November 18, 2025 • 49 mins
In an anatomy and physiology class, you may learn how the different heart valves work to circulate your blood, how the structure of your kidney helps to maintain electrolyte levels, and how the expansion and contraction of your lungs sets off a carefully orchestrated cascade of gas exchange and transport. The human body is an endlessly fascinating machine. But when you spend so much time learning about the body, you can lose sight of the fact that it isn’t a machine. It is the story of your life. In this book club installment, I am joined by surgeon and award-winning writer Gabriel Weston to discuss her latest book Alive: Our Bodies and the Richness and Brevity of Existence. In this compelling blend of memoir, science, and meditation, Weston examines different body parts chapter by chapter - what they have meant to her or her loved ones, their significance in history, and how their meanings are shaped by our scientific understanding. Weston inspires readers to take a moment to reflect on what it’s like to live in your body, feel your heart beat, your lungs expand. Doing so can help us connect with ourselves and others. Tune in for a delightful conversation!
Support this podcast by shopping our latest sponsor deals and promotions at this link: https://bit.ly/3WwtIAu
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 (00:44):
Hi, I'm Aaron Welsh and this is this Podcast Will
Kill You. Welcome to another episode in the tp w
k Y book Club series, where I get to interview
authors of popular science and medicine books about their latest work.
We have covered some fascinating topics so far this season,
from the history of the pelvic exam to the origin
(01:05):
of language, the world of regenerative medicine, and how everything
truly is tuberculosis. If you'd like to see the full
list of books we've covered in this season and past seasons,
head over to our website This Podcast Will Kill You
dot com, where you'll find a link to our bookshop
dot Org affiliate page under the extras tab. That page
(01:26):
has lots of TPWKY booklists, including one for the book Club.
I'm always updating these lists, so check in regularly to
see what's new or upcoming. As always, we love hearing
from you all, whether it's a book suggestion, episode suggestion,
first hand account, or anything else on your mind, so
please feel free to reach out through our contact us
(01:47):
form on our website. Thank you to everyone who has
sent in book suggestions. I truly appreciate it. Two last
things before we dive into the episode, and that is
to first rate, review, and subscribe if you haven't already.
It really does help us out. And second, we are
now releasing full video versions of most of our episodes.
Make sure you're subscribed to exactly Right Media's YouTube channel
(02:10):
so you never miss a new episode. Drop How does
our heart pump blood? How does our gut digest food?
How do our lungs draw in oxygen and exhale carbon dioxide?
Medical training focuses on the how and the why of
our bodies, the anatomy and physiology of all the parts
(02:32):
that keep us alive and healthy, what happens if they fail,
and how to fix it. There are diagrams and charts
and atlases that help instill specialize knowledge in medical trainees
that they can use to heal, to relieve, and to repair. Sometimes,
over the course of a career, a doctor might find
(02:52):
themselves forgetting that a kidney is not just a kidney,
it's this person's kidney. A heart in need of star
surgery is more than Tuesday's operation. It's the beating muscle
that has faithfully kept this mother, son, friend, spouse alive
for the past fifteen thirty sixty ninety years. And it's
(03:14):
not just medical professionals that may benefit from a moment
of reflection on what it means to live in our bodies.
When is the last time you thought about your skeleton,
the bones inside you, and how it supports us? When
have you last looked over your skin, examined the scars
and freckles and wrinkles, and appreciated how it protects us
(03:37):
and holds us together. In Alive, our bodies and the
richness and brevity of existence, Award winning writer and surgeon,
Doctor Gabriel Weston transcends the usual boundary between doctor and
patient to instill a sense of humanity in our bodies.
Throughout each chapter, she explores a different part of the body,
(03:59):
examining not just how it works, but what it has
meant throughout history and how it has shaped the story
of her life. The liver with its incredible capacity for
regeneration and transplantation. The brain unfathomably complex and yet so vulnerable,
as doctor Weston discovers with her son, the womb that
(04:21):
nurtures and provides, and that has been used to control
women for millennia. A profound blend of memoir, science and meditation.
Alive is a beautiful, absorbing book that honors what it
means to be human with our incredible yet not infallible bodies.
I really loved chatting with doctor Weston, so we'll just
(04:44):
take a quick break here before getting into the interview.
(05:12):
Doctor Weston, thank you so much for joining me today.
Speaker 2 (05:15):
Thank you so much for having me. I'm absolutely thrilled
to be part of this podcast. Oh, thank you.
Speaker 1 (05:21):
It means the world well. In your latest fantastic book, Alive,
you take readers on this really thoughtful and captivating tour
through the human body. You weave together your personal experiences
and reflections with the history and the science of the
body parts that you explore. So tell me how did
this book take shape?
Speaker 2 (05:42):
I mean, I think, first and foremost, it just came
from this place of and this is why I called
it Alive, this sort of sense that as doctors and
medical students that the anatomy that I was taught at
medical school and as the basis for my surgical training
had this kind of dead call to it. So, you know,
physiology always felt like it was a kind of experimental
(06:05):
sort of specialty, and pathology, of course, had all the fantastic,
wonderful illnesses that are so exciting. But there was something
about anatomy, which I had expected that I would love,
that just seemed really kind of inanimate, and almost like
the way it was taught was inanimate as well. And
basically I got to this point sort of twenty five
(06:26):
years into my surgical experience, where I started realizing that
actually the facts of anatomy are not as inert as
we were led to believe, and also that many of
those facts don't really apply to women or people of color.
But then, I think even more than that, I had
this feeling, as a doctor who was herself getting older
(06:48):
and going through lots of life's experiences, that actually the
way that we live in our bodies is so ever
changing and so kind of like not just a progress.
You know, you have times in your life where you
feel like you're going backwards and where everything has collapsed
in on itself, And I just sort of thought it
would be really interesting to try and write a book
(07:11):
that was almost like an alternative anatomy that would allow
me to explore some of these kind of spaces that
I didn't feel I saw anything of when I was
learning myself.
Speaker 1 (07:22):
Yes, and I think that is what is one of
the things that makes this book so valuable is being
able to see the body parts and read about these
body parts, not just in the way that you are
exposed to it in a medical class or even in
a history class, but it's this bigger picture, that complete,
more beautiful picture. And each chapter kind of goes into
(07:44):
a different body part. You've got gut, lungs, kidneyed, genital's heart,
and so on many more. And I'm curious how you
decided on this organization, especially the order of the chapters.
Speaker 2 (07:55):
I mean, I was very keen that the book should
start with a post mortem, because I thought, in a way,
like the dead body, and the first chapter of the
book is called dead, that in a way is my
start points as a surgeon, as a kind of medical
student that once was, as I was saying before, this
kind of sense that the anatomy I was taught was dead.
