of things that I've written on and done research on, but most of them coming from my clinical ethics work.

24:48

So a case will come up or we'll I'll be having a conversation with somebody about some sort of kind of obscure technology or something.And that will spark an idea that will spark a conversation that will spark a a paper research question.And I try to use include students as much as I can.

25:07

I don't think my goal, this is kind of a, I'm not promoting this as a goal for everybody, but I, my goal is to always be a co-author.So I I've never published something where I'm a sole author, a primary single author, but also I love being like the second or third or fourth author.

25:28

Well, that's, but that's normal in bioethics publishing.It's it, it's it's not as if nobody ever single authors anything, but quite a bit of research in bioethics is co-authored.Yeah.Yeah, you have to be really good at collaborating.I think so, yeah.My, I, I want my epitaph to be the best third off there in the game.

25:49

So I'm, I'm a, I'm a good editor.Yeah, What's a what's a publication that you're particularly proud of?Besides our publication.Obviously, besides our stellar publication.Publication, there's been a a couple that I'm so there.I'll tell you about one that I is my favorite publication and then like the big publication and then one that I'm working on.

26:11

So one of my favorite publications is when I wrote with a buddy of mine here at W Med, who's moved on since since then.But his name was John Mincer and he's a poet.And we wrote a paper, We did a research project where we were gathering and analyzing urban legends about medicine.

26:30

And so we collected probably close to 500 different urban legends and analyzed them about like kind of what are they?What's the moral of them?Why are they being told like, what are some of the kind of literary constructs or aspects of it?

26:48

And so can.You give an example.Yeah.So an example, see, I mean, some of them are have to do with kind of the medicalization of people in unflattering ways.So like, you think about the urban legend of like the hook, right?A couple is like making out in the car and they hear over the radio that's, you know, a deranged killer from the local prison has escaped and he's got a hook on his hand.

27:14

And, you know, they, they hear scratching on the window or something like that.And so there's like this medicalization of individuals in the, in the stories.And so that's, that's one category.But there's also ones that have that are really common that lots of people have heard about.And what's interesting about urban legends is they don't have to be true or not true.

27:33

The fact that they are told is like sufficient enough.And so you think about somebody meeting the story of somebody meeting a, you know, a beautiful woman in the hotel lobby.They have some drinks.She seduces him back to her hotel.

27:49

He wakes up in the bathtub, missing a kidney hooked up to tubes, like with a note saying sorry or something like that, Right.So that's that's an example of a a medical urban legend.OK.And so you, what kind of things did you come out with gathering all of these?

28:06

Oh, it's so interesting.I, I would love to go back and and kind of delve into them deeper, but we so the, the article that we wrote was basically a taxonomy of all of these different kinds of urban legends, but it's entitled.I know a guy who once heard oh.It's great, yeah.

28:22

Which is a great article.OK, so and what's your most fancy famous article?Well, I've got a couple that were in big journals.So I, I was part of, there were three of us who wrote a paper that got published in the New England Journal of Medicine, which is a big one.And then I was involved in another group that we wrote a couple of papers about during COVID that gets cited quite a bit.

28:45

Annals of Internal Medicine was where one of those words at so.Those are two very prominent medical journals, and it's unusual to get ethics stuff in those kinds of journals, so kudos to you and your team.Yeah, thanks.Yeah, it was, it's it's cool.I mean it, it's fun to publish things.

29:02

It's fun to have ideas that actually get out into the world.And then people cite and people think about and hear about.But but you add up all of the citations and and references of all of my papers over my career and the podcast outdoes that in one episode.

29:19

Oh, absolutely.Yeah.It's like, not even close.Yeah.Not even close.Yeah, So what?So what are you working on now?I'm, I'm involved in a big project right now that is looking at professional misconduct, OK.And so think about like the board of nursing or the board of social work or the board of medicine.

29:39

Each state has one of these boards, and part of their responsibility is to discipline and punish people who misbehave.And so I'm involved in a project here in Michigan that is looking at all of the ways in which providers have misbehaved over a period of time and looking at trends and patterns.

30:00

And, you know, hopefully with an eye towards, like, how do we avoid this?And if people are really bad actors and shouldn't be practicing healthcare, maybe we need to do a better job of getting them out of healthcare.Yeah.And from what you've told me, it's doesn't seem like these boards are punishing physicians too severely for the kinds of misconduct that they might be doing.

30:22

Yeah.That's true.None of the boards.So the Board of medicine, the board of nursing, there's about 25 different boards in in Michigan that where our research is focused and it's eye opening, I think a lot of problems with the system.

30:39

And I think what's what's surprising to me the most is how much, quote UN quote, losing your license is brought up in clinical practice.Like, oh, we can't, we can't do that.I'm afraid that they're going to sue us and we're going to lose our license.And you know, stuff like that you hear about all the time.

