Speaker 1: No, actually, you sound, uh, you sound quite good here.

Speaker 2: Oh, okay. Because I have this nice fancy microphone, but it only works to the computer.

Speaker 1: But, okay.

Speaker 2: Good. Let's do it.

Speaker 1: And one of these days, I will, uh, actually, I've tried Skype in the past, but I've never pursued it aggressively.

Speaker 2: Well, you can buy these nice microphones to go on the computer, but no, they don't work for the phone.

Speaker 1: There are some wonderful USB mics out there that are just remarkable. Good morning. How are you?

Speaker 2: It's nice to hear your cheerful voice. I'm good.

Speaker 1: Yeah. Good talking to you. It's been a long time since I've asked you to pronounce your name twice. Would you please do that for me?

Speaker 2: Ofri. Ofri.

Speaker 1: Like Ofri in The Brave. Ofri in The Brave. All right.

Speaker 2: Or like my patients say, like Oprah Winfrey.

Speaker 1: Our next president, right?

Speaker 2: Mm-hmm.

Speaker 1: Could be. It's, um, it's entirely possible. Okey-doke. All right. Moving right along. Anyhow, congratulations on your latest book, is that correct? Mm-hmm. Which is What Patients Say. What Patients Say, by Dr. Sierra. Mm-hmm. And why did you write that book? Why did I write that book? Are we recording? Yes, we are.

Speaker 2: So I wrote this book because I, um, I was intrigued by the different perspectives of doctors and patients.

Speaker 1: I'm going to, I'm going to interrupt you again. Will you, when you answer the question, will you please repeat the question? Sure. I wrote the book, What Patients Say, Why Doctors Hear, so it's a stand-alone statement. Tell me, doctor, why did you write this book?

Speaker 2: I wrote the book, What Patients Say, Why Doctors Hear, after I had the experience of interviewing a doctor and then a patient separately about the same experience and they gave me two completely different stories. And it's almost like they were in two different movies all together. And it wasn't as though one was right or one was wrong. They both were intelligent and thoughtful, but they saw it so differently. And so that got me the idea to write a book called, kind of, What Patients Say, Why Doctors Hear, and vice versa.

Speaker 1: Isn't that similar to one of the health literacy techniques that doctors use called the teach-back method, where they ask a patient to explain in their own words what I, as a physician, just told you?

Speaker 2: Yeah, and the teach-back method of having the patient, you know, repeat back what you've explained to them is very helpful because you can see that often you have a very different perspective. And especially when it comes to, you know, a major illness and, you know, long-term medical care, really doctors and patients see things quite differently. So my goal had been to interview many doctor-patient pairs and then I would bring them together and solve all the problems, but it turned out to be harder than I thought. I was able to find a few, but usually when the communication goes well, there's not a lot to write about, but when it doesn't go well, then one person doesn't want to talk. So I also ended up, for the book, then interviewing researchers in the field of communication to understand why it is we have so much trouble getting our message across in medicine.

Speaker 1: What will readers take away from your book? What do you hope to infuse them with?

Speaker 2: The main message of my book is that the doctor-patient conversation is the single most important tool in medicine. You know, we often think about a bedside manner, it's nice if you can get it, you know, kind of, you know, some affable doctors with bow ties have it, but, you know, but someone can be a great doctor, but a lousy bedside manner. And I feel that's, you know, impossible, that in order to be a good doctor, you must have good communication skills, and that as a patient, to recognize that the doctor-patient interaction, the conversation, is the most important part of the visit, more than the blood test, even more than the physical exam, and to give it its due, and recognize that that's how most doctors will make their diagnosis and impart the medical care.

Speaker 1: How do we create a desire, an intent, and frankly, a mandate on the part of physicians to practice medicine this way, by asking the questions, and then listening?

Speaker 2: Well, you can't, you can't quite mandate how physicians will interact, but I think if you can demonstrate to them how much more efficient you become when you, in fact, let the patient talk and don't interrupt, or take the time away from the computer, I think doctors will quickly see that it is a much more efficient way to practice, and you're much less prone to medical error, and I would say more likely to avoid getting sued, although the data to back that up isn't quite as strong, but certainly suggestive, if you take the time to listen and to put your emphasis and effort in communication.