And I thought, if I can begin the book not
(08:17):
just with a dead body, but actually with a kind
of language that feels very cold and clinical, then that
will be a kind of start point from which the
rest of the book should be almost a coming alive
of not just the body itself, but my way of
kind of integrating my understanding of the body when it
(08:38):
came to the actual like organs and which ones to
go first and stuff. I mean, in a very sort
of light way. I had all of the piles of
organs on the floor at one point, and I remember
kind of noticing that a lot of the organs have
got memories of my own body in them, and I
sort of thought, I wonder if I could just very
(08:59):
lightly arrange them in order of my age. So, for example,
you know, I think I remember a nasal fracture from
when I'm a child in bone, which is the first organ,
and then obviously womb is an organ I wanted to
put later so that I could examine childbirth, manopause, all
that kind of stuff in there. So there is some
sense in which these organs are kind of telling the
(09:21):
story of my body, but you know, it's not super visible,
so it was more like a kind of scaffolding for
my sake rather than the readers.
Speaker 1 (09:30):
Throughout your book, you share many personal stories with the readers.
You give them it's really intimate glimpse into some of
the most challenging times of your life. And I was
wondering whether that was difficult to be vulnerable in that way,
or to put so much of yourself out there.
Speaker 2 (09:46):
I mean, it's such a great question. And what I
find really difficult actually is not vulnerability, and it's not
telling the truth of my experience of the body. I
think my difficulty is I think in medical literature, I
don't mean like textbooks, but more kind of popular medical literature,
there is a lot of sentimentality that attaches to the
(10:10):
way that people write about the body. You know, it's
I mean, it's a hard thing to describe without sounding
slightly psychopathic, but I slightly feel, particularly as women, that
there's this sort of expectation that if we're writing, for example,
about childbirth or motherhood, that there should be a kind
of softness to the way that we do that, when
(10:31):
in fact, many of my experiences of certainly of motherhood
have not been soft, fuzzy, nurturing ones. They've been ones
that have been kind of full of confusion and sometimes
rage and exasperation and even regret at times. And so
I think what I wrangled with was not the sense
(10:51):
that there was anything that I didn't want the reader
to get to see about me, but that I wasn't
wanting to write in a set mental way or in
a way that I felt for me would not be true,
and so it did mean kind of departing from a
lot of the sort of medical writing that I have read,
(11:14):
particularly written by women, where I feel sometimes there's this
expectation of, you know, what these feelings ought to be
around death and birth and reproduction and love and all
this stuff. So I think always kind of as a
feminist writer, I'm very keen to have myself be an
(11:35):
example maybe of a slightly like monstrous female who doesn't
always feel all of these nurturing feelings that I think
were Still there's still such a great expectation that we
should have.
Speaker 1 (11:46):
Let's take a quick break, and when we get back,
there's still so much to discuss. Welcome back everyone. I've
(12:08):
been chatting with doctor Gabriel Weston about her book Alive
Our Bodies and the richness and brevity of existence. Let's
get back into things. I'm sure that that also filters
into not just your role as a writer, but also
your role as a surgeon and how you are expected
to be or think or feel about your patience or
about your own self.
Speaker 2 (12:30):
I think so, and I think I mean in a way.
One of the things that I find most beautiful about
the body as a writer, as a doctor, but also
just as a human walking around as a woman, is
you know, if you have a thought, it is very
likely that most other people are having that thought to you. Like,
you're going to have thoughts and you're going to think
you're the only person in the world that is having
(12:51):
those thoughts or desires, or you're going to think that
you've just thought something that is the most shocking thing
that you could even ever imagine someone thinking. It is
highly unlikely to be that shocking. And the body as well.
I feel like the way that we experience kind of
life's big changes and events through our bodies. It's like
(13:12):
if the body is kind of telling you I feel discussed,
or I feel desire, or I feel fear, or I
feel longing, it's okay. And sometimes we might have those
feelings in odd circumstances, and I like putting that on
the page, but I absolutely have I just have an
(13:32):
aversion to doctoring and writing that is about telling people
what they're experiencing in that moment. So yeah, that's a
big thing for me.
Speaker 1 (13:45):
Your background is not necessarily you didn't start out your career,
your adulthood with designs on becoming a doctor. Can you
tell me a little bit about your atypical journey.
Speaker 2 (13:56):
Yeah, yeah, So, I mean in the UK, we have
this crazy system where when you're about sixteen you have
to choose three subjects that become the only three subjects
you're going to study at school, and then usually you
choose one of them to go on and do it university.
And I gave science up when I was thirteen as
soon as I possibly could, so I had to keep
(14:16):
one science for what we call GCSE, which is a
kind of fifteen sixteen year old style exam. And then
after that science disappeared from my life. That was a
great relief to me, and I had a year out.
Then I went off to do English and philosophy. You know,
English was always the thing that I was good at,
so it seemed like the obvious choice of thing to
(14:36):
read at university. And then when I was at Uni,
I just started kind of discovering that whenever someone was
sick or someone like fell off a ladder or broken
arm or it was around the time that Er was
on TV for the first time. That's how old I
am now that It came on around that time that
I was doing my English degree, and I noticed that
(14:59):
I was much more than usually interested in all of
this stuff, and not from the point of view of
I did not have an overarching desire to help people.
That was not the impulse. The impulse was just pure,
untrammeled fascination, like kind of not okay style fascination. And
(15:22):
then completely by happenstance, one of my friends, who was
a maths student, his dad came to visit us up
in Edinburgh, and his dad was a surgeon, and this
was back in the day where you know, there were
no mobile phones or anything like that, and he had
these old school photo albums in his car filled with
photographs that he or his scrub nurse had taken when
(15:43):
he was operating. And I remember everyone else went out
clubbing and drinking. He and I stayed in alone, and
at the end of that evening he said, next time
you're in London, give me a call. You can come
to my operating theater. So I did that. I was
about twenty one, back in the day where you could
just rock up to someone's operating theater with no credentials,
(16:04):
and I just literally walked into this room and it
was like I was having some kind of religious conversion.
I mean, I was just beside myself with excitement. And
I went a couple more times after that, and then
I kind of thought, I don't really see how I'm
going to make be able to make surgery a hobby.
(16:27):
I don't think that's going to be a kind of
socially acceptable thing for me to be doing in my
spare time. So after a little kind of while of
arming and ring, I just thought, I think I'm going
to have to go and be a doctor. So I
had to go back because I had English, French and
Latin A levels and I had to basically do all
the science A levels that would get me a place
(16:48):
at medical school. And then into medical school I went.
And the crazy thing was that, apart from that early
year where I had to do all the science and
it was so difficult for me, really the rest of
it was kind of fine. It's like I loved it
and I had this amazing feeling that most of the
(17:09):
other medical students didn't have, of like a kind of
glorious sense of the glamour of being a medical student
who had come from a background where it didn't seem
like that would ever be possible. And so I never
quite lost my sense of the kind of in loveness
with the persona of this new person that I was,
(17:32):
And in a way, I think I still have that now.