30:55

And so I have a unique perspective of being like, OK, from a legal perspective, putting on my lawyer hat, the risk is very, very little or the amount of consternation put into like the act of getting sued is disproportionate to like the rates of actually being sued or actually losing a lawsuit.

31:15

And so that's kind of an overblown fear, in my opinion, for healthcare providers.Very real people experience it and it's it's horrible.But then also the other motivation of being like, well, you can lose your license for this thing.And truth is like it takes a lot to lose your license and usually a lot of bad things over a long period of time.

31:35

OK.Yeah.So it's not like one thing you did that may have been iffy and you lose your license.No, not, not even close.I not even like one time you did something really bad and then you still don't lose your license.Like I mean, you can get fined and suspended and all that stuff and it's not a pleasant, you know, process by any means.

31:53

But it's yeah, losing your license once you get it is actually you have to earn losing your license and sometimes multiple times over before you actually lose it.Yeah, so super interesting project.And tell me about your who is your aspirational bioethicist?

32:08

Like who do you love to read?Who do you sort of follow?Yeah, there's a couple people who I really like.So one of my colleagues, Parker Crutchfield, has he been?I don't think we've had him on the podcast yet.We'll have to.He's one of my favorite writers of all writers, fiction, non fiction.

32:26

He is just like a clear, crisp writer.And I don't agree with everything he writes.Obviously I don't agree with everything anybody writes, but he's one of my favorite writers.I would say as far as like bioethicists that I like to read.I think there's a couple of people who, regardless of what they're talking about, like, I will go and listen to him speak, right?

32:46

I think so.Our mentor Jeff Bishop is on that list.Like, his way of looking at the world is just really interesting, I think, and very different than the way that I look at the world.And I always learn something from him.So yeah, you, of course, Devin, a big fan.

33:02

Big fan of your work.Goes without saying.Yeah, yeah, there's a number of people especially so there's some young bioethicists who I think young, like our age, who I think are doing such interesting work.Joel Joel Reynolds at at Georgetown, for example.Are there like a lawyer bioethicist that you enjoy reading?

33:21

Yeah, so I mean some of the big names, so Thad Pope, Thaddeus Pope up in Minnesota, he's a JDPHD, does a lot of like end of life work, physician assisted suicide aid and dying, stuff like that.Yeah, yeah, there's, there's a handful.

33:37

Yeah, that's, that's a press you.Yeah.And what are your, what's kind of like a dream in bioethics that you have?Have you checked off all the things that you hope to do in bioethics, or what's still on your bioethics bucket list?Yeah, I I still have the dream of finishing a book.

33:58

I think that that's not something that everyone has to do in in academics, but for me that that's something that I still aspire to do.Yeah, I think a lot of what I want to do has is like bioethics adjacent.And so I'm really interested in developing, helping folks around here develop kind of an international experience for our students that has to do with, you know, ethics of working in under resourced communities and the ethics of kind of concierge medicine and travel medicine and global health that and that kind of Harkins back to my medical anthropology core love.

34:37

At some point I want I want to construct the projects such that somebody could walk in and be like, is this an anthropologist or is this a an ethicist?So.Yeah, cool.Those are good.Those are good aspirations, seems to me.So a book, a book which is totally doable, you can do it.

34:53

You did write a dissertation.I did write a dissertation.That's like prime for a book.I could turn it into a book, maybe, yeah.You could maybe maybe.Then I got to go back and read it again, and that might be the most painful.Part might be worth just writing a whole new book.

35:09

It's on my shelf sitting right there though, so.Yeah, I remember you had it bound.I did.I had it bound and I gave it.I gave a couple of copies to people who are important to me.Nice.Well, that's it.That's literally all the interesting things I can think about talking.We we totally exhausted your your world.

35:26

OK.Yeah.Good.Thanks, Tyler.All right.Thanks, Evan.You're my bioethics CRO, and it was nice to learn.I feel like I actually did learn a little bit about you.There are some things you slipped in there I didn't know before.Good.Thanks for tuning into this episode of Bioethics for the People.

35:45

We can't do it alone.So a huge shout out to Christopher Wright for creating our theme music and to Darien Golden Stall for designing our logo and all of the artwork.If you're into what we're doing, give us a rating on Apple Podcasts, Spotify, Amazon Music, or wherever you listen.

36:03

And if you're really into what we're doing, head over to bioethicsforthepeople.com to snag some merch.Really.I didn't like you in grad school.I liked everybody.OK?I liked everybody.OK.

36:19

Well, not.Everybody.Definitely not everybody, OK

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Conteúdo fornecido por Devan Stahl and Tyler Gibb. Todo o conteúdo do podcast, incluindo episódios, gráficos e descrições de podcast, é carregado e fornecido diretamente por Devan Stahl and Tyler Gibb ou por seu parceiro de plataforma de podcast. Se você acredita que alguém está usando seu trabalho protegido por direitos autorais sem sua permissão, siga o processo descrito aqui https://pt.player.fm/legal.

