What are the risk factors and potential causes that should lead someone to ask their physician, could I be screened?

It's a great, great point here.

You don't want to screen big populations where the overall risk may be low because you'll get a lot of false positives, unnecessary testing.

But you want to screen populations at risk.

So one population, as we talked about, are smokers.

So smokers are absolutely at the highest risk.

We have standard guidelines, 20 pack years of smoking per having smoked or quit within the last 15 years.

Have you found that to be true?

As a physician, when you just see that, our bell is going off already.

Oh, yeah.

Yeah.

So you think it's a weird infection or it's cancer.

Like those are the two things you think about first, especially in a guy.

I was 49.

I'm 52 now.

And when you think about them, I'm sure when you're talking with your wife and you're trying to figure out how do we have this conversation with them? What do we share? What do we not share? How transparent or not transparent are we? Are you open to sharing some of how you've processed that?

So you, right from the unique perspective of being both a physician and a person living with illness, what did becoming a patient reveal to you that you could not fully understand as a physician?

That's a great question.

I guess first, I just want to say, and I'm definitely not unique in terms of lots of physicians here, are undergoing their own health journeys.

And many of them are probably just not as vocal and transparent as I am about it.

It's not a choice for everybody.

I use this phrase often to describe this as...

You know, I knew, but I didn't know, right? As a physician, I knew what a patient goes through, but I didn't really know until I walked in the patient's shoes, in my shoes, in this case.

What does finding sunshine look like for you on an ordinary day? Or what advice would you give to somebody wanting to cultivate an embodied life of gratitude? I

You, you wanna talk a little bit about that, Bryant? I mean, as much as you feel comfortable with.

No, no, I've, I've been very open about this and, and, um, I, I think it's early on actually I made a decision.

I'm like, I don't know how I could, at least for me personally, kind of be partially sharing.

I think that's tough for me as a, as just my personality.

It's kinda all or nothing.

So yeah, I've been very open about this and, and I think it's surprisingly helped other people.

You know, people have emailed me and said, and contacted me and saying, "Hey, you sharing, hearing your story has helped me in my own journey." Um, yeah, no, it was tough.

You give the example of her and how kind she was.

[laughs] I'm sorry?

Yes.

I'm like, "Okay.

What is that?" But it's interesting, when I introduce or I talk about Frisch, that is literally the only way I can describe her.

Once you understand what it is, it just encapsulates perfectly what she does.

You know, I think I was the one who suggested the idea.

I said, "Hey, Frisch, you should teach a class about this." Frisch was like, "God, I can do that?" You know, because Stanford is this confusing, complicated place, and I'm like, "I start lots of random classes," and this is before I started, [laughs] well before I had cancer, well before I started my lung cancer class.

Given what you've said and w- and the unique position that you have stepped up to, has it changed how you doctor?

But can you speak to what, what was different about having that turnaround in six days versus the baseline, which would be much longer?

Absolutely, it did.

I think, you know, even though my overall long-term prognosis is, number one, poor, and number two, uncertain, I would say that short-term anxiety of not having a plan is very s- very stressful, very emotional.

You know, especially at the beginning when you're being diagnosed and, you know, I went through kind of all the five stages of grief in different order rapidly several times.

And, you know, having that diagnosis enables you to get a plan.

And once you have the plan, at least in my case, and, and I know just from experience as a primary care doc, that does settle people down, and that did-- in my case, you know, it settles you down.

"Hey, I have a plan.

Mm-hmm

Do you think there's a meaning to suffering or is there a purpose to suffering?

Yeah, so this is again philosophical and spiritual question, right? To me, personally, no.

I mean, there's no kind of overlying kind of meaning or reason.

That's probably setting up too much order to the universe.

But some people do, and I don't disagree with them.

I don't have any basis to either say there's meaning or purpose or not to suffering.

I think a lot of that's really dependent on your religious background, right? So that's a very philosophical and kind of religious framework, right? I do believe, you know, I'm not a religious person.

So one question I've always had was, why is Asian health under-researched if Asians make up a dominant majority