It's like when I go into the operating theater now
to do you know, very small surgery with you know,
very low risk and kind of nothing to write home about.
When I put my scrubs on, I just still feel
that's very cool, you know, I've never lost that sense,
and so I think there's a lot to be said
(17:54):
for that, you know, for kind of whatever it is
that makes you keep loving it. And I really, I mean,
even despite our NHS being in the most kind of
powerless state, the actual business of being a doctor who
gets to handle people's bodies it's just a joy, isn't it.
(18:15):
It's just it's like intimacy of the most extraordinary, beautiful
kind that life has on offer.
Speaker 1 (18:23):
You write about the human body with such care and
with such lyricism. It shines through along with your endless
curiosity about the human body and about your own ability
to express your stories. And I wanted to kind of
get into a few specific parts of the body that
you covered in your book, starting with bone. So in
(18:46):
your chapter on bone, you talk about the common misconception
that bones are these static, unchanging things, when really they
are very dynamic. Can you talk about how our use
of the skeleton as the symbol of death really contradicts
the true vitality of bones.
Speaker 2 (19:03):
Yeah, I mean, skeleton's so interesting, isn't it, because it's
like lay people. You don't have to be a doctor. Like,
we all know what skeletons look like. Kids know what
they look like. They wear Halloween costumes with skeletons on
the front of them, and you can go for a
walk in the woods and like see a bird skeleton.
And most of us have touched bones, you know, whether
we're eating a chicken wing or whatever. We have a
(19:25):
very kind of established sense of what bones are. And
yet when you see bones inside a body that is alive,
they're not like that at all. So for this book,
I went to there's an amazing orthopedic hospital just outside
of London called the Royal National and I went there
and saw an amazing surgery where a guy was basically
(19:48):
removing a tumor from a woman's thigh bone and he
had to kind of take an enormous length of her
thigh out in order to take this tuma out. And
when they were sawing through the femur, it's just so
struck by the cross section of this biggest bone in
the body that it was filled with marrow, and it
was filled with blood vessels, and it had this kind
(20:11):
of live, yellowy looking periostium, and it just I looked
at it and I thought, it's just not at all
the way you would think bones are. And then of
course when you look at the physiology of bone, you
realize that bone is kind of changing itself all the time.
So the bone, you know, the bones that you have today,
you wouldn't have had ten years ago. Every year, ten
(20:33):
percent of our bones are being remodeled by a process
of you know, osteoclasts removing old bits and osteoblasts putting
in new bits. So I think even this kind of
symbol of death, when you look closely at it inside
the living body, which obviously most people don't get to do,
you just see that it's alive in a way that's
(20:55):
really counterintuitive and really beautiful.
Speaker 1 (20:58):
It's like, instead of ship of theseus, we have the
skeleton of theseus. You know, the bones that we have
now are not the bones that we started out with.
They've just been continuously remodeled throughout our entire lives. And
in your chapter on the womb, you take readers on
journeys through the inner workings of this amazing organ. You know,
(21:21):
the ways that it's been used to dismiss or harm women,
as well as your own experiences in childbirth, both you know,
as the one giving birth and as the one observing childbirth.
Did any part of this chapter feel especially meaningful or
challenging to write?
Speaker 2 (21:41):
Yeah, I mean, like you say, it's such an incredibly
sort of dynamic organ, the womb when you think it
sort of begins as something the size of a small pair,
and then if you're pregnant, you know, it occupies your
entire abdomens, so it kind of it presents itself as
something to write about, almost like the most beautiful kind
of metaphor for changeableness, and that really appealed to me.
(22:05):
And then it kind of, you know, it kind of
intersepted with really in a way. The main drive behind
this book is this kind of philosophical desire that I
have all the time with the body to somehow occupy
that space between being in a body and observing a body,
you know, like where that's the mystery, isn't It is
(22:28):
like when you're a surgeon. You're standing at the operating cable.
You have your hands inside someone's body, but your own
heart is beating, your lungs are working, your hands are
warm because of blood running through them. I'm so struck
always by that kind of like a desire to be
and know at the same time, which never feels possible.
(22:50):
It's always like a hologram that you have to kind
of flip from one side to another of And So
when I had my so my first two children, I
had vaginal the second two at the same time by
sea section because they were twins, which was also kind
of cool because I thought I get to kind of
experience all the ways that the womb can give birth
to children. And I just thought it would be really
(23:11):
interesting to get in touch with the obstetrician who delivered
my babies by sea section, which I did about six
months after they were born. I mean, I think she
probably thought I was crazy, but she was very accommodating,
and I just sort of said to her, like I
really I want to see what you did to me.
I want to kind of be on the other side
(23:32):
of the line, like having Laine on that table with
my womb open and you pulling my twins out. I
want to stand there next to you with my scrubs on,
seeing you do that to someone else. And so in
the womb chapter, I'm really exploring that kind of very
female again. I think it's a very existentially deep part
(23:54):
of being a female, this way that our bodies are
the thing that life is enacted on, but it is
also self. It's like, if we are to express agency,
it's through our bodies. And yet the second you hit
puberty as a girl, you're suddenly aware that the world
(24:15):
is objectifying you. And so I felt like the womb
was a really really exciting organ to look at some
of those things through and then just as the icing
on the cake. I also, for the BBC went to
Sweden to see a womb transplant being performed. That was
(24:35):
just kind of mind boggling in a wonderful way as well,
to see like in adjoining operating theaters, you know, a
mother's womb being carried down a corridor in a dish
to be put inside the pelvis of the daughter who
had been gestated in that womb herself. Just so cool,
you know, just like those moments again where I'm kind
(24:59):
of maybe thinking to myself, in this moment, I should
be having a sentimental reaction, but actually I'm just blown
away by how exciting it is and how kind of
existentially deep it is. And you know, so that was
really like a terrific experience as well.
Speaker 1 (25:18):
I don't have the words. It is the coolest thing.
And it is also you know, earlier you mentioned and
I wanted to circle back to this. Earlier you talked
about how it wasn't like you went into medicine because
you wanted to help people or because you had this
like altruistic this is what I was put on this
earth for. You love the huge and I feel like
that is the expectation to feel that way, to feel
(25:40):
like I went into medicine because I want to save
the world and make the world a better place, and
I feel like it is it is challenging then, or
is maybe viewed as sometimes not acceptable to say I
really just thought this was fascinating and I wanted to
do this.
Speaker 2 (25:56):
I mean, I definitely feel sometimes when I was a
jenior surgeon that I would be so excited in an operation,
I'd kind of think, I'm glad I've got a mask on,
because then they you know, they're not going to see
how excited I am. I mean, obviously there is a
limit to how much a patient wants to see that
on a person's face. But we would prefer all of us,
I think, to have our doctors really into what they do.
(26:19):
And I definitely think for writing about the body, like
there are lots and lots of places to get facts
about the body, and I think it's I still feel
that it's very political writing the truth about the experience
of being inside one. I still feel that that is something.
