January 15, 2026 • 7 mins
On this episode of Our American Stories, Theodore Schwartz, a neurosurgeon at Weill Cornell Medicine and best-selling author of Gray Matters: A Biography of Brain Surgery, shares how he approaches one of the most difficult responsibilities in medicine: delivering bad news to patients with terminal and late-stage brain cancer. Drawing on decades of experience, Dr. Schwartz explains how honesty, compassion, and clarity guide these conversations, even when there is no cure to offer. He reflects on what patients ask when time is short, how doctors prepare for moments medicine cannot fix, and why the way bad news is delivered can matter as much as the news itself.
Support the show (https://www.ouramericanstories.com/donate)
Support the show: https://www.ouramericanstories.com/donate
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
This is Lee Habib and this is Our American Stories,
the show where America is the star and the American people.
Up next, the story from a brain surgeon, one of
the best in the country, about how he breaks bad
news to patients. His name is doctor Theodore Schwartz. His
book Gray Matters, a biography of brain surgery, is an
(00:34):
amazing read. He's a real life brain surgeon at wild
Cornell Medicine in New York City, one of the busiest
and highest rank neurosurgery centers in the world. He's also
a heck of a storyteller. We did a longer version
of the whole story of brain surgery, and you can
go to our American Stories dot com and search for
(00:56):
doctor Theodore Schwartz. Here now is doctor Schwartz talking about
how he breaks bad news to patient.
Speaker 2 (01:05):
The initial office visit in facts can be surreal. At
this early stage. The patient is often minimally symptomatic. They're
obviously aware that something is growing in their brain. They
sought out medical care, after all, and they know it
needs to be removed. Maybe they've done a little research,
or they've had a family member with a brain tumor,
which may or may not have been similar. They're also
(01:25):
often scared and unsure of what lies ahead or what
it all means. Commonly, they're frequently somewhat oblivious to the
gravity of the situation. This is all new to them.
But as I listen to their questions, I see things
they are not yet capable of seeing, let alone processing.
I see the mother of three young children who will
not make it to their high school graduation.
Speaker 3 (01:45):
I see the.
Speaker 2 (01:45):
Father and sole provider for a family of teenagers with
college payments looming, who will not be walking his daughter
down the aisle. I see the hedge fund manager who
is sitting on top of the world, planning his retirement
and next lavish vacation, who will soon be closing his fond.
He's about to lose not only his long anticipated opportunity
to spend his money, but his ability to bathe and
(02:06):
feed himself. And yes, thinking of others' deaths can be debilitating.
It's even the most hardened of US surgeons giving bad news,
seeing families crumple from the oncoming train bearing down on them.
As I stare into the void imagining their future, I
want to stand up and scream at the top of
my lungs. Or collapse on the ground in a flood
of tears. I do none of this, of course. My
(02:27):
job at this moment is to fight this battle with
every fiber in my body and shepherd these victims of
nature's callous and indifferent design. I believe in revealing the
truth of my patient's prognosis at a slow and deliberate pace,
but I also never ever take away their most powerful weapon.
Speaker 3 (02:44):
Hope.
Speaker 2 (02:45):
We're not talking about false hope, as in, we're going
to beat this thing, but rather true hope, a concept
introduced by Jerome Grubman in his book The Anatomy of Hope,
How people prevail in the face of illness. True hope
sounds more like this. They're a small group of long
term survice and I'm going to do everything in my
power to give you the best chance of being one
of them. Or even your remaining days with your family
(03:06):
can be beautiful, maybe even more beautiful than all the
days that have come before. So how does a doctor
walk this tightrope between truth and hope. I usually start
the conversation with a clear presentation of the facts. I
may say that the preliminary diagnosis showed what we feared,
that the tumor is in fact malignant. I prefer to
(03:27):
use the words we and us. I also emphasize whatever
positives I can. The good news is that the surgery
went extremely well and we got out as much tumor
as could safely be removed. Although it's a tough tumor
to be the surgery puts US in the best place
going forward to attack the microscopic disease invariably left behind.