In this episode we do a deep dive into the work and life of our co-host Dr. Tyler Gibb.

Transcript

0:00

Welcome to this episode of Bioethics for the People, the most popular podcast on the planet according to Grandma Nancy.I'm joined by my Co host Doctor Tyler Gibb, who if he weren't here recording right now, would probably be golfing.And I'm joined by my Co host Doctor Devin Stahl, who dutifully completes the same 5 New York Times puzzles every day.

0:27

All right Tyler, the long-awaited Dr. Gibb episode.Here we go.Here we go.I'm a little uncomfortable.I got to be honest, a little nervous about this.I I will be gentle.OK, I'll try to be as candid and non meandering as I can.

0:48

But all right, well, don't change your personality.We want the we want the listeners to know you.So first, just tell me about your current role.Where are you this morning?How do you introduce yourself?Go.Yeah, so I am currently an associate professor in the Department of Medical Ethics, Humanities and Law at Western Michigan University, Homer Stryker, MD School of Medicine, which is in Kalamazoo, MI, so kind of the southwest corner of Michigan.

1:23

And I'm also the Co chair of our department, but it's a really small department.So that sounds better on paper than it really, really is, except I get to go to a lot of meetings about random stuff.But yeah, so that's what I do here in Kalamazoo.And how did you find yourself?

1:39

You're not from Michigan, right?So how did you get from, how did you get there wherever, wherever you were?Like, tell us the trajectory.Like how did you find yourself there?Yeah.So I grew up in Indiana, kind of Northwest Indiana, just outside of West Lafayette, IN, which is where Purdue University is.

1:57

And my dad was on the faculty for his whole career at Purdue University.So that's where I grew up, but we moved here in 2015 from Los Angeles and we were in Los Angeles because I was finishing A2 year postdoctoral fellowship in clinical ethics at UCLA.

2:19

Impressive.So did you always know you wanted to be a bioethicist?No, I had, that's such a funny question because there was no such thing as a bioethicist.So I I had kind of a meandering educational journey.This may come as a surprise, but in my friend group in high school, I was the dumb jock that people made fun of for being dumb.

2:42

That is surprising.Yeah.Mostly because you were a jock.I just don't see that for you.Yeah.Yeah, there's a lot of reasons why that's strange, but yeah, my friends used to make fun of me for being the dumb one.But then at some point I fell in love with learning and knowing things.

2:58

And so in college I took a seminar class like a 7:00 AM really brutal class that all pre Med students had to take and it was just called bioethics.Wait wait wait, you were pre Med?I was, yeah, yeah, yeah.How did you go from being a dumb high school student to being a pre Med college student?

3:16

Well, life, the vicissitudes of life.Yeah, like I said, it's kind of a meandering journey, but I went to a small college after high school called Wabash College, go little Giants and tried to pursue a career in mediocre football, which didn't work.

3:34

Then I left for left college for a couple years.I was raised in the Mormon church, which also surprises some people.And I went and was a missionary in Japan for the Mormon Church for two years.And then, yeah, had a great time.

3:50

Learn how to speak Japanese, learn how to eat sushi with with the best of them.So it was a good time.Can you say something in Japanese You.Want me to to to prove that I can speak Japanese?No, I'm not going to do that.I'm going to.I'm going to.Yeah, it's.

4:05

Been so long.So I used to speak fairly well, like fairly fairly like fluidly, but I it's been what, 20 years now?And so in my head I'm still just as as fluent, but I'm sure it would be terrible coming out and recorded for all eternity so.Fair enough.

4:21

Yeah.So I went to came back from Japan, moved in, started going to college part time out in Utah and then kind of got re enrolled in a Community College there and then just kind of kept going and kept going and kept going until there was no more school left to go to.

4:38

So.So.So at what point were you in?Were you were pre Med at Wabash?Is that right?Yeah.So I ended up graduating from Brigham Young University out in Utah.And it was there that I obviously was trying to figure out who and what I was going to do with my life.

4:57

And I definitely spent many semesters as pre Med doing all of the pre Med classes, physics O chem, chemistry labs, like all that stuff.Yeah.And part of the requirement was this bioethics seminar class.

5:14

OK, so say more.Yeah.So 7:00 AM once a week go to this seminar and we just had readings and we were supposed to go and discuss.But the professor who was in charge of it, he didn't want to be there.None of the other students wanted to be there.Like everybody hated it except for me.

5:29

I was in the front row every week.And I was like looking around at the class.I was like, this stuff is so interesting.Like, why are you guys all not listening or why is this professor phoning it in?Yeah.So that that was my very first introduction to it.That's incredible that you were more enthusiastic about the class than even your professor.