Speaker 1: I just heard 10,000 of our listeners saying in the background, listen to me doctor, what a novel thought.

Speaker 2: I know, and the thing is, it's so simple, it's nothing fancy, and you know, compared to all the other things we do to patients, and MRIs, and CAT scans, and procedures, and medications with side effects, this is pretty cheap, doesn't hurt, doesn't make you nauseous or constipated, and it is quite effective, so in terms of paying for your buck, and the least amount of side effects, doctor-patient communication is the number one thing in medicine.

Speaker 1: Well, we're going to continue on to talk about In Search of a Beloved Teacher, but while I'm thinking about it, I'm going to say, Dr. Ofri, thank you so much for joining us today on Life, Love, and Health.

Speaker 2: Thanks for having me.

Speaker 1: I'll try that once more. Dr. Ofri, thank you so much for joining us today on Life, Love, and Health.

Speaker 2: Thank you, and it's great to be here again.

Speaker 1: Got to get my homework out of the way early. You wrote a wonderful article in The Lancet entitled In Search of a Beloved Teacher. Would you please read the opening paragraph from that article, which will really get us into this discussion of how you became a writer, and perhaps even a physician.

Speaker 2: Written and Illustrated By. These words were written on a blackboard in September 1971 in crisp, authoritative chalk. We first graders at Colton Elementary School sat in awe as a young, energetic teacher took the stage in our lives. Ms. Zive, and she was the first person we knew to use that term, Ms., she beguiled us with a dazzling smile, a secret store of bugle corn snacks, plus a tantalizing promise to let us in on the magic that adults possessed, reading.

Speaker 1: In your article to describe reading and writing, you used the word magic about a half dozen times. She infused in you not only a love for the word, but also a real passion for the process. How would you explain that?

Speaker 2: Well, you know, I think of it as practical magic, because for a child, the conversion of those squiggles on the page into stories and books, it does seem like magic. It seems like alchemy. And the other way of having a story in your head, of getting it onto a paper, the other way of having a story in your head and getting it onto the page, that's also magic. And crossing that divide, it seems incredible. And you know, as adults, we don't think much about it now, it's so obvious, but as a child, it truly is a magical process. And I think being a first grade teacher or a kindergarten teacher is really a special spot to be, to watch children gain that amazing power.

Speaker 1: You wax poetic in the article about keeping a journal. When did you start keeping a journal as a physician or perhaps as a medical student that essentially led you to become an author?

Speaker 2: Well, I confess that I didn't exactly keep a journal in the true sense of the word. As a kid, in my first grade class, in my elementary class, I loved writing books and stories. But when I became a medical student and resident, I remember thinking, I should be writing these experiences down. They were so intense, so intimate, so singular. But there wasn't, I think there wasn't space, both time-wise there wasn't space, but emotionally there wasn't space. And while I did write them all down in the medical chart, I knew their spleen size and their platelet counts, but it's not quite the same thing. But they stayed in me until I finally had a chance to take a break from medicine. And then all the stories just came pouring out. But I wanted to, I guess I kept a mental journal. I couldn't quite get myself to get it on the page until I could step away from medicine.

Speaker 1: Fifteen years ago, you say, when you published your first book, Singular Intimacies, Becoming a Doctor at Bellevue, about the journey through medical school and residency, you thought of Ms. Zive. Did I pronounce that correctly?

Speaker 2: Yes, you did. And the precious gift of, go on. Yeah, as soon as I published the book, I wanted to find Ms. Zive because I felt like, in some ways, this book was her book, too, because I couldn't have written it without her. And I wanted to find her. But, you know, teachers, how do you find a teacher that didn't even have first names back then, remember?

Speaker 1: Well, actually, you apparently remembered her married name, which was Steinberg, and you look for her in California, where you see her often. Interestingly enough, you remembered that Ms. Zive had named her daughter Danielle, apparently, after you. So you put two and two together. Well, in this case, you put together Danielle Steinberg and found her on Facebook. What was that process like?