I then tell them that they will likely need radiation
and chemotherapy, the standard of care in treating glioblastomas, and
(03:50):
that we will find them the most experienced neuraloncologists to
help coordinate the next stage of this process. While our
neural oncologists at Cornell are some of the best in
the world. Patients often want second opinions, so I let
them know we will help them get their records together
to send wherever they'd like. Patients often express a fear
of telling you they want a second opinion, as if
they're cheating on their spouse or insulting a relative. You
(04:10):
never want anyone looking back as the end approaches, feeling
that they didn't do everything in their power to find
the right treatment, didn't explore all the options or left
a stone unturned.
Speaker 1 (04:21):
It's unimaginable what it must be like to share that
kind of news, the kind of job some people have.
What doctor Schwartz said bears repeating. As I stare into
the void imagining their future, I want to stand up
and scream at the top of my lungs, or collapse
on the ground in a flood of tears. I do
(04:42):
none of this, of course. My job is to fight
this battle with every fiber in my body and shepherd
these victims through nature's callous and indifferent design.
Speaker 3 (04:55):
What words, and then that hope and how to give
patients hope? And what a talent that is? And then
doctor Schwartz well, he started to talk about how he
breaks the bad news to patients. Here's doctor Schwartz.
Speaker 2 (05:12):
I've witnessed only a handful of medical miracles in my career.
Tumors that miraculously shrank without any treatment, long term survivors
of fatal diseases. What's the explanation. We just don't know.
But these cases do provide some room for hope. The
patients I've treated who are still alive five, ten, or
even fifteen years after a GBM diagnosis are a rare
(05:32):
reminder that my degree and years of experience go only
so far. What makes these long term survivors so special?
What do they do to beat the odds? Another frequent
question my malignant tumor patients ask is why me? Was
it anything I did? It's human nature to attempt to
find cause for suffering, to create order out of chaos,
to shake our fist at the randomness of fate. Often
(05:52):
my patients will place blame on environmental exposures, such as
smoking power lines or toxic chemicals released by a local factory.
They also worry that their brain tomor might have been
inherited or will be passed to future generations. Both fears
are somewhat legitimate. Most brain cancers are triggered by some
random and little understood series of events that either alters
their DNA within the nucleus of brain cells or misaligns
(06:13):
the careful balance of proteins that promote and suppress cell growth.
I therefore try to emphasize to my patients that they
did nothing to bring this upon themselves. There is no
one to blame or resent, and there's no reason to
feel guilty that their children might be at a higher
risk of the same fate. As scientifically unsatisfying as the
answer may be, the cause for most brain tumors is
just plain old bad luck.
Speaker 1 (06:34):
And you've been listening to doctor Theodore Schwartz. He's the
author of Gray Matters, a biography of brain surgery. He's
a neurological surgeon at while Cornell Medicine in New York City,
one of the busiest and highest ranked neurosurgery centers in
the world. Schwartz has removed nearly ten thousand brain tumors.
And that question, that recurring question he gets from patients
(06:57):
is why me? Was it anything I did? He described
how it was human nature to attempt to find causes
for suffering and to create order out of chaos, but
in the end he always just settled them in with
the idea that there was no one to blame, no
one to resent. It was just a case of plain
old bad luck. The story of our brain surgeon breaks
(07:20):
the bad news to his patients. Hear on our American Stories,
Lee h Habib here, and I'm inviting you to help
our American Stories celebrate this country's two hundred and fiftieth
birthday coming soon. If you want to help inspire countless
others to love America like we do and want to
(07:41):
help us bring the inspiring and important stories told here
about a good.
Speaker 3 (07:45):
And beautiful country.
Speaker 1 (07:46):
Please consider making a tax deductible donation to Our American Stories.
Go to Ouramericanstories dot com and click the donate button.
Any amount helps, go to Ouramerican Stories dot com and
give
This is Lee Habib and this is Our American Stories,
the show where America is the star and the American people.