5:46

Well, I mean, it's not that surprising, is it, that I was like, wait a second, let's talk about this.But yeah, it was a terrible class.And I thought that I thought that that is like the type of question, the quite the type of thing that I'm really interested in.OK, yeah.

6:02

So you weren't like a failed pre Med, which sometimes happens.You were doing pre Med, you were passing classes, but then you got introduced to bioethics and even though your professor wasn't great at teaching it, which is actually pretty heartening to all the bioethics professors out there, is like people can get into your topic even if you're not great at teaching it.

6:23

Obviously we're great teachers so we don't need to worry about that.But that just tells you how compelling the topic is, and it's it switched your whole career.Yeah, so at that time I was still trying to figure out, yeah, I was doing well in all my pre Med classes and you know, even O chem and there's a couple that are kind of wieder classes like that, like organic chemistry lab and stuff like that.

6:42

But no, I was doing fine.I had a couple more semesters before I finished up because that, like I said, I was doing kind of a Community College for a while and then enrolling full time and also working and stuff.So I was taking my time getting through undergrad.So I had a couple more semesters and I took a class in, I can't remember the name of the class, something in the anthropology department.

7:05

And that's what really like blew my mind.I was like, there are people who get to sit around and think about like what different cultures think about health and illness.And, and so I took a medical anthropology class and that's what I really fell in love with was this idea of different communities, different groups of people like approaching this concept about health and Wellness and disease in very, very different ways.

7:35

So from there though, you decide not to be AMD, but you decide to be a JD.So how did you, so you know from Jock in high school to oh, should I be a physician or should I be a lawyer?Like how did you then get into the law?

7:52

Yeah, yeah.So part of my struggle in life is that I am trying to make up for things that I did in a previous life.So lots of, lots of trying to make up for kind of adventurous adventures earlier in life.

8:08

So when I was in this, this spot when I was taking these anthropology classes and falling, falling in love with like this idea, like this big, big picture, big concepts of like health illness, like healthcare systems.I went to West Africa for two summers in a row with a medical anthropology professor just to do research about.

8:30

So it's called medical pluralism or basically the idea that there's different healthcare systems existing within the same community.And so we went to West Africa and did research looking at the difference between like traditional healers, like traditional herbalists and different healers called like bone setters or priests.

8:50

And that was existing at the same time in the same community with like Western biomedical, like British trained hospital system.And so looking at the, the interaction between those 2 is what we really spent a couple of summers doing research on which I loved.

9:06

And I think if I were not married and did not have children, I would have pursued a medical anthropology PhD program and just been like, you know, doing field studies and living and, and doing that.But as happens to all of us, not all of us, to the lucky of us, I fell in love, got married, and then the idea of dragging my family along to West Africa to do field studies became less and less, not, not less appealing, but like less practical.

9:37

But then having fallen in love with the idea of these big ideas and teaching, I kind of came to the realization that I didn't want to be a doctor for a person, right?I didn't want to be somebody's doctor.But I wanted to look at these issues of health and illness and the ways that systems and our communities and our politics and our laws influence people's health in either good ways or bad ways.

10:03

And so one Ave. into that is looking looking at it through the legal lens.And I think like a lot of kids who grow up who are maybe a little bit smart mouthed and and can talk back to to to adults and hold interesting conversations with grown-ups.

10:19

I was always told that I should go to law school and that would be something that would be good for me.Does it translate?Is it the case that if you're a smart mouth kid, you're good?You're good in law school.No, not unless you turn into a smart mouth lawyer.But I didn't really turn into a smart mouth lawyer.

10:35

Yeah.So then that was kind of a big realization.And then I was looking at graduate programs rather than medical programs because I wanted to, I really wanted to be a professor.Like I, I like the, I like the life, I like the interaction with students.I like wrestling with big complicated topics and reading and writing and doing that stuff more than I I thought that I would enjoy being a a person's doctor so.

11:01

So you're living the dream.Well, kind of.It's also probably a lot of revisionist history going on into this story as well, right?Yeah.So then started looking at graduate programs.And a really wise professor of mine said that for, he said for you, Tyler, he said, I think law school would put you in a competitive advantage when you're trying to find a job.

11:26

And also it's a good fall back plan.You can do a lot of things with a law degree.It's not cheap, it's not easy.It's not it's not quick.But for me, that was kind of my practical side winning out a little bit where I thought, you know, what if this professor thing doesn't go well, which is kind of a, it's a kind of a crapshoot.

11:44

I mean, getting a job as a professor, especially if professor of like ethics or philosophy or religion, I mean, it's hard.And so I thought, boy, I'm going to have to provide for my family at some point.And so having a backup plan doing law, I think was kind of the practical choice.

12:04

Yeah, that makes total sense.And I was not on my radar when I was like, yeah, I'll do an M division and APHD.It was like not as marketable.You were.It makes more sense to like if you're going to have a fall back, the law is a fall back.Although when you graduated from law school, wasn't that right at the point when even getting a job as a lawyer was becoming much, much more difficult?

