Ditch The Labcoat

Dr. Mark Bonta reads the obituary section every weekend. Not morbidly. But because when he cares for patients in the hospital, he sees them in a blue gown having their worst day. He never knows their life, their legacy, or how they wanted to be remembered. The obituary fills in the gaps.Katie Engelhart, a Pulitzer Prize-winning journalist and contributing writer at The New York Times Magazine, does something similar. She finds the stories medicine doesn't tell. The ethical dilemmas playing out in ICUs and hospital rooms that the public never hears about. Medical aid in dying for eating disorders. Covert consciousness in patients diagnosed as vegetative. Dementia patients timing their own deaths before losing capacity to consent.
Her work challenges the way medicine operates. Not the science. But the values, the judgments, the institutional culture that shapes standards of care without public input. She spends months, sometimes years, with patients and families navigating impossible decisions. And she lets the stories stay messy because real life doesn't fit tidy narratives.
Mark and Katie talk about how she finds the people whose stories need to be told, how she earns trust over months of conversations, and why she has respect for doctors and medical science but not deference to the way things are in medicine.
If you've ever wondered how medical journalism actually works, why certain stories get told and others don't, or what happens when families navigate end-of-life decisions without the ethical support they need, this conversation will give you a behind-the-scenes look at one of the best medical writers working today.
Katie Engelhart:  https://www.katieengelhart.com/

Episode Takeaways1. Standards of medical care are shaped by value judgments, ethics, institutional culture, and history — not just science and mathematics. The public is often unaware of why policies exist or how they came to be.
2. Katie's reporting process involves months (sometimes years) of conversations, thousands of pages of medical records, and cross-referencing with family members and experts to verify every detail.
3. Covert consciousness research shows that about 25 percent of patients presumed to be in vegetative states are actually aware and can perform tasks like imagining playing tennis, but families making decisions rarely have access to these tests.
4. What "better" or "recovery" means to an ICU physician is often very different from what it means to a family member — even medical terms are shaped by values, not just facts.
5. Katie finds people to profile by spending months building trust with providers, writing letters they can share with patients, and navigating institutional barriers that either support or block her work.
6. The healthcare system lacks ethical support for patients making major moral decisions, leaving millions of people to face these choices alone even though their neighbors are going through the same thing.
7. Patients will do their own research, and clinicians need to accept that and expand conversations to include it rather than dismissing skepticism as uninformed or pseudoscience.
8. Choices that seem unfathomable from the outside become completely understandable when you spend time with the people making them and walk through their reasoning step by step.
Episode Timestamps04:48 – Why Katie Is Drawn to Medical Writing
08:24 – Telling Robert Munch's Dementia Story Without Making It About Dementia
15:22 – Covert Consciousness: A Quarter of Vegetative Patients Are Actually Aware
19:32 – The Ego and Humility Problem in Medicine
22:56 – What "Better" Means to Doctors vs. Families
28:17 – Finding the People Whose Stories Need to Be Told
32:05 – How Katie Vets Sources and Verifies Information
37:38 – The Existential Crisis of Our Own Mortality

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.  

 >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.   

 Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University.

We're going to cure cancer in our lifetime." It's a rallying cry at every charity event, every fundraiser, every race. But what does that actually mean?Dr. Sonal Gandhi, a medical oncologist, joins Ditch the Labcoat to break down what most people don't understand: we already cure cancer. All the time. Early stage cancers like breast, colon, and skin cancer caught in time have cure rates approaching 90 to 100 percent.
The challenge is stage four cancer. Metastatic disease. Cancer that has spread to other organs. And even there, the conversation is shifting. Cancer is increasingly becoming a chronic illness. People are living longer with it, sometimes dying with it rather than from it, just like they do with heart disease or diabetes.
Dr. Gandhi walks through what "curing cancer" really means, how treatment has evolved beyond chemotherapy into targeted therapies and immunotherapy, and why prevention matters. Up to 40 percent of cancers are related to modifiable lifestyle factors: smoking, alcohol, obesity, lack of exercise. But even doing everything right doesn't guarantee you won't get cancer. Age is the number one risk factor, and we can't modify that.
She also challenges the guilt people carry when they're diagnosed and reframes the fear around the "C word." Maybe it's time to pull cancer back into the middle with the menu of other chronic illnesses we manage, not cure.
If you've ever wondered what "curing cancer" actually means, why some cancers are more treatable than others, or what you can do to reduce your risk, this episode will reframe how you think about one of medicine's most feared diagnoses.
If you've ever wondered why so many people have unexplained symptoms, why standard treatments fail them, or what actually works when medicine runs out of answers, this episode will reframe how you see chronic illness.
Dr. Sonal Gandhi's Linkedin