(26:42):
Women can keep writing truthfully about their experiences of being
inside their bodies till the cows come home, and it
will not be enough, you know, the deficit.
Speaker 1 (26:54):
Let's take a quick break here, We'll be back before
you know it. Welcome back, everyone, I'm here chatting with
the wonderful Gabriel Weston about her book Alive. Let's get
(27:18):
into some more questions. So Skin is an incredible organ.
I mean again, like they all are. I say this
about all the organs, but I really appreciated how your
chapter encouraged readers to see skin not just as the
thing that holds us together, not as a barrier to
the outside world. And you talked about some of the
things that skin can show, what it can reveal, as
(27:40):
well as what it can hide, and I was hoping
you could just elaborate a little bit more on that.
Speaker 2 (27:45):
Yeah, I just so, I think, again, like with all
of these organs, I'm always sort of after something literal.
You know, what does the skin do? What is its
function as our biggest organ? And I guess its main
function is letting sunlight in and heat out in the
most basic way, but it's kind of it is a
barrier and a protective barrier, but it's also like a
(28:06):
filter because your skin doesn't work well and if it's
completely impermeable, it wouldn't be doing the things that has
to do. But also I got, of course thinking about
skin more symbolically as the thing that marks out where
I end and the world begins, which is again kind
of going back to the more philosophical sense of like
(28:29):
what is a self? Where are we inside ourselves? And
where do we touch the outside world? And we do
that through our skin. So it was a chapter that
I felt was kind of a really interesting chapter to
examine themes of time through. So one of the things
I did in this chapter was kind of take a
(28:50):
bit of a like a spread of members of my
family from at the time my twins were like toddlers
right up to my parents in their eighties, and have
these kind of moments where I'm stopping my usual physiological
inquiry into the skin to just look at the skin
of these loved ones, you know, of my little kids
and my teenage kids, and my middle aged husband and
(29:12):
my elderly parents. And then I also had this amazing
opportunity to visit one of the immigration removal centers near
one of our airports in London. So these are kind
of like hidden places with no signposts, and basically it's
where tens of thousands of people who don't have their
asylum papers are left, often for years while those papers
(29:36):
are processed. And I managed to get access with a
GP who goes in there to kind of assess some
of these asylum seekers claims for asylum. I managed to
go in with her and had this fascinating day where
I realized that this particular young man who we were
seeing that his job and the job of the GP
(29:58):
who'd come to visit him, was to document all of
the scars on his skin, which were his evidence that
he had come from a place where he had been
traumatized and tortured. And so since really fascinating, like turning
on its head of how we usually want our skin
(30:19):
to be, particularly again women aging, we want skin to
be sort of perfect, like the perfect flawless canvas. And
yet here was this young man at pains to show
all these kind of traumatic blemishes because he knew that
if we could document enough of them, and if he
could get them to match the story that he was
(30:41):
telling us, that that might be the ticket for him
to be able to stay in the UK. So that
was the kind of way of acknowledging the complexity of
skin as a political organ without treading on ground that
didn't feel like my ground to tread on.
Speaker 1 (30:59):
It's sort of runs parallel in some ways to some
of the challenges that people face and the range of
challenges that people face when seeking healthcare in general, and
one of those being communication and being able to adequately
receive care and attention and explanations from their physician and
(31:24):
This is something that you touch on in your chapter
on the kidneys, some of the ways that doctors just
aren't always the best communicators. Why do you think communication
still poses such a challenge and there's still so much
room for improvement.
Speaker 2 (31:39):
So I think in the UK, the primary difficulty is
one of the resource of time. So in our NHS,
which is free at the point of access and kind
of on its knees now as a system which is
just totally overrun with need and insufficient resources to meet
those needs. I genuinely think that if hospitals and medical
(32:04):
schools could take whatever paltry funding they have that they're
diverting into communication skills courses and just somehow enable that
to manifest itself as a couple more minutes per consultation
for each doctor, a lot of the communication problems would disappear.
So I think, you know, if you can imagine, like
(32:24):
if you were trying to talk to your partner about
being unhappy in the relationship, or you know, talk to
one of your kids about their drug problem or whatever,
if someone said you've got ten minutes to do that,
it would be absolutely impossible. And yet that's what doctors
and nurses are expected to do with highly complex patients
(32:44):
who they've never met before. It's just totally extraordinary. So
I think time is one thing. I think the other
thing is we have such an embedded kind of distance
in the way that we're taught as doctors, the kind
of ancient ways of treating patients from on the other
(33:05):
side of a desk, from above. You know, if you've
got through medical school, you're someone who's really good at
learning facts. You're probably someone who's come from a pretty
advantage background with all the assumptions that go with that.
And I just think there's still such a distance between
doctor and patient so much of the time, and you know,
(33:27):
that's a really complex thing to fix. But I think,
certainly in my own experience, I think having become a patient,
and perhaps more importantly, the mother of a patient, I
have just really experienced now how awful it feels to
(33:48):
be in a doctor's room or in a hospital where
you're terrified, you feel like no one is listening to
the thing that you need them to know, and this
kind of awful sense that you somehow have to kind
of behave yourself in order not to irritate the people
who you need to look after you, and I think
(34:09):
a lot of those problems are probably quite British problems
and quite entrenched in the fact that our healthcare system
doesn't involve any exchange of money in the way that
it does in other places. So it's almost as if
any motivation for a doctor to be nice to a
patient that might have anything to do with patronage or
(34:33):
reputation that doesn't exist here. And so in a way,
all you're left with is these very overworked, exhausted healthcare
providers who are just going to get paid what they're
going to get paid regardless. And yeah, I just I
think the dual problem of this kind of culture of
(34:55):
superiority combined with real time deprivation is the problem of
communication between doctors and patients.
Speaker 1 (35:04):
Now, I think it's also not helped by some of
the as you kind of touched on, this entrenched way
that physicians see patients, where we've incorporated more quantitative tools
to assess a patient's condition, or you know, we have
these scans, we have blood tests, we have all of
these these ways to look at the individual parts of
(35:26):
a patient that can sometimes then make a doctor lose
sight of the person as a whole, not just as
a patient or as a patient's body part. What role
do you think that plays, and how can we maybe
strike a better balance between using these quantitative tools not
just as something that's shaping the entire narrative.
Speaker 2 (35:46):
Yeah, it's really tricky, isn't it. I mean in an
area like, for example, psychiatry versus neurology. I mean, that's
quite interesting. Those two specialties were the same specialty until
the late nineteenth century, early twentieth century, and then as
neurology became I guess a more sort of objectifiable form
(36:08):
of medicine, it kind of split off. I mean interestingly,
Freud I think, was a neurologist to begin with, and
then became a psychiatrist. And once he started, you know,
developing ideas of a kind of psychological and psychiatric self,
those two things split. And now we're in a situation
where as you say, the quantitative tools that have gone
(36:28):
so far with neurology have given people with neurological conditions
a kind of status in a way that is very,
very different from the continuing stigmatized low status of psychiatric patients.
