Dr. David Weill: 5 Things I Wish Someone Told Me When I First Became A Doctor
Aristotle said, “In order to avoid criticism, say nothing, do nothing, and be nothing.” It takes courage to speak your mind, to share a message you believe in with the world, even if unpopular. I write in my book Exhale about the times that I have had to say “hard truths” to my bosses, in order to see change happen. It’s hard to do this and, from my experience, not always well-received. Nonetheless, if each of us wants to make a difference, at times that involves saying things that folks sometimes don’t want to hear. But it’s the right thing to do.
As part of my series about healthcare leaders, I had the pleasure of interviewing Dr. David Weill.
David Weill is the former Director of the Center for Advanced Lung Disease and Lung and Heart-Lung Transplant Program at Stanford University Medical Center. Dr. Weill’s writing has appeared in the Wall Street Journal, USA Today, Salon, Newsweek, the Chicago Tribune, STAT, the Washington Post, The Hill, and the Los Angeles Times. He also has been interviewed on CNN and by the New York Times, the San Francisco Chronicle, and the Wall Street Journal. His memoir Exhale: Hope, Healing, and A Life in Transplant will be published in May 2021 by Post Hill Press.
Thank you so much for joining us in this interview series! What is your “backstory”?
I grew up in New Orleans and went to college and medical school at Tulane. I recently moved back home after 26 years away, mostly out West. I am married to Jackie and have two teenage daughters Hannah and Ava (who keep me busy!). When I moved back to New Orleans, I opened a healthcare consulting business called (Imaginatively!) Weill Consulting Group that focuses on improving the delivery of complex medical care, like organ transplantation. I divide my time between family, my consulting practice, my non-profit work, and writing (books, Op-eds, and essays).
Can you share the interesting story that happened to you since you started your career?
I fell in love with transplant in 1990 — and it was clear, yellow piss that did it.
On my first day of internship, the program director gathered us fresh interns together, and told us that one of the fifth-year residents had become seriously sick, and he needed one of us to volunteer to staff the kidney transplant service. My hand shot up instantly and I was “hired.” Talk about getting too far over your skis — I hadn’t even figured out where the johns were yet, much less being anywhere nearly equipped to manage a kidney transplant recipient. Nonetheless, the hubris of youth won the day and led me to the assignment that would change my life. Off I went.
I hustled to the residents’ library and found a relatively recent book about kidney transplant. Leafing through it, I tried to absorb as much information about postoperative care as I could. I was interrupted by my pager going off every few minutes, but I learned a few principles. The first priority post-surgery was to get the patient peeing — new kidneys, have to make sure they work. To hasten this process, we would give the kidney recipient enough fluids for him to urinate, but not enough to drown his lungs. I didn’t know exactly how much that would be, but I guessed I’d figure it out.
Hours later after the patient got out of surgery and was in the postoperative recovery room, it happened — urine happened! I jerked forward in my seat. I never thought I would be so excited to see yellow liquid passing into a Foley catheter bag — slow drips at first, and then a steady stream. I turned my back to see if anyone else was seeing what I was seeing, and then turned back to the bag. It was now filling up and beginning to bulge out. I lifted the bag and squeezed it, feeling its warmth with my hand and smiling.
And so it happened. A jolt of transplant lighting had just gone right through me. I was hooked for life. For me, giving that gift of hope that night sparked a flame that would burn hot in me for the rest of my career.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
“Dr. Weill, will you come up and read this chest x-ray for us?”
I was a first year medical school in an auditorium filled with my classmates but also with several faculty members sitting in the front rows. The faculty members, called “attendings” in the academic world, were physicians who were fully trained in their specialties and were, from my vantage point in those early days in medical school, essentially gods — all knowing, full of confidence and wisdom. We were learning that day about chest x-rays, the basics — how they were shot, what one could see on them, and what parts of the radiograph correlated to what body part. I’m talking X-Rays 101.
My closest medical school friend, Del, was sitting next to me. He elbowed me and said, “I think they mean you.” He started to laugh, soon joined in by all the others around me. I stood, my heart racing, my legs heavy, and made my way to the front.
As I took my place in front of the x-ray box, the light from the box, felt like it was heating the skin on my face to about a thousand degrees. I soon felt like I was trying to interpret a chest x-ray in a room full of real doctors and would-be doctors on the surface of the sun. Sweat formed on my lower back. I made a half-turn to look over at my father (the head of the pulmonary department), who smiled slightly, nodded, and tilted his head toward the x-ray box.
I turned back to the box and started in, feeling a couple hundred eyes boring into the back of my head. I started to speak, remembering to call out structure by structure, to be systematic, to stay organized in the film interpretation, just like my father told the young doctors back then. Starting from the outside and working in, I said, softly, “The soft tissue and bony structure looks good,” without knowing if they really did but at least knowing to start there. No one stopped me so I continued. “The trachea and mediastinum look good.” No interruption. So far, so good. “The heart looks…” Let’s see, I think he said at one time when I was listening as a kid, spinning around on a stool in the x-ray room, that the cardiac silhouette (the shadow the heart makes on the chest x-ray) is normal size if it’s less than a third of the width of the entire film. “The cardiac silhouette is…maybe…a bit enlarged.” I heard nothing, except my father sort of grunt from the first row, “Mmm.” I must have gotten that one wrong.