Episode Takeaways1. We already cure cancer. Early stage cancers (stage 1 or 2) caught in time have cure rates approaching 90 to 100 percent, depending on the type.
2. Cancer is not one disease. It's dozens of diseases with different stages, treatments, and outcomes. We're better at treating some than others.
3. Stage four (metastatic) cancer is increasingly becoming a chronic illness. Treatments help people live longer with cancer, sometimes dying with it rather than from it.
4. Up to 40 percent of cancers are related to modifiable lifestyle factors: smoking, alcohol, obesity, and lack of exercise. Being a healthy weight matters for cancer prevention.
5. Age is the number one risk factor for cancer. Every decade you get older, cells get worse at repairing mistakes. We can't modify aging.
6. Only 10 to 20 percent of cancers are due to inherited genes. Most cancers happen because of the complicated interplay between lifestyle, environment, and cellular aging.
7. Immunotherapy works by preventing cancer cells from turning off the immune system, but it can cause severe autoimmune side effects that need rapid treatment.
8. Whole body scans and experimental blood tests sound appealing, but they often create more harm than good. Screening needs to be done in context with clear downstream action plans.
Episode Timestamps03:51 – What Does "Curing Cancer" Actually Mean?
08:15 – Early Stage vs. Late Stage Cancer: The Critical Difference
12:42 – How Chemotherapy, Targeted Therapy, and Immunotherapy Work
18:35 – Prevention: Lifestyle Factors That Reduce Cancer Risk
21:50 – Why Immunotherapy Can Cause Severe Side Effects
30:48 – Cancer as a Chronic Illness, Not a Death Sentence
38:22 – Environmental and Occupational Cancer Risks
45:51 – Why Whole Body Scans Aren't the Answer

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.  

 >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.   

 Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University.

Dr. Dave Clarke returns to Ditch the Labcoat to dig deeper into something medicine still doesn't talk about enough: what happens when your body creates real, debilitating symptoms but there's nothing structurally wrong.This isn't about imaginary illness or psychosomatic complaints. This is about the brain physically changing in response to stress, trauma, and unresolved emotional burdens, and manifesting those changes as chronic pain, migraines, irritable bowel syndrome, fibromyalgia, chronic fatigue, and dozens of other conditions that standard medical tests can't explain.
Dr. Clarke walks through what neuroplastic treatment actually looks like. How he identifies patients whose symptoms stem from adverse childhood experiences, current stressors, or past traumas they've buried so deep they don't even recognize the connection. How he helps them see that their bodies are okay, their brains have just learned to create symptoms as a warning signal. And how, once that fear is removed and the real stressors are addressed, symptoms that have plagued people for years can resolve. Sometimes dramatically, sometimes over time with therapy.
The conversation challenges everything medicine teaches about the link between pathology and symptoms. Why do ten people with identical "bone-on-bone" knee arthritis x-rays experience completely different levels of pain? Why do half of people over 40 have abnormal spine MRIs but no symptoms at all? Why do patients get told their spine is "abnormal" or they have Ehlers-Danlos or chronic Lyme when the real issue is unprocessed trauma from childhood?
Dr. Clarke also addresses the system failures that keep neuroplastic treatment on the margins. Why physicians trained to think about organs and structures struggle to diagnose conditions rooted in the mind. Why patients resist the idea that their pain could be brain-generated, even when it's the only explanation that fits. And why collaborative care between medical doctors and trauma-informed mental health professionals is the most cost-effective intervention we're not using.
If you've ever wondered why so many people have unexplained symptoms, why standard treatments fail them, or what actually works when medicine runs out of answers, this episode will reframe how you see chronic illness.
Dr. Dave Clarke's Website:  https://www.symptomatic.me/