Up next, the story from a brain surgeon, one of
the best in the country, about how he breaks bad
news to patients. His name is doctor Theodore Schwartz. His
book Gray Matters, a biography of brain surgery, is an
(00:34):
amazing read. He's a real life brain surgeon at wild
Cornell Medicine in New York City, one of the busiest
and highest rank neurosurgery centers in the world. He's also
a heck of a storyteller. We did a longer version
of the whole story of brain surgery, and you can
go to our American Stories dot com and search for
(00:56):
doctor Theodore Schwartz. Here now is doctor Schwartz talking about
how he breaks bad news to patient.
Speaker 2 (01:05):
The initial office visit in facts can be surreal. At
this early stage. The patient is often minimally symptomatic. They're
obviously aware that something is growing in their brain. They
sought out medical care, after all, and they know it
needs to be removed. Maybe they've done a little research,
or they've had a family member with a brain tumor,
which may or may not have been similar. They're also
(01:25):
often scared and unsure of what lies ahead or what
it all means. Commonly, they're frequently somewhat oblivious to the
gravity of the situation. This is all new to them.
But as I listen to their questions, I see things
they are not yet capable of seeing, let alone processing.
I see the mother of three young children who will
not make it to their high school graduation.
Speaker 3 (01:45):
I see the.
Speaker 2 (01:45):
Father and sole provider for a family of teenagers with
college payments looming, who will not be walking his daughter
down the aisle. I see the hedge fund manager who
is sitting on top of the world, planning his retirement
and next lavish vacation, who will soon be closing his fond.
He's about to lose not only his long anticipated opportunity
to spend his money, but his ability to bathe and
(02:06):
feed himself. And yes, thinking of others' deaths can be debilitating.
It's even the most hardened of US surgeons giving bad news,
seeing families crumple from the oncoming train bearing down on them.
As I stare into the void imagining their future, I
want to stand up and scream at the top of
my lungs. Or collapse on the ground in a flood
of tears. I do none of this, of course. My
(02:27):
job at this moment is to fight this battle with
every fiber in my body and shepherd these victims of
nature's callous and indifferent design. I believe in revealing the
truth of my patient's prognosis at a slow and deliberate pace,
but I also never ever take away their most powerful weapon.
Speaker 3 (02:44):
Hope.
Speaker 2 (02:45):
We're not talking about false hope, as in, we're going
to beat this thing, but rather true hope, a concept
introduced by Jerome Grubman in his book The Anatomy of Hope,
How people prevail in the face of illness. True hope
sounds more like this. They're a small group of long
term survice and I'm going to do everything in my
power to give you the best chance of being one
of them. Or even your remaining days with your family
(03:06):
can be beautiful, maybe even more beautiful than all the
days that have come before. So how does a doctor
walk this tightrope between truth and hope. I usually start
the conversation with a clear presentation of the facts. I
may say that the preliminary diagnosis showed what we feared,
that the tumor is in fact malignant. I prefer to
(03:27):
use the words we and us. I also emphasize whatever
positives I can. The good news is that the surgery
went extremely well and we got out as much tumor
as could safely be removed. Although it's a tough tumor
to be the surgery puts US in the best place
going forward to attack the microscopic disease invariably left behind.
I then tell them that they will likely need radiation
and chemotherapy, the standard of care in treating glioblastomas, and
(03:50):
that we will find them the most experienced neuraloncologists to
help coordinate the next stage of this process. While our
neural oncologists at Cornell are some of the best in
the world. Patients often want second opinions, so I let
them know we will help them get their records together
to send wherever they'd like. Patients often express a fear
of telling you they want a second opinion, as if
they're cheating on their spouse or insulting a relative. You
(04:10):
never want anyone looking back as the end approaches, feeling
that they didn't do everything in their power to find
the right treatment, didn't explore all the options or left
a stone unturned.
Speaker 1 (04:21):
It's unimaginable what it must be like to share that
kind of news, the kind of job some people have.
What doctor Schwartz said bears repeating. As I stare into
the void imagining their future, I want to stand up
and scream at the top of my lungs, or collapse
on the ground in a flood of tears. I do
(04:42):
none of this, of course. My job is to fight
this battle with every fiber in my body and shepherd
these victims through nature's callous and indifferent design.
