Why is this interesting? - The Monday Media Diet with Dr. Sunita Puri

On pallative medicine, the beauty of Point Reyes, and the backstory of Bone Thugs.

Dr. Sunita Puri (SP) is the Medical Director of the Palliative Medicine Service at Keck Hospital and Norris Cancer Center of the University of Southern California, where she also serves as Chair of the Ethics Committee. Sunita is the author of That Good Night: Life and Medicine in the Eleventh Hour, a literary memoir examining her journey to the practice of palliative medicine, and her quest to help patients and families redefine what it means to live and die well in the face of serious illness. Sunita received writing residencies at the MacDowell Colony, UCross Foundation, and Mesa Refuge. The recipient of a Rhodes Scholarship, her writing has appeared in the New York Times, the Los Angeles Times, Slate, and the Journal of the American Medical Association. -Colin (CJN) 

Tell us about yourself.

I am a writer and a doctor who practices hospice and palliative medicine. I was always a writer and artist before I went to medical school. I played classical piano for years and have been writing since I was a child. I was genuinely torn about whether to become a doctor and yet I wanted to be exactly like my mother, who is an anesthesiologist. I grew up in her hospital – rounding with her, eating cafeteria brownies in the anesthesia lounge when my brother and I had a day off from school, sleeping in her on-call room while she took care of patients in the operating room.  My first book, That Good Night: Life and Medicine in the Eleventh Hour, was published by Viking in 2019. It’s a memoir weaving together stories of growing up as the daughter of deeply spiritual immigrants from India and my experiences in medical training that led me to practice what I truly think is the rebel field of palliative care. I’ve also written for the New York Times, Los Angeles Times, and Slate – mostly personal pieces that blend together medical practice and specific experiences in my life.

I also direct the program in Palliative Medicine at Keck Hospital and Norris Cancer Center at the University of Southern California. Most people don’t know what palliative medicine is, and to be honest, most doctors don’t understand it. Our specialty focuses on alleviating suffering – physical, emotional, spiritual, and existential – that people and families experience when dealing with a serious illness. People can get curative or life-extending treatments like chemotherapy, dialysis, or advanced heart failure devices, and STILL get palliative care right alongside these other treatments. On a typical day, I will be asked to help with managing severe cancer pain, shortness of breath and anxiety from heart failure, nausea and vomiting from any number of causes, and anxiety and depression related to a person’s advancing illness. I also sit with families and patients – often in the ICU, the cardiac care unit, and the surgical intensive care unit -  to help them think through what matters most to them, and what they want most for themselves when they are very sick. If I know those goals and priorities, and I can help people truly understand their medical situation and options available, I can help ensure they make treatment choices that don’t compromise what they may want – for example, being well enough to get to a wedding or graduation, or dying at home with loved ones rather than in the ICU.

It’s been especially important work amid COVID when people become deathly ill suddenly and die without their families in their hospital room. The grief, shock, anger, and pain I’ve seen this year are unparalleled. Our work in palliative care has never been more urgent or important. 

I think some of my colleagues wonder if I have my head in the clouds. But both writing and doctoring rely on similar traits: empathy, observation, relating to others, and seeking to understand and illuminate – whether it is the complexity of human nature or the complexity of worsening disease. Writing makes me a better doctor. Practicing medicine makes me a better writer.

Describe your media diet. 

I’m afraid this won’t be a very exciting answer. In the morning I read the New York Times (news, op-eds, and book review) almost every day, usually between patients at the hospital. I also check the Journal of the American Medical Association and the New England Journal of medicine for any relevant COVID updates; every week, I also read the most-read articles in both of these journals.

In the afternoon and evening, I check out the New Yorker and The Times of India and email myself articles I want to read over the weekend when I have the time. I also have to admit that I read US weekly – in residency, I used to read it alongside the Journal of the American Medical Association, and hence I dubbed US weekly “The Journal of Popular Culture.” But I have to admit that I don’t know who most of the people covered are. Too many reality stars on shows I’ve never heard of. It’s become less and less fun to read over the years.

What’s the last great book you read?