12:26

It was the worst, Yeah.So I was, I was looking almost exclusively at dual programs.So PhD and or a JD MA program is because I wanted to have that opportunity to teach where just a straight JD program wouldn't allow that as easily.

12:44

And so I found this program at Saint Louis University, which apparently nobody had ever done before, and it existed on the books.And so I applied to the law school and got accepted.And then I deferred for a year and then applied to the PhD program.

12:59

So I so I matriculated.I entered Saint Louis University, having already been accepted to both programs.I didn't realize you were the first.Wow.So you were the trailblazer JDPHD at Slew?Yeah, there were a couple other folks in my cohort.There were three of us who all started at the same time in the pH, in the JDPHD dual program.

13:20

But they after law school, they continued a little bit, but they ended up just kind of relying upon their law degree.And I think they're doing very well.I don't have a lot of contact with them, but I'd like to.Kelly, Shane, reach out.So, so, yeah.

13:36

So you were the first to graduate with both of those degrees.And OK, for those who are unfamiliar, how long does it then take?Is it any quicker to do them at the same time?Yeah, so I, I started law school in 2007 and then the way the program works is you finish the law degree with the with the dual credits and then you go on for the PhD program.

13:57

But SO started in 2007 and I left Saint Louis in 2013, so 6 years.Yeah, that's faster than so a law degree takes three years, and a PhD can take anywhere from four to seven years. 7 is still the average.

14:12

Yeah, yeah.And then when I left, I went to UCLA to do the postdoctoral fellowship, and that's where I finished writing my dissertation.And so I graduated in 2015 with the PhD, but I was mostly done by that point, so.That makes sense.I didn't realize you were still writing the dissertation.

14:27

So but this talk about the fellowship because that's a full time job.So how were you writing your dissertation with this full time job with a family and children to take care of?Yeah, I have a Good Wife.That's that's how I answer that question.It was hard.

14:43

I do not recommend it.I was just in Saint Louis at ASPHA couple of weeks ago and meeting with a couple of current JDPHD students and was talking about my experience.It I I would get up early in the morning and write on my dissertation.Then the kids would get up, we'd do the morning stuff to school, go to the fellowship, do that all day, come home late, have dinner, bath time, put the kids to bed, and then I would go right until in the morning.

15:12

So it was, it was rough, but we finished it.You know, our advisor said it can't be good until it is.And mine got to the is point and never got past that.So, yeah.So graduated from UCLA, their fellowship program, which is excellent.

15:30

If anybody is looking for clinical ethics training programs specifically, you can't ask for much better than UCLA's program.And then went on the job market, interviewed a bunch, and then landed here.

15:46

We've kind of talked about it that in other episodes, but you and I were looking for jobs at the same time and both ended up here in Michigan for a while.Yes.And my guess is the JD did help you because we were up for all of the same jobs and you got your job 1st.And I think they were like these, these are both stellar candidates, but this one has a law degree and that one has a divinity degree.

16:07

And on the whole, JD is just going to be a little bit more impressive to most job positions.JD wins there.Yeah, I, I tell people that I did the, I did the PhD.So doctors, when I'm in the room, they have to call me doctor.They call me doctor, but I did the law degree, so they actually listen to what I'm saying.

16:27

So yeah, yeah, it's, it's helpful.Every once in a while I'll say, okay, putting on my lawyer hat.Actually did that in a meeting just recently.But I don't usually, I don't lean into it very much.I never took the bar, so I'm not barred.I can't practice law but I can play one on TV and podcasts apparently.

16:46

Yeah, Yeah, you can.Just, you can say things like, you know, putting on my lawyer hat, right, which gives a certain kind of cachet to what you're about to say.Yeah.But you can say that like putting on my what pastor hat.Yeah.Putting on my chaplains hat.I could say that depends on who your dog you do, I suppose.

17:03

Yeah, yeah, yeah.So you did this.So the fellowship, you're like doing intensive clinical ethics.And so you have then tons of experience.But actually, as I remember, at Saint Louis University, you led Ethics Committee meetings.I remember going to meetings that you had at the hospital where you would sort of help run ethics too, right, Which put you in a good position to get this fellowship, which are also really competitive.

17:26

Super competitive, yeah.There's not enough good high quality fellowship training programs, I don't think postdoctoral training in clinical ethics.So towards the end of my time at Saint Louis University, again, thinking about jobs, thinking about children, supporting my family, it became very clear to me that I would best be able to support my family by working somewhere in clinical ethics because clinical ethics pays better than a, you know, entry level humanities professor at some university, right?

18:00

And so just looking at the job salaries, I was like, I need to get more training, more experience in clinical ethics.And at the time, Saint Louis University's program wasn't didn't have much of A clinical ethics emphasis.And so Erica Salter, who's now the chair of the department there and directing the PhD program, she had some contacts and she and I worked together to help kind of weasel our way into some brown bag lunches in the hospital, meeting with ICU residents and having conversations about cases.