And I think it is really interesting that, you know,
(36:49):
if you think the brain is the site where schizophrenia,
bipolar depression, you know, all that stuff is coming from there,
and the brain tumors and all the neurological stuff. And
yet I know from my own experience one of my
son had a brain tumor. You know, it was an
awful time. But you couldn't imagine a situation where people
(37:12):
would be nicer than a children's hospital with a brain tumor.
But by comparison, I have a very close family member
who's been very acutely psychiatrically well for a long time,
and I've walked through that path with that family member,
and all there is is stigma and low status. You know.
(37:35):
It's and that is because I think because there isn't
a scan that shows what the problem is in a
way that kind of makes it easy to delineate. And
also I think when we can't find it's the same
with all these conditions where there's a little controversy over
whether the condition is a so called functional condition or
(37:55):
an organic condition. There's something that kind of brings out
the kind of nasty playground thing in us that is
to do with kind of this idea of a person
faking something or like why are they saying they have
these symptoms when there's nothing to correlate them with. And
(38:16):
so I think there is that problem in psychiatry that
because it's all in someone's head, so to speak, we
can't kind of corroborate it in the ways that we
seem to need to.
Speaker 1 (38:33):
You mentioned this really terrifying medical ordeal with your son,
and you begin that chapter on the brain by asking,
you know, did I think being a doctor would protect me?
And you discuss some of your roles as mother, as surgeon,
as patient yourself. How did those roles intersect during that time.
Speaker 2 (38:55):
Yeah, I mean it's so interesting. I try very hard.
Because a friend of mine who first came to see
us in the emergency department when we first realized that
my son he'd had headaches, and then they did a
scan and they discovered he had a map quite a
large mass in his brain. So, in that awful early
stage of realizing something was wrong, a friend of mine,
(39:18):
who was an edy doctor, said to me, just be
a mother here, Like, that's my one piece of advice
to you is don't try and be a doctor, just
be a mother. And I kind of tried to do that,
but I also feel in all honesty that there were
certain moments in that journey where the fact that I
was a surgeon helped me advocate for him in a
(39:40):
way that I think actually did make a difference. I mean,
I'll never be able to say whether it was a
life or death difference, but there were definitely a couple
of junctures where I was able to say to a
system that was not acknowledging how serious something was. You
know that I'm saying as to you as a mother,
(40:02):
as a surgeon, and with this other surgeon friend of
mine who's my kind of backup plan guy. So there
was a weird braiding of mother with surgeon in that time.
And I think if the healthcare system had been perfect,
I would not have needed to be a surgeon at all.
And I certainly I was astonished by my lack of curiosity,
(40:27):
like about the actual surgery my son had and about
the particular he ended up when they finally found out
what it was, because they thought he had something called
a medulla blastoma to begin with, but he actually had
a cavanoma, which is an abnormal cluster of blood vessels
in his brain. Once we knew what it was and
that he was going to have surgery. I amazed myself
(40:49):
with how like I did no research. I didn't go
on Google, I didn't look anything up. I said to
my family and friends, I don't want anyone telling me
anything outside of what the surgeon looking after him tells me,
Like he is my source of information and that's all
I want. So I really did the opposite of what
(41:10):
I do as a writer and a doctor in other circumstances,
which is to cast my net as wide as I can,
you know. But it was a very I mean, we
were very lucky because he came out of that surgery,
he's recovered, he's fine. It's given me a lasting feeling
for any patient who is in a situation where they
(41:33):
are completely terrified. And I don't think i'd realized before
that happened to me. You're not in your right mind
when you know, I mean, never mind that you're not sleeping,
you're like you're in an altered state. And the way
that I am with patients now when they're in the
early stages of discovering something very shocking, is completely different
(41:54):
than it was before in view of that. So, you know,
I'm grateful to have learned that, and I sometimes feel
I feel a little bit ashamed of the young doctor
I was. I don't think I was harsh, but I
think I was very disconnected, almost as if by being
a doctor. I don't know, I had some kind of
(42:16):
I mean, I can't ever have actually been that stupid
is to think that that was going to protect me,
But in a weird way, I think I did think
it was protecting me.
Speaker 1 (42:24):
Throughout your book, you also discuss you interspersed correspondence with
some of your physicians and recollections about your own heart condition,
and you end the book with a chapter on the heart.
Would you mind sharing a bit about sort of the journey,
sort of how you decided to intersperse those, and then
why you decided to end with the heart.
Speaker 2 (42:43):
Yes, so all the way, as you say, all the
way in between the organs, I have these little fragments
of clinical evidence in a way from my own heart condition.
I've got mutual valve regurgitation, so one of my heart
valves doesn't work properly and it's getting worse. At some
point on need to have open heart surgery for that.
So that was all kind of happening while I was
(43:05):
writing this book, And really what I wanted to convey
by interspersing these little kind of emails from doctors or
little kind of moments of almost like clinical text is
present to the reader, this very profound textual difference between
(43:27):
what happens when we tell a story and everything is
perfect and has jeopardy and it has a kind of
narrative arc and it goes up to a crisis and
then it kind of falls away and wraps itself up,
And on the other hand, the totally unshapely, inconclusive, disorientating
(43:49):
experience of being a patient in the middle of a
clinical story whose end you cannot predict. So someone who
reviewed my book said something like they felt that these
fragments in between were kind of a bit of a
letdown because they didn't rise to a sufficient conclusion. And
I thought to myself, well, no, like that's they're not
(44:12):
meant to.
Speaker 1 (44:13):
Like.
Speaker 2 (44:13):
What I'm trying to do, in a way is almost
destabilize my own narrative by saying, Okay, I've just written
this chapter on the breast or the skin or the liver,
and when you get to the last sentence, you'll feel
a sense of satisfaction that I have closed that chapter.
But here's the reality of me being in this body
where there's just these few facts and there's all this
(44:36):
space and all these questions that are not answered, and
it doesn't go anywhere. It's like it doesn't end with
me telling you what happens, because here I am, I
don't know what's going to happen, Like my valve is
still flapping around there with blood going in the wrong direction,
and I don't know. I don't know what the end
of the story is. And that's my experience of being
(44:58):
in a body, and that's the way that I chose
to tell it. So of course, at the end, I
then thought, I need a heart chapter as well, to
talk about some of the issues around really interesting new staff,
to do with how kind of stress and emotion actually
manifests itself in the tissues of our body, or the
(45:19):
really shocking statistics around women and heart health, and how
badly served we are currently in terms of our cardiology.
So I thought, at the end of the day, I'd
better provide that chapter, because there is all this really
interesting stuff and if I just leave these fragments, it's
like too big an organ to ignore. So I guess
(45:41):
at the end it was like starting with a dead
body and hopefully ending with this kind of integrated sense
of an organ that is a pump but also the
feeling center of ourselves.