Episode Takeaways1. Neuroplastic conditions are not imaginary. The brain has physically changed in response to stress or trauma, creating real symptoms in the body.
2. Over 40% of people who present to primary care have medically unexplained symptoms, and at least a quarter to a third of adults experience neuroplastic conditions.
3. More than half of people over age 40 have abnormal spine MRIs with zero symptoms, proving that structural abnormalities don't always correlate with pain.
4. Pain reprocessing therapy starts with reassurance: your body is okay, you don't need to fear lifelong disability, and shifting attention from body to mind begins reducing symptoms.
5. Adverse childhood experiences (ACEs) are often subtle. Not just physical or sexual abuse, but emotional neglect, perfectionism, or growing up in chaotic households create lasting neuroplastic effects.
6. The key to uncovering hidden trauma: ask patients to imagine their own child growing up exactly as they did. This reframe helps them see experiences they minimized as actually harmful.
7. Collaborative care between medical doctors and trauma-informed mental health professionals produces the best outcomes and is highly cost-effective, reducing ER visits and healthcare utilization.
8. Resources are now widely available: apps (Curable, Nirvana, Digestible, FreeMe), self-help books, the Association for the Treatment of Neuroplastic Symptoms (symptomatic.me), and trained providers worldwide.
Episode Timestamps03:45 – What Neuroplastic Treatment Actually Looks Like
07:09 – The Stress Evaluation: Finding the Link Between Trauma and Symptoms
13:35 – How to Get Patients to Believe Their Brain Creates Physical Pain
18:55 – Placebo, Nocebo, and Why Pain is Always Generated by the Brain
24:46 – Conditions That Benefit from Neuroplastic Treatment
29:35 – Why the System Still Doesn't Believe This
36:53 – How to Uncover Hidden Childhood Trauma
46:45 – Resources for People Who Can't Access Specialized Care

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.  

 >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.   

 Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University.

Alfredo Borodowski has lived through public failure, bipolar disorder, and the work of rebuilding identity from the ground up. Now he helps leaders navigate disruption without losing their humanity.
In this episode of Ditch the Labcoat, Dr. Mark Bonta sits down with Alfredo to explore what happens to meaning when systems accelerate. They discuss why productivity metrics fail to capture human performance, what AI accelerates and what it erodes, and how leaders can maintain purpose and resilience when certainty disappears.
Alfredo's formula is simple but powerful: Positivity + Purpose = Peak Performance. But the conversation goes deeper than frameworks. It asks hard questions about what humans need to preserve as work becomes more automated, why resilience isn't grit or endurance theater, and where positive psychology helps versus where it breaks.
This isn't a how-to episode. It's a thinking episode for leaders, clinicians, and anyone navigating a world where the system is outpacing the human.
 Dr. Borodowski : https://www.linkedin.com/in/alfredo-borodowski/

Episode Takeaways
1. Positive psychology focuses on nurturing what's already working, not fixing what's broken—a fundamental shift from traditional problem-solving approaches.
2. The formula Positivity + Purpose = Peak Performance isn't about motivation—it's about maintaining agency and meaning when systems accelerate beyond human capacity.
3. AI accelerates efficiency but can erode meaning, dignity, and the human experience of work if leaders don't actively preserve it.
4. Resilience isn't grit or pushing through—it's about internal stability, purpose, and psychological adaptability in permanent uncertainty.
5. Leadership in the AI era requires shifting from predicting the future to guiding people through disorienting change.
6. Burnout happens when purpose disconnects from work—not from working too hard or lacking work-life balance.
7. Productivity metrics capture output but miss what actually drives human performance: meaning, connection, and psychological safety.
8. Positive psychology helps when it addresses real tension and limits—it breaks when it becomes toxic positivity or denial of difficulty.