18:29

And I think that's kind of where it it came from.And what what was interesting for me is the law is interesting to know.And it's interesting to be able to like, you know, refer back to and read and understand.But I think the most benefit that came from law school was being able to quickly think on your feet in a public space about really detailed things, right?

18:51

And so being able to sit in a meeting and and read a policy quickly and interact with people who are in crisis and be able to have those kind of conversations, that's a skill set that I think law and lawyers have that's different than a lot of other people in clinical ethics.So.

19:07

Yeah, totally worth the half $1,000,000 you paid for that skill set.Well, it wasn't that.Yeah, Well, maybe, yeah.And so I, I really kind of fell in love with clinical ethics, particularly because it reminded me of when I was working in the, the legal aid office and working for the law clinic in, in law school where where, you know, clients would come into us with some sort of crisis.

19:33

And we had to quickly understand where what they were talking about, what the law was, and then give them some sort of meaningful advice that would help them in their lives.And oftentimes it really made a big difference.And so it's a lot of the same skills that I think really good lawyers have, just in a different setting and be able to do that with people who are in crisis about medical decision making or, you know, end of life decisions or something like that.

20:00

Mm hmm, right.So you do the two year fellowship, you're set up well to be a clinical ethicist.I also didn't realize you like forged the path of the practicum at slew.So I have you to thank for lots of things besides just being my.Friend, it was Erica Salter.I'm sorry, Erica Salter.So then you get this job in SO and your job is kind of hybrid, right?

20:21

So you do clinical ethics for the hospitals and you teach the medical students.So talk about that.Yeah, It's really a great situation because so our medical school is fairly new.I mean it's been around since just before I got here.So we are kind of developing all of the curriculum and the clerkships and like everything as we were going.

20:40

But at the same time, we had two really strong hospital system partners here in Southwest Michigan.And they both had identified a need for kind of expert level clinical ethics support for their committees and their consultation services.And so I was hired in to not only help with the curricular needs of the medical school, but also to meet these two hospital needs, which has turned out really great.

21:03

I spent about 1/3 of my time doing clinical ethics and then maybe 1/3 doing research and writing and admin, then a third doing teaching.So it's, it's perfect.I I love my job so much.So what kinds of things do you do with the Med students?So you got to build the curriculum, which is really cool.

21:21

So as somebody who was there in the Med school from the ground up and you have the most beautiful Med school building and lots of fireplaces and water features.That's how you know it's nice.It's just a stunning medical school, but you got to like be there from the ground up building curriculum.So what kinds of things were important to you as you thought about what?

21:38

What should Med students need to know about clinical ethics?Yeah, and so one, one of the one of the best parts of my job is my my colleague, the other Co chairs Mike Redinger said.He's a psychiatrist and obviously a physician, but comes from his undergraduate Notre Dame.

21:57

So kind of has that Catholic ethics, Catholic healthcare approach, as well as just being a great person to work with.And so the two of us together were able to kind of dip our feet and, and dip our toes into a lot of different areas because there was just kind of a vacuum of infrastructure.

22:17

So for example, we said, you know, we would love to teach as much as we possibly can.And as a result, we've been able to have our ethics and humanities and law type of curriculum material interspersed throughout all four, four years of the curriculum.

22:33

So one of the first lectures that we give to our medical students is about professionalism and what it means to be a doctor and how that has kind of changed historically, but also what it means today and how social media impacts that.So that's like day one, not day one, but week one.

22:49

It's like professional identity formation.And then all the way through like one of the last sessions that we do with the students is again, kind of like here we are like four years later, like what have we, what have we done?What have we accomplished?And so a lot of like like virtue development type of professional development type of ideas, we talk a lot about being about trust and trustworthiness.

23:11

But then we also have have a lot of fun.There's a session that I get to do with the 4th year students where we, we do a mock malpractice trial.I was.Just going to say I got to witness this and it was so fun.Yeah, it's, it's great.I don't know of a lot of other places, I don't know maybe any other places that do a mock trial with fourth year medical students.

23:29

But it's based upon the Terasov case, which is we did an episode a couple of weeks months ago about the Terasov case.I don't want to spoil it in case there's any medical students listening, but it's a good time.Everyone dresses up.There were a lot of fun outfits, There were a lot of fun accents.

23:46

Yeah.People decided accents were a good idea for the smoke trial.I loved it.Yeah, yeah, yeah.Lots of costuming pre pandemic, we got to go to the local courthouse and actually the probate court judge that actually does a lot of the like the competency hearings and stuff locally.

24:05

He allowed us to use his courtroom and but as our student body grew, we outgrew the space that was available.So we just do it in here in the building.We set it up and, you know, students are the bailiffs and the jurors and the witnesses and the judge and, you know, to wear robes and gavels and all kinds of stuff.