The professor walked over and looked at the x-ray and then me. “Doctor Weill, why don’t you look at the left lung again?” I turned to the x-ray box again, knowing that I had missed something, maybe even something obvious. I scanned the left lung but whatever I missed, I couldn’t see. It would be like asking me to read Mandarin. In fact, I might have a better chance with Mandarin.
I turned and looked at the professor, pleading really, a white flag had been raised. He paused for a few moments, letting me dangle for a while. He took out his pointer and used it to circle a quarter size abnormality that was in the left lung and obscured slightly by the cardiac shadow, a place that I would find out later is a classic one to hide a cancer on chest x-rays. “A lung cancer, doctor. Congratulations, you just missed a potentially curable cancer in your patient.” The whole auditorium laughed and I looked over at my father who was smiling, clearly enjoying himself. “You can sit down now.” I made my way back to my seat, sat down next to my buddy Del and allowed my heart rate to settle back down. He pushed me on the forehead. “Nice job. You just killed that guy.” I smiled and said, “Probably won’t be the last one.”
Are you working on any new or exciting projects now?
Yes, I am working on my second book that will focus on the loss of American Healthcare Exceptionalism, resulting in a loss of trust in our system. I will show many examples of where our system of delivering care has failed patients — and failed those who provide the care.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
I think I owe much of my success to my parents. My father was an academic pulmonologist that was disciplined, rigorous in his thinking, and determined. He taught me to never give him and to stand up for what was right, even if others disagreed. My mother was a nurse and taught me two great lessons: empathy and the love of books. I wouldn’t be anywhere without the two of them.
Is there a particular book that made an impact on you? Can you share a story?
Speed: Facing Our Addiction to Fast and Faster — and Overcoming Our Fear of Slowing Down by Stephanie Brown, PhD. Speed details the syndrome of how some people (probably me included) have a fear of not being busy, a fear of being quiet with our thoughts and emotions. Dr. Brown tells the stories in her book of individuals who improved their lives and their productivity by slowing down. I think this was an important lesson for me as I found my life as a transplant doctor had gotten too chaotic, and the “speed” at which I was traveling was unsustainable. Ultimately reading Dr. Brown’s book made me reassess my own life and make positive changes that I will carry with me for the rest of my life.
How have you used your success to bring goodness to the world?
I try to focus my non-profit board work and philanthropy on the things that I care most about: giving the under-resourced people of our country a chance, especially people of color. Even in the schools that I work with that are considered elite private institutions, I try to steer the conversation toward how do we help give the people of different backgrounds than ours a chance to be successful. I also have the privilege of just recently joining the Board of Trustees of Xavier University of Louisiana, a renowned historically black college, and look forward to helping an issue that I feel passionately about: how do we get more Black doctors, which I think will go a long way toward alleviating the racial disparities that have been present in healthcare for a long time.
Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant to you in your own life?
Aristotle said, “In order to avoid criticism, say nothing, do nothing, and be nothing.” It takes courage to speak your mind, to share a message you believe in with the world, even if unpopular. I write in my book Exhale about the times that I have had to say “hard truths” to my bosses, in order to see change happen. It’s hard to do this and, from my experience, not always well-received. Nonetheless, if each of us wants to make a difference, at times that involves saying things that folks sometimes don’t want to hear. But it’s the right thing to do.
Can you share your top three “lifestyle tweaks” that will help people feel great?
- Stay connected with family and friends — work every day on your relationships
- Take care of your mind and body every day (nourish both as a habit)
- Never forget those less fortunate than you — they need your help
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
- How doing the right thing can meet so much resistance!
- That the greatest gift is a healthy mind and body
- That what is said at your funeral matters (even while you are alive!)
- That the work never stops, that making an impact is hard, but that the effort is worth it
- That having kids would be the greatest joy of my life
If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?
Connectedness. I think especially in these times, the need to be connected to one another is now greater than ever. And many of society’s problems (mental health issues, and even medical problems) are related to isolation. Humans are built to interact with one another — we have learned that once again during the pandemic. The solution to so many of our challenges is to connect with one another, to avoid isolation at all costs. As I go through life, I think it is more and more important.
We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them :-)
I would like to have lunch with Tom Brady — I think he has much to teach the rest of us about how to take care of your body and mind, follow your passion, and build a winning brand. His reach goes far beyond sports!
What is the best way our readers can follow you online?
Readers can visit my website at davidweillmd.com where there is a lot of information about what I am working on and much of the writing that I have published. I also am on Twitter @davidweillmd, Facebook, and LinkedIn. My Instagram account (relatively new) is davidweill1.
Thank you so much for these wonderful insights!