Speaker 3 (04:55):
What words, and then that hope and how to give
patients hope? And what a talent that is? And then
doctor Schwartz well, he started to talk about how he
breaks the bad news to patients. Here's doctor Schwartz.
Speaker 2 (05:12):
I've witnessed only a handful of medical miracles in my career.
Tumors that miraculously shrank without any treatment, long term survivors
of fatal diseases. What's the explanation. We just don't know.
But these cases do provide some room for hope. The
patients I've treated who are still alive five, ten, or
even fifteen years after a GBM diagnosis are a rare
(05:32):
reminder that my degree and years of experience go only
so far. What makes these long term survivors so special?
What do they do to beat the odds? Another frequent
question my malignant tumor patients ask is why me? Was
it anything I did? It's human nature to attempt to
find cause for suffering, to create order out of chaos,
to shake our fist at the randomness of fate. Often
(05:52):
my patients will place blame on environmental exposures, such as
smoking power lines or toxic chemicals released by a local factory.
They also worry that their brain tomor might have been
inherited or will be passed to future generations. Both fears
are somewhat legitimate. Most brain cancers are triggered by some
random and little understood series of events that either alters
their DNA within the nucleus of brain cells or misaligns
(06:13):
the careful balance of proteins that promote and suppress cell growth.
I therefore try to emphasize to my patients that they
did nothing to bring this upon themselves. There is no
one to blame or resent, and there's no reason to
feel guilty that their children might be at a higher
risk of the same fate. As scientifically unsatisfying as the
answer may be, the cause for most brain tumors is
just plain old bad luck.
Speaker 1 (06:34):
And you've been listening to doctor Theodore Schwartz. He's the
author of Gray Matters, a biography of brain surgery. He's
a neurological surgeon at while Cornell Medicine in New York City,
one of the busiest and highest ranked neurosurgery centers in
the world. Schwartz has removed nearly ten thousand brain tumors.
And that question, that recurring question he gets from patients
(06:57):
is why me? Was it anything I did? He described
how it was human nature to attempt to find causes
for suffering and to create order out of chaos, but
in the end he always just settled them in with
the idea that there was no one to blame, no
one to resent. It was just a case of plain
old bad luck. The story of our brain surgeon breaks
(07:20):
the bad news to his patients. Hear on our American Stories,
Lee h Habib here, and I'm inviting you to help
our American Stories celebrate this country's two hundred and fiftieth
birthday coming soon. If you want to help inspire countless
others to love America like we do and want to
(07:41):
help us bring the inspiring and important stories told here
about a good.
Speaker 3 (07:45):
And beautiful country.
Speaker 1 (07:46):
Please consider making a tax deductible donation to Our American Stories.
Go to Ouramericanstories dot com and click the donate button.
Any amount helps, go to Ouramerican Stories dot com and
give
Host
Lee Habeeb
Popular Podcasts
Two Guys, Five Rings: Matt, Bowen & The Olympics
Two Guys (Bowen Yang and Matt Rogers). Five Rings (you know, from the Olympics logo). One essential podcast for the 2026 Milan-Cortina Winter Olympics. Bowen Yang (SNL, Wicked) and Matt Rogers (Palm Royale, No Good Deed) of Las Culturistas are back for a second season of Two Guys, Five Rings, a collaboration with NBC Sports and iHeartRadio. In this 15-episode event, Bowen and Matt discuss the top storylines, obsess over Italian culture, and find out what really goes on in the Olympic Village.
iHeartOlympics: The Latest
Listen to the latest news from the 2026 Winter Olympics.
Milan Cortina Winter Olympics
The 2026 Winter Olympics in Milan Cortina are here and have everyone talking. iHeartPodcasts is buzzing with content in honor of the XXV Winter Olympics We’re bringing you episodes from a variety of iHeartPodcast shows to help you keep up with the action. Follow Milan Cortina Winter Olympics so you don’t miss any coverage of the 2026 Winter Olympics, and if you like what you hear, be sure to follow each Podcast in the feed for more great content from iHeartPodcasts.