24:24

It's a lot of fun.So that's the, so the third of it is the the clinical ethics, which you talked about 1/3 of it's the teaching.And so talk about the other third, which is your research, like what is really exciting to you to research and write on?Yeah.So there's, I guess there's a wide variety of things that I've written on and done research on, but most of them coming from my clinical ethics work.

24:48

So a case will come up or we'll I'll be having a conversation with somebody about some sort of kind of obscure technology or something.And that will spark an idea that will spark a conversation that will spark a a paper research question.And I try to use include students as much as I can.

25:07

I don't think my goal, this is kind of a, I'm not promoting this as a goal for everybody, but I, my goal is to always be a co-author.So I I've never published something where I'm a sole author, a primary single author, but also I love being like the second or third or fourth author.

25:28

Well, that's, but that's normal in bioethics publishing.It's it, it's it's not as if nobody ever single authors anything, but quite a bit of research in bioethics is co-authored.Yeah.Yeah, you have to be really good at collaborating.I think so, yeah.My, I, I want my epitaph to be the best third off there in the game.

25:49

So I'm, I'm a, I'm a good editor.Yeah, What's a what's a publication that you're particularly proud of?Besides our publication.Obviously, besides our stellar publication.Publication, there's been a a couple that I'm so there.I'll tell you about one that I is my favorite publication and then like the big publication and then one that I'm working on.

26:11

So one of my favorite publications is when I wrote with a buddy of mine here at W Med, who's moved on since since then.But his name was John Mincer and he's a poet.And we wrote a paper, We did a research project where we were gathering and analyzing urban legends about medicine.

26:30

And so we collected probably close to 500 different urban legends and analyzed them about like kind of what are they?What's the moral of them?Why are they being told like, what are some of the kind of literary constructs or aspects of it?

26:48

And so can.You give an example.Yeah.So an example, see, I mean, some of them are have to do with kind of the medicalization of people in unflattering ways.So like, you think about the urban legend of like the hook, right?A couple is like making out in the car and they hear over the radio that's, you know, a deranged killer from the local prison has escaped and he's got a hook on his hand.

27:14

And, you know, they, they hear scratching on the window or something like that.And so there's like this medicalization of individuals in the, in the stories.And so that's, that's one category.But there's also ones that have that are really common that lots of people have heard about.And what's interesting about urban legends is they don't have to be true or not true.

27:33

The fact that they are told is like sufficient enough.And so you think about somebody meeting the story of somebody meeting a, you know, a beautiful woman in the hotel lobby.They have some drinks.She seduces him back to her hotel.

27:49

He wakes up in the bathtub, missing a kidney hooked up to tubes, like with a note saying sorry or something like that, Right.So that's that's an example of a a medical urban legend.OK.And so you, what kind of things did you come out with gathering all of these?

28:06

Oh, it's so interesting.I, I would love to go back and and kind of delve into them deeper, but we so the, the article that we wrote was basically a taxonomy of all of these different kinds of urban legends, but it's entitled.I know a guy who once heard oh.It's great, yeah.

28:22

Which is a great article.OK, so and what's your most fancy famous article?Well, I've got a couple that were in big journals.So I, I was part of, there were three of us who wrote a paper that got published in the New England Journal of Medicine, which is a big one.And then I was involved in another group that we wrote a couple of papers about during COVID that gets cited quite a bit.

28:45

Annals of Internal Medicine was where one of those words at so.Those are two very prominent medical journals, and it's unusual to get ethics stuff in those kinds of journals, so kudos to you and your team.Yeah, thanks.Yeah, it was, it's it's cool.I mean it, it's fun to publish things.

29:02

It's fun to have ideas that actually get out into the world.And then people cite and people think about and hear about.But but you add up all of the citations and and references of all of my papers over my career and the podcast outdoes that in one episode.

29:19

Oh, absolutely.Yeah.It's like, not even close.Yeah.Not even close.Yeah, So what?So what are you working on now?I'm, I'm involved in a big project right now that is looking at professional misconduct, OK.And so think about like the board of nursing or the board of social work or the board of medicine.

29:39

Each state has one of these boards, and part of their responsibility is to discipline and punish people who misbehave.And so I'm involved in a project here in Michigan that is looking at all of the ways in which providers have misbehaved over a period of time and looking at trends and patterns.

30:00

And, you know, hopefully with an eye towards, like, how do we avoid this?And if people are really bad actors and shouldn't be practicing healthcare, maybe we need to do a better job of getting them out of healthcare.Yeah.And from what you've told me, it's doesn't seem like these boards are punishing physicians too severely for the kinds of misconduct that they might be doing.

30:22

Yeah.That's true.None of the boards.So the Board of medicine, the board of nursing, there's about 25 different boards in in Michigan that where our research is focused and it's eye opening, I think a lot of problems with the system.