Episode Timestamps
05:54 – What Is Positive Psychology? (Nurturing What Works, Not Fixing What's Broken)
09:06 – The Positivity + Purpose = Peak Performance Formula
11:21 – Why Most Leadership Fails in Times of Uncertainty
14:02 – How AI Changes What Humans Need to Focus On
18:11 – The Difference Between Efficiency and Meaning
22:50 – Why Burnout Is Misunderstood by Leaders
28:03 – Resilience Is Not Grit or Endurance Theater
32:03 – What Positive Psychology Gets Wrong
35:32 – Leadership When Certainty Is Gone

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.  

 >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.   

 Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University.

Joshua Resnikoff was a bench scientist at Harvard's Wyss Institute, surrounded by cutting-edge science. He believed healthcare could solve anything. Then his son started having unexplained recurring fevers. Monthly ER visits. Ice baths to prevent seizures. Years of diagnostic uncertainty. Finally, a diagnosis: PFAPA, a hyper-inflammatory condition so rare only 500 kids in the US have it. The doctor's response? "There's nothing we can do. It's not terminal, so don't worry about it."

That was his red pill moment.
On this episode of Ditch the Labcoat, Dr. Mark Bonta sits down with Joshua, founder and CEO of Sunstone Health, to explore what happens when families get trapped in the diagnostic odyssey. Joshua built a platform that compresses a seven-year diagnostic journey into 12 weeks by using AI to find hidden rare disease patients buried in insurance claims data.
Dr. Bonta and Joshua tackle the hard questions: What happens when doctors don't know what's wrong? Why does the healthcare system fail zebra patients while teaching doctors to only look for horses? And what role does physician attitude play in solving diagnostic mysteries?
If you've ever felt dismissed by the healthcare system or wondered whether AI can actually help real patients, this conversation will challenge everything you thought you knew about precision medicine and patient advocacy.
Joshua Resnikoff's Website : https://www.sunstonehealth.com/
Episode Takeaways

1. The diagnostic odyssey for rare diseases averages 7 years—Sunstone compresses it to 12 weeks using AI and insurance claims data.
2. "There's nothing we can do" isn't medical reality—it's often a failure of attitude, not knowledge or skills.
3. Rare disease families are desperate for answers, making them vulnerable to predatory experimental treatments and unproven therapies.
4. Health plans, not patients, are Sunstone's customers—financial incentives align when undiagnosed kids cost insurers millions in repeated ER visits.
5. Doctors are taught "when you hear hoofbeats, think horses not zebras"—but 2% of hospital patients are zebras with no diagnosis after 24 hours.
6. Genetic testing isn't just about diagnosis—it's about getting specialty guidance back to local doctors so families don't travel hours for care.
7. Patient data ownership matters—families should control their genetic reports and medical records, not insurance companies.
8. Expanding from genetic epilepsy into autism, familial hypercholesterolemia, and other rare diseases—the goal is to be infrastructure for all non-oncology genetic disease.
Episode Timestamps
04:11 – The Red Pill Moment: "There's Nothing We Can Do"
07:07 – Building Community: From Desperation to Action
11:42 – How Sunstone Works: Finding Hidden Patients in Claims Data
19:22 – Seven Years to 12 Weeks: Compressing the Diagnostic Odyssey
25:17 – Zebras vs. Horses: When Rare Disease Becomes Your Reality
33:46 – The Attitude Problem: Why Doctors Give Up on Diagnostic Mysteries
37:48 – Medical Desperation: Experimental Treatments and Predatory Care
45:38 – The Future: Expanding Beyond Epilepsy into Autism and Beyond

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.  

 >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.   

 Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University.