Speaker 1 (45:53):
It touches on again this theme of honesty of this
is the reality, you know, sort of this how you
said there is no narrative arc to this, to your story.
There's no narrative arc to any of our stories. If
there is one, we've constructed it artificially. And that's fine,
but that's not necessarily the reality. And I'm curious how
(46:13):
you feel this honesty is or is not being accurately
portrayed or acknowledged in science communication these days, or how
we can all do better about incorporating honesty into science communication.
Speaker 2 (46:29):
I mean, that's such a big question, isn't it. And
I guess it just really depends on sort of what
area we're talking about. I mean, I think the introduction
of AI and machine learning has been really really interesting
in this regard, because now that AI is doing such
a good job of data gathering and kind of synthesizing
data in a way that you know, we used to
(46:51):
have to do for ourselves just a few years ago.
I think the lovely thing about that is it kind
of puts more of an onus, on each of us. Actually,
when we are communicating about science, to be doing it
in a way that is not a way a machine
could do, you know, in an authentic way, in a
disruptive way, in a way that doesn't feel nice or comfortable,
(47:12):
because the machine can do that stuff. So I prefer
the messy truth, and I prefer it in I prefer
it in lectures, I prefer it in books. I prefer
it in movies, I prefer it in people. I'm not
interested in the airbrushed version, but I am not like
I don't think I'm in the main stream there. I
think most people do prefer the polished version. So I
(47:35):
don't know what we do with that.
Speaker 1 (47:37):
Well, I'm excited to see what you do next. And
doctor Western, I just want to thank you for taking
the time to chat with me today. This was so fantastic.
Speaker 2 (47:46):
Honestly, it was an absolute thrill for me.
Speaker 3 (47:48):
Aaron, thank you.
Speaker 1 (48:08):
A big thank you again to doctor Gabriel Weston for
taking the time to chat with me. If you enjoyed
today's episode and would like to learn more, check out
our website This podcast will kill You dot com, or
I'll post a link to where you can find Alive
our Bodies and the richness and brevity of existence, as
well as a link to doctor Weston's website where you
can find her other incredible work. And don't forget you
(48:31):
can check out our website for all sorts of other
cool things, including but not limited to, transcripts, quarantine and
Placeibereta recipes, show notes and references for all of our episodes,
links to merch our bookshop dot Org, affiliate account, our
Goodreads list, a first hand account, form, and music by Bloodmobile.
Speaking of which, thank you to Bloodmobile for providing the
(48:52):
music for this episode and all of our episodes. Thank
you to Leana Squalacci and Tom Bryfocal for our audio mixing,
and thanks to you listeners for listening. I hope you
liked this episode and our loving being part of the
TPWKY book Club. A special thank you, as always to
our fantastic patrons. We appreciate your support so very much. Well,
(49:15):
until next time, keep washing those hands,
Hi, I'm Aaron Welsh and this is this Podcast Will
Kill You. Welcome to another episode in the tp w
k Y book Club series, where I get to interview
authors of popular science and medicine books about their latest work.
We have covered some fascinating topics so far this season,
from the history of the pelvic exam to the origin
(01:05):
of language, the world of regenerative medicine, and how everything
truly is tuberculosis. If you'd like to see the full
list of books we've covered in this season and past seasons,
head over to our website This Podcast Will Kill You
dot com, where you'll find a link to our bookshop
dot Org affiliate page under the extras tab. That page
(01:26):
has lots of TPWKY booklists, including one for the book Club.
I'm always updating these lists, so check in regularly to
see what's new or upcoming. As always, we love hearing
from you all, whether it's a book suggestion, episode suggestion,
first hand account, or anything else on your mind, so
please feel free to reach out through our contact us
(01:47):
form on our website. Thank you to everyone who has
sent in book suggestions. I truly appreciate it. Two last
things before we dive into the episode, and that is
to first rate, review, and subscribe if you haven't already.
It really does help us out. And second, we are
now releasing full video versions of most of our episodes.
Make sure you're subscribed to exactly Right Media's YouTube channel
(02:10):
so you never miss a new episode. Drop How does
our heart pump blood? How does our gut digest food?
How do our lungs draw in oxygen and exhale carbon dioxide?
Medical training focuses on the how and the why of
our bodies, the anatomy and physiology of all the parts
(02:32):
that keep us alive and healthy, what happens if they fail,
and how to fix it. There are diagrams and charts
and atlases that help instill specialize knowledge in medical trainees
that they can use to heal, to relieve, and to repair. Sometimes,
over the course of a career, a doctor might find
(02:52):
themselves forgetting that a kidney is not just a kidney,
it's this person's kidney. A heart in need of star
surgery is more than Tuesday's operation. It's the beating muscle
that has faithfully kept this mother, son, friend, spouse alive
for the past fifteen thirty sixty ninety years. And it's
(03:14):
not just medical professionals that may benefit from a moment
of reflection on what it means to live in our bodies.
When is the last time you thought about your skeleton,
the bones inside you, and how it supports us? When
have you last looked over your skin, examined the scars
and freckles and wrinkles, and appreciated how it protects us
(03:37):
and holds us together. In Alive, our bodies and the
richness and brevity of existence, Award winning writer and surgeon,
Doctor Gabriel Weston transcends the usual boundary between doctor and
patient to instill a sense of humanity in our bodies.
Throughout each chapter, she explores a different part of the body,
(03:59):
examining not just how it works, but what it has
meant throughout history and how it has shaped the story
of her life. The liver with its incredible capacity for
regeneration and transplantation. The brain unfathomably complex and yet so vulnerable,
as doctor Weston discovers with her son, the womb that
(04:21):
nurtures and provides, and that has been used to control
women for millennia. A profound blend of memoir, science and meditation.
Alive is a beautiful, absorbing book that honors what it
means to be human with our incredible yet not infallible bodies.
I really loved chatting with doctor Weston, so we'll just
(04:44):
take a quick break here before getting into the interview.
(05:12):
Doctor Weston, thank you so much for joining me today.
Speaker 2 (05:15):
Thank you so much for having me. I'm absolutely thrilled
to be part of this podcast. Oh, thank you.
Speaker 1 (05:21):
It means the world well. In your latest fantastic book, Alive,
you take readers on this really thoughtful and captivating tour
through the human body. You weave together your personal experiences
and reflections with the history and the science of the
body parts that you explore. So tell me how did
this book take shape?
Speaker 2 (05:42):
I mean, I think, first and foremost, it just came
from this place of and this is why I called
it Alive, this sort of sense that as doctors and
medical students that the anatomy that I was taught at
medical school and as the basis for my surgical training
had this kind of dead call to it. So, you know,
physiology always felt like it was a kind of experimental
(06:05):
sort of specialty, and pathology, of course, had all the fantastic,
wonderful illnesses that are so exciting. But there was something
about anatomy, which I had expected that I would love,
that just seemed really kind of inanimate, and almost like
the way it was taught was inanimate as well. And
basically I got to this point sort of twenty five
(06:26):
years into my surgical experience, where I started realizing that
actually the facts of anatomy are not as inert as
we were led to believe, and also that many of
those facts don't really apply to women or people of color.