30:39

And I think what's what's surprising to me the most is how much, quote UN quote, losing your license is brought up in clinical practice.Like, oh, we can't, we can't do that.I'm afraid that they're going to sue us and we're going to lose our license.And you know, stuff like that you hear about all the time.

30:55

And so I have a unique perspective of being like, OK, from a legal perspective, putting on my lawyer hat, the risk is very, very little or the amount of consternation put into like the act of getting sued is disproportionate to like the rates of actually being sued or actually losing a lawsuit.

31:15

And so that's kind of an overblown fear, in my opinion, for healthcare providers.Very real people experience it and it's it's horrible.But then also the other motivation of being like, well, you can lose your license for this thing.And truth is like it takes a lot to lose your license and usually a lot of bad things over a long period of time.

31:35

OK.Yeah.So it's not like one thing you did that may have been iffy and you lose your license.No, not, not even close.I not even like one time you did something really bad and then you still don't lose your license.Like I mean, you can get fined and suspended and all that stuff and it's not a pleasant, you know, process by any means.

31:53

But it's yeah, losing your license once you get it is actually you have to earn losing your license and sometimes multiple times over before you actually lose it.Yeah, so super interesting project.And tell me about your who is your aspirational bioethicist?

32:08

Like who do you love to read?Who do you sort of follow?Yeah, there's a couple people who I really like.So one of my colleagues, Parker Crutchfield, has he been?I don't think we've had him on the podcast yet.We'll have to.He's one of my favorite writers of all writers, fiction, non fiction.

32:26

He is just like a clear, crisp writer.And I don't agree with everything he writes.Obviously I don't agree with everything anybody writes, but he's one of my favorite writers.I would say as far as like bioethicists that I like to read.I think there's a couple of people who, regardless of what they're talking about, like, I will go and listen to him speak, right?

32:46

I think so.Our mentor Jeff Bishop is on that list.Like, his way of looking at the world is just really interesting, I think, and very different than the way that I look at the world.And I always learn something from him.So yeah, you, of course, Devin, a big fan.

33:02

Big fan of your work.Goes without saying.Yeah, yeah, there's a number of people especially so there's some young bioethicists who I think young, like our age, who I think are doing such interesting work.Joel Joel Reynolds at at Georgetown, for example.Are there like a lawyer bioethicist that you enjoy reading?

33:21

Yeah, so I mean some of the big names, so Thad Pope, Thaddeus Pope up in Minnesota, he's a JDPHD, does a lot of like end of life work, physician assisted suicide aid and dying, stuff like that.Yeah, yeah, there's, there's a handful.

33:37

Yeah, that's, that's a press you.Yeah.And what are your, what's kind of like a dream in bioethics that you have?Have you checked off all the things that you hope to do in bioethics, or what's still on your bioethics bucket list?Yeah, I I still have the dream of finishing a book.

33:58

I think that that's not something that everyone has to do in in academics, but for me that that's something that I still aspire to do.Yeah, I think a lot of what I want to do has is like bioethics adjacent.And so I'm really interested in developing, helping folks around here develop kind of an international experience for our students that has to do with, you know, ethics of working in under resourced communities and the ethics of kind of concierge medicine and travel medicine and global health that and that kind of Harkins back to my medical anthropology core love.

34:37

At some point I want I want to construct the projects such that somebody could walk in and be like, is this an anthropologist or is this a an ethicist?So.Yeah, cool.Those are good.Those are good aspirations, seems to me.So a book, a book which is totally doable, you can do it.

34:53

You did write a dissertation.I did write a dissertation.That's like prime for a book.I could turn it into a book, maybe, yeah.You could maybe maybe.Then I got to go back and read it again, and that might be the most painful.Part might be worth just writing a whole new book.

35:09

It's on my shelf sitting right there though, so.Yeah, I remember you had it bound.I did.I had it bound and I gave it.I gave a couple of copies to people who are important to me.Nice.Well, that's it.That's literally all the interesting things I can think about talking.We we totally exhausted your your world.

35:26

OK.Yeah.Good.Thanks, Tyler.All right.Thanks, Evan.You're my bioethics CRO, and it was nice to learn.I feel like I actually did learn a little bit about you.There are some things you slipped in there I didn't know before.Good.Thanks for tuning into this episode of Bioethics for the People.

35:45

We can't do it alone.So a huge shout out to Christopher Wright for creating our theme music and to Darien Golden Stall for designing our logo and all of the artwork.If you're into what we're doing, give us a rating on Apple Podcasts, Spotify, Amazon Music, or wherever you listen.

36:03

And if you're really into what we're doing, head over to bioethicsforthepeople.com to snag some merch.Really.I didn't like you in grad school.I liked everybody.OK?I liked everybody.OK.

36:19

Well, not.Everybody.Definitely not everybody, OK

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