The Far Field, by Madhuri Vijay. I read it when the pandemic first began and I bought fifteen books and read them all in a row. This was the first one of the batch, and I read it in two nights during four-hour stretches. It’s about a grieving daughter’s journey from Bangalore to Kashmir to find a friend of her mother’s – a Kashmiri man who used to visit their neighborhood selling rugs and other art. It’s about life after loss, reconciling fantasy with reality, and finding your way home after a mother’s death and the loss of one’s naivete. After finishing it, I wondered for days how the main characters are doing. It’s a must-read. 

What are you reading now?

I am re-reading The Power of Now, by Eckhart Tolle. It is a logical and well-written approach to mindfulness and spirituality, and he always reminds me that watching my thoughts is the best way to find peace. Everyone should read this book. When I’m not re-reading it straight through, I am opening it before I go to sleep and reading whatever page I happen to land upon.

What’s your reading strategy when you pick up a print copy of your favorite publication?

I look at the headlines on the front cover and then I kind of haphazardly go through the magazine. I’ve never been one to start at the beginning and read a magazine all the way through. Sometimes I skip around even when I’m reading books! I can’t explain it.

Who should everyone be reading that they’re not?

Helen MacDonald. She is a gorgeous storyteller, a gifted naturalist, and a writer I seek to emulate. We need her observations on the natural world and the connection between humans and the planet now more than ever. She has a new book called Vesper Flights. The first essay begins with descriptions of her childhood curiosity about birds’ eggs; it ends with her describing her work in a lab with incubated eggs, and, quite unexpectedly, revealing that she and her twin brother were premature and incubated in the neonatal intensive care unit themselves. He dies and she lives. It only gets better from the first essay onwards.

What is the best non-famous app you love on your phone? 

I feel so lame but I only have the standard apps on my phone! Nothing that everyone doesn’t already know about!

Plane or train?

I always prefer train if that’s still an option. At least before COVID, when traveling abroad, you could be with others, swap stories, get travel tips, and see the country up close, from the best angles. I have always loved scenery passing by a train window. I’ve taken trains in India, France, Italy, and Japan, and those hours were far more memorable than anything I saw from the sky. In college, I even loved taking the Metro-North from New Haven to New York and back. Some might say there isn’t much to see on the ride, but I always appreciated what I saw. It took my mind off everything I’d been worried about. Looking out a train window is both mindful and mindless.

What is one place everyone should visit? 

Pt. Reyes, a small town about an hour north of San Francisco, is sacred to me. I spent two weeks there at the Mesa Refuge as part of a writing residency I received to work on my book. In the surrounding forests, I walked among elk, foxes, quails, trees of every imaginable shade of green and gray, and breathed in the cleanest air I have ever inhaled, always tinged with the scent of looming rain. I looked up to the sky and nearly always saw hawks circling my writing studio on the banks of the marshland separating Pt Reyes and Inverness. Two tectonic plates meet underneath this land, and all life here sprouts from a shifting and uncertain surface, but it persists and always will. I am nourished deeply by this place – the surroundings, the food, the air, and the earth. Everyone should spend at least a day there, hike out to Tomales Point and to the lighthouse, and stand outside at night and see the stars as you’ve never seen them before.

Tell us the story of a rabbit hole you fell deep into. 

I am a huge fan of Bone Thugs N Harmony, but I never knew the backstory of each member. I recently started taking boxing lessons and my instructor and I were talking about how much I love all the great rappers of the 90s – especially Bone Thugs. He made a comment about how one of the members had been kidnapped and molested as a child, and I went online and obsessively read for probably three or four hours about each of the group members’ stories. There was a time when I knew most of their songs by heart, but at the time I knew very little about any of them because this was the late 90s and I was still in high school, so my dad monitored everything I did online. But after boxing, I took a deep dive into each of their stories. All of them have pretty fascinating backstories, but Bizzy Bone really suffered terribly as a child – abducted by his father, who told him and his sisters that their mother and grandmother were dead. His mother managed to get his photo to appear at the end of America’s Most Wanted, and Bizzy’’s babysitter saw the photo and called the police. Bizzie became really open about what he went through, and I cried as I read some of the interviews where he talked about that part of his life. I can’t imagine how much courage it took to come forward like that.

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Thanks for reading,

Noah (NRB) & Colin (CJN) & Sunita (SP) 

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