Speaker 2: Well, I'll say first, I tried to search Danielle Steinberg, California, over the years. And it was just too common a name in California. It's too big a state. But then, one day, I looked on Facebook, and I got a singular result from my search. I thought, OK, I'll set up a quick note. Benny Chance is your mother's maiden name. Zive, did you teach first grade at Colton Elementary School? And she shot back a response in under a minute and said, oh, so you're the person I'm named after.

Speaker 1: And so I found her, and all of a sudden, I was murdered. I would have loved that when I read it. I'm sorry. Why don't you go? I interrupted you. So you wrote a note, Benny Chance is your mother's maiden name, Zive. And did she ever teach first grade at Colton Elementary School? And what happened?

Speaker 2: And she shot back a response within a minute, saying, so you're the person I'm named after.

Speaker 1: How did that make you feel?

Speaker 2: I was just, I mean, shocked and amazed. I mean, here in this big, wide world of California with 15 million people and lots of Danielles and lots of Steinbergs. And I found the one person. And the thing is, the funny thing is that Ms. Zive never moved to California. I had made that up in my head. I don't know how I got that piece of information. Maybe it was fake news, or I somehow put it together. So my information was wrong. But it turns out that her daughter moved to California after college. And so that bit of misinformation became serendipitous, and I did, in fact, find her.

Speaker 1: How did you all finally get together and where?

Speaker 2: So Ms. Zive had moved to Michigan. After finishing our year, she moved to Michigan and never left. And she was still living there, not a person who used the internet. But because the daughter lived in California, she visited periodically. And the daughter now had children. And one day, I was giving a lecture at a medical school near Los Angeles. And the mother was coming to visit. So I invited the daughter and her mother to come to my medical grand rounds. And if you've ever been to one of these medical grand rounds, the speaker gets up in front of the audience of 200 and 300 people and gives their disclosures. They say, you know, I have a grant from this pharmaceutical company. I consult here and all these disclosures. So I gave my disclosure.

Speaker 1: And what was that like?

Speaker 2: 40 years ago, somebody wrote, written and illustrated by on the blackboard. And that person taught me how to read. And I had her stand up in the audience. And I said to the group, you know, look at all of us with our white coats and our degrees and our grants. We owe it all to our first grade teachers. You know, if they didn't teach us how to read, we wouldn't be there. And so I got to give her a round of applause. And I got to give her my books. And it was such a meaningful moment to reconnect with her.

Speaker 1: In the words of In Search of a Beloved Teacher, will you please read to us the moment of handing your book? Will you please read to us that moment of handing your book to her?

Speaker 2: When I finally placed copies of books in Ms. Ziv's hands, there were tears in both of our eyes. It had taken but I was finally able to say thank you to the person who planted me onto the path.

Speaker 1: I'm going to have to interrupt you. There's there's some interference in the line. It's as if someone is pushing keys in the background. Tell me in your own words, well, the words you wrote in the article In Search of a Beloved Teacher, what that moment was like when you not only got together with Ms. Ziv, but you gave her copies of your books.

Speaker 2: When I finally placed copies of my books in Ms. Ziv's hands, there were tears in both of our eyes. It had taken far too long, but I was finally able to say thank you to the person who planted me onto the path to becoming a writer as well as a physician. These books were in some way her books too.

Speaker 1: Would you please repeat that once more? Because there was another blip on there.

Speaker 2: Okay, and did you want me to read the paragraph that follows also?

Speaker 1: Sure.

Speaker 2: Okay, you can always cut it out. When I finally placed copies of my books in Ms. Ziv's hands, there were tears in both of our eyes. It had taken far too long, but I was finally able to say thank you to the person who planted me onto the path to becoming a writer as well as a physician. These books were in some way her books too. Hundreds of students passed through Ms. Ziv's class during her years at Colton Elementary School. All of us walked out the door armed with the ability to read and to write. I multiply this times the tens of thousands of Ms. Ziv's and their millions upon millions of first graders. We've scattered in terms of geography and career. We staff the hospitals of the world, populate the boardrooms, propel the levers of government, animate the legal system, run the engine of the global economy. But together, we form a sprawling, motley book. Written and illustrated, it should be said, by our teachers.