But then, I think even more than that, I had
this feeling, as a doctor who was herself getting older
(06:48):
and going through lots of life's experiences, that actually the
way that we live in our bodies is so ever
changing and so kind of like not just a progress.
You know, you have times in your life where you
feel like you're going backwards and where everything has collapsed
in on itself, And I just sort of thought it
would be really interesting to try and write a book
(07:11):
that was almost like an alternative anatomy that would allow
me to explore some of these kind of spaces that
I didn't feel I saw anything of when I was
learning myself.
Speaker 1 (07:22):
Yes, and I think that is what is one of
the things that makes this book so valuable is being
able to see the body parts and read about these
body parts, not just in the way that you are
exposed to it in a medical class or even in
a history class, but it's this bigger picture, that complete,
more beautiful picture. And each chapter kind of goes into
(07:44):
a different body part. You've got gut, lungs, kidneyed, genital's heart,
and so on many more. And I'm curious how you
decided on this organization, especially the order of the chapters.
Speaker 2 (07:55):
I mean, I was very keen that the book should
start with a post mortem, because I thought, in a way,
like the dead body, and the first chapter of the
book is called dead, that in a way is my
start points as a surgeon, as a kind of medical
student that once was, as I was saying before, this
kind of sense that the anatomy I was taught was dead.
And I thought, if I can begin the book not
(08:17):
just with a dead body, but actually with a kind
of language that feels very cold and clinical, then that
will be a kind of start point from which the
rest of the book should be almost a coming alive
of not just the body itself, but my way of
kind of integrating my understanding of the body when it
(08:38):
came to the actual like organs and which ones to
go first and stuff. I mean, in a very sort
of light way. I had all of the piles of
organs on the floor at one point, and I remember
kind of noticing that a lot of the organs have
got memories of my own body in them, and I
sort of thought, I wonder if I could just very
(08:59):
lightly arrange them in order of my age. So, for example,
you know, I think I remember a nasal fracture from
when I'm a child in bone, which is the first organ,
and then obviously womb is an organ I wanted to
put later so that I could examine childbirth, manopause, all
that kind of stuff in there. So there is some
sense in which these organs are kind of telling the
(09:21):
story of my body, but you know, it's not super visible,
so it was more like a kind of scaffolding for
my sake rather than the readers.
Speaker 1 (09:30):
Throughout your book, you share many personal stories with the readers.
You give them it's really intimate glimpse into some of
the most challenging times of your life. And I was
wondering whether that was difficult to be vulnerable in that way,
or to put so much of yourself out there.
Speaker 2 (09:46):
I mean, it's such a great question. And what I
find really difficult actually is not vulnerability, and it's not
telling the truth of my experience of the body. I
think my difficulty is I think in medical literature, I
don't mean like textbooks, but more kind of popular medical literature,
there is a lot of sentimentality that attaches to the
(10:10):
way that people write about the body. You know, it's
I mean, it's a hard thing to describe without sounding
slightly psychopathic, but I slightly feel, particularly as women, that
there's this sort of expectation that if we're writing, for example,
about childbirth or motherhood, that there should be a kind
of softness to the way that we do that, when
(10:31):
in fact, many of my experiences of certainly of motherhood
have not been soft, fuzzy, nurturing ones. They've been ones
that have been kind of full of confusion and sometimes
rage and exasperation and even regret at times. And so
I think what I wrangled with was not the sense
(10:51):
that there was anything that I didn't want the reader
to get to see about me, but that I wasn't
wanting to write in a set mental way or in
a way that I felt for me would not be true,
and so it did mean kind of departing from a
lot of the sort of medical writing that I have read,
(11:14):
particularly written by women, where I feel sometimes there's this
expectation of, you know, what these feelings ought to be
around death and birth and reproduction and love and all
this stuff. So I think always kind of as a
feminist writer, I'm very keen to have myself be an
(11:35):
example maybe of a slightly like monstrous female who doesn't
always feel all of these nurturing feelings that I think
were Still there's still such a great expectation that we
should have.
Speaker 1 (11:46):
Let's take a quick break, and when we get back,
there's still so much to discuss. Welcome back everyone. I've
(12:08):
been chatting with doctor Gabriel Weston about her book Alive
Our Bodies and the richness and brevity of existence. Let's
get back into things. I'm sure that that also filters
into not just your role as a writer, but also
your role as a surgeon and how you are expected
to be or think or feel about your patience or
about your own self.
Speaker 2 (12:30):
I think so, and I think I mean in a way.
One of the things that I find most beautiful about
the body as a writer, as a doctor, but also
just as a human walking around as a woman, is
you know, if you have a thought, it is very
likely that most other people are having that thought to you. Like,
you're going to have thoughts and you're going to think
you're the only person in the world that is having
(12:51):
those thoughts or desires, or you're going to think that
you've just thought something that is the most shocking thing
that you could even ever imagine someone thinking. It is
highly unlikely to be that shocking. And the body as well.
I feel like the way that we experience kind of
life's big changes and events through our bodies. It's like
(13:12):
if the body is kind of telling you I feel discussed,
or I feel desire, or I feel fear, or I
feel longing, it's okay. And sometimes we might have those
feelings in odd circumstances, and I like putting that on
the page, but I absolutely have I just have an
(13:32):
aversion to doctoring and writing that is about telling people
what they're experiencing in that moment. So yeah, that's a
big thing for me.
Speaker 1 (13:45):
Your background is not necessarily you didn't start out your career,
your adulthood with designs on becoming a doctor. Can you
tell me a little bit about your atypical journey.
Speaker 2 (13:56):
Yeah, yeah, So, I mean in the UK, we have
this crazy system where when you're about sixteen you have
to choose three subjects that become the only three subjects
you're going to study at school, and then usually you
choose one of them to go on and do it university.
And I gave science up when I was thirteen as
soon as I possibly could, so I had to keep
(14:16):
one science for what we call GCSE, which is a
kind of fifteen sixteen year old style exam. And then
after that science disappeared from my life. That was a
great relief to me, and I had a year out.
Then I went off to do English and philosophy. You know,
English was always the thing that I was good at,
so it seemed like the obvious choice of thing to
(14:36):
read at university. And then when I was at Uni,
I just started kind of discovering that whenever someone was
sick or someone like fell off a ladder or broken
arm or it was around the time that Er was
on TV for the first time. That's how old I
am now that It came on around that time that
I was doing my English degree, and I noticed that
(14:59):
I was much more than usually interested in all of
this stuff, and not from the point of view of
I did not have an overarching desire to help people.