Speaker 1: What a great gift. And you have certainly returned the gift to not only all of us as readers, but to the hundreds, perhaps even thousands of patients you've met too. Your ability to write and to listen. You have become an advocate for the word. Or is that a little gushy?

Speaker 2: Hey, you know, if you want to ****, I wouldn't say no.

Speaker 1: It is a little gushy.

Speaker 2: That's okay.

Speaker 1: Let me go through some notes here. You're very good. You're very, very good at this. Do you see writing as a sense of release or closure? Or is it just such an indelible part of who you are as a practicing physician that the two go hand in hand, the pen and the scalpel, as it were?

Speaker 2: I actually tend not to think about writing as a method of closure or release. That sometimes is a byproduct of that. But the writing is more an exploration. And so often in medicine, there isn't time to process the depth of what's happening. You know, things happen so fast in real time with really no time for reflection. And writing is the chance to slow down the tape, to take it slowly, to rewind as much as you want, replay as much as you want, rethink it, set the frame in a different spot, and just sort through and figure out where will this intense experience, where will it come to rest in my soul? And it may also offer closure in doing that. It may not. But it's a chance to give the experience its due. And I agree with you that it does go a bit hand in hand with being a physician because what we do is stories. Patients tell us a story. We write a note, a snippet of the patient's life. It's a chapter in their life. And so it's, I think, not an accident that medicine tends to produce many writers. And we're attracted to the stories because that's what our patients bring to us.

Speaker 1: And you have brought those stories to us, Dr. Daniel O'Frey. Thank you so much for joining us today on Life, Love, and Health.

Speaker 2: Thank you, Chris. Anytime.

Speaker 1: You're really good at this. It's been so long since we've gotten together.

Speaker 2: I know. Well.

Speaker 1: I miss you.

Speaker 2: Happy anytime.

Speaker 1: All right.

Speaker 2: Let me know when it's up and we'll send it around.

Speaker 1: I will certainly do that. Hold on just a second. Let me make sure everything's working. Okay. Well. Tell me, Dr. O'Frey, how can our listeners learn more about you and your work? Perhaps a website, the names of several of your books? This is your opportunity.

Speaker 2: Well, I keep all of my writings on my website, which is just danielleofrey.com.

Speaker 1: And how is that spelled, please?

Speaker 2: Oh, D-A-N-I-E-L-L-E-O-F-R-I.

Speaker 1: One of these days, I will teach you to do that. Tell me, Dr. O'Frey, how can our listeners learn more about you? Perhaps a website? And please spell the URL.

Speaker 2: So I keep all of my writings at my website, danielleofrey.com. D-A-N-I-E-L-L-E-O-F-R-I.com. And I have a monthly newsletter that gives people the new writings, as well as access to my books, including the most recent one, What Patients Say, What Doctors Hear, and the one before that, What Doctors Feel, How Emotions Affect the Practice of Medicine. And I also keep links to the Bellevue Literary Review, which is a literary journal that I edit here at Bellevue Hospital, in which we publish fiction and poetry about health and healing.

Speaker 1: Dr. O'Frey, it's been an absolute joy, and congratulations. And I know Ms. Zive is smiling because she's listening to the show. Hello. Dr. O'Frey, thank you so much for joining us today on Life, Love, and Health.

Speaker 2: Thank you, Chris. We'll do it again.

Speaker 1: All right, we did it. Yay for us.

Speaker 2: Yeah, excellent. Okay, anytime. Let me know. This was pretty easy.

Speaker 1: Thanks.

Speaker 2: But check out Skype. It actually works pretty well.

Speaker 1: No, I actually, I will. And since you apparently have a really terrific Skype microphone or USB mic, I'd like to try that out.

Speaker 2: Yeah, yeah. And they're pretty easy to get. All right.

Speaker 1: We'll do a test one of these days. All right, have a great day. Thanks.

Speaker 2: Thanks again. Bye-bye.