That was not the impulse. The impulse was just pure,
untrammeled fascination, like kind of not okay style fascination. And
(15:22):
then completely by happenstance, one of my friends, who was
a maths student, his dad came to visit us up
in Edinburgh, and his dad was a surgeon, and this
was back in the day where you know, there were
no mobile phones or anything like that, and he had
these old school photo albums in his car filled with
photographs that he or his scrub nurse had taken when
(15:43):
he was operating. And I remember everyone else went out
clubbing and drinking. He and I stayed in alone, and
at the end of that evening he said, next time
you're in London, give me a call. You can come
to my operating theater. So I did that. I was
about twenty one, back in the day where you could
just rock up to someone's operating theater with no credentials,
(16:04):
and I just literally walked into this room and it
was like I was having some kind of religious conversion.
I mean, I was just beside myself with excitement. And
I went a couple more times after that, and then
I kind of thought, I don't really see how I'm
going to make be able to make surgery a hobby.
(16:27):
I don't think that's going to be a kind of
socially acceptable thing for me to be doing in my
spare time. So after a little kind of while of
arming and ring, I just thought, I think I'm going
to have to go and be a doctor. So I
had to go back because I had English, French and
Latin A levels and I had to basically do all
the science A levels that would get me a place
(16:48):
at medical school. And then into medical school I went.
And the crazy thing was that, apart from that early
year where I had to do all the science and
it was so difficult for me, really the rest of
it was kind of fine. It's like I loved it
and I had this amazing feeling that most of the
(17:09):
other medical students didn't have, of like a kind of
glorious sense of the glamour of being a medical student
who had come from a background where it didn't seem
like that would ever be possible. And so I never
quite lost my sense of the kind of in loveness
with the persona of this new person that I was,
(17:32):
And in a way, I think I still have that now.
It's like when I go into the operating theater now
to do you know, very small surgery with you know,
very low risk and kind of nothing to write home about.
When I put my scrubs on, I just still feel
that's very cool, you know, I've never lost that sense,
and so I think there's a lot to be said
(17:54):
for that, you know, for kind of whatever it is
that makes you keep loving it. And I really, I mean,
even despite our NHS being in the most kind of
powerless state, the actual business of being a doctor who
gets to handle people's bodies it's just a joy, isn't it.
(18:15):
It's just it's like intimacy of the most extraordinary, beautiful
kind that life has on offer.
Speaker 1 (18:23):
You write about the human body with such care and
with such lyricism. It shines through along with your endless
curiosity about the human body and about your own ability
to express your stories. And I wanted to kind of
get into a few specific parts of the body that
you covered in your book, starting with bone. So in
(18:46):
your chapter on bone, you talk about the common misconception
that bones are these static, unchanging things, when really they
are very dynamic. Can you talk about how our use
of the skeleton as the symbol of death really contradicts
the true vitality of bones.
Speaker 2 (19:03):
Yeah, I mean, skeleton's so interesting, isn't it, because it's
like lay people. You don't have to be a doctor. Like,
we all know what skeletons look like. Kids know what
they look like. They wear Halloween costumes with skeletons on
the front of them, and you can go for a
walk in the woods and like see a bird skeleton.
And most of us have touched bones, you know, whether
we're eating a chicken wing or whatever. We have a
(19:25):
very kind of established sense of what bones are. And
yet when you see bones inside a body that is alive,
they're not like that at all. So for this book,
I went to there's an amazing orthopedic hospital just outside
of London called the Royal National and I went there
and saw an amazing surgery where a guy was basically
(19:48):
removing a tumor from a woman's thigh bone and he
had to kind of take an enormous length of her
thigh out in order to take this tuma out. And
when they were sawing through the femur, it's just so
struck by the cross section of this biggest bone in
the body that it was filled with marrow, and it
was filled with blood vessels, and it had this kind
(20:11):
of live, yellowy looking periostium, and it just I looked
at it and I thought, it's just not at all
the way you would think bones are. And then of
course when you look at the physiology of bone, you
realize that bone is kind of changing itself all the time.
So the bone, you know, the bones that you have today,
you wouldn't have had ten years ago. Every year, ten
(20:33):
percent of our bones are being remodeled by a process
of you know, osteoclasts removing old bits and osteoblasts putting
in new bits. So I think even this kind of
symbol of death, when you look closely at it inside
the living body, which obviously most people don't get to do,
you just see that it's alive in a way that's
(20:55):
really counterintuitive and really beautiful.
Speaker 1 (20:58):
It's like, instead of ship of theseus, we have the
skeleton of theseus. You know, the bones that we have
now are not the bones that we started out with.
They've just been continuously remodeled throughout our entire lives. And
in your chapter on the womb, you take readers on
journeys through the inner workings of this amazing organ. You know,
(21:21):
the ways that it's been used to dismiss or harm women,
as well as your own experiences in childbirth, both you know,
as the one giving birth and as the one observing childbirth.
Did any part of this chapter feel especially meaningful or
challenging to write?
Speaker 2 (21:41):
Yeah, I mean, like you say, it's such an incredibly
sort of dynamic organ, the womb when you think it
sort of begins as something the size of a small pair,
and then if you're pregnant, you know, it occupies your
entire abdomens, so it kind of it presents itself as
something to write about, almost like the most beautiful kind
of metaphor for changeableness, and that really appealed to me.
(22:05):
And then it kind of, you know, it kind of
intersepted with really in a way. The main drive behind
this book is this kind of philosophical desire that I
have all the time with the body to somehow occupy
that space between being in a body and observing a body,
you know, like where that's the mystery, isn't It is
(22:28):
like when you're a surgeon. You're standing at the operating cable.
You have your hands inside someone's body, but your own
heart is beating, your lungs are working, your hands are
warm because of blood running through them. I'm so struck
always by that kind of like a desire to be
and know at the same time, which never feels possible.
(22:50):
It's always like a hologram that you have to kind
of flip from one side to another of And So
when I had my so my first two children, I
had vaginal the second two at the same time by
sea section because they were twins, which was also kind
of cool because I thought I get to kind of
experience all the ways that the womb can give birth
to children. And I just thought it would be really
(23:11):
interesting to get in touch with the obstetrician who delivered
my babies by sea section, which I did about six
months after they were born. I mean, I think she
probably thought I was crazy, but she was very accommodating,
and I just sort of said to her, like I
really I want to see what you did to me.
I want to kind of be on the other side
(23:32):
of the line, like having Laine on that table with
my womb open and you pulling my twins out. I
want to stand there next to you with my scrubs on,
seeing you do that to someone else. And so in
the womb chapter, I'm really exploring that kind of very
female again. I think it's a very existentially deep part
(23:54):
of being a female, this way that our bodies are
the thing that life is enacted on, but it is
also self. It's like, if we are to express agency,
it's through our bodies. And yet the second you hit
puberty as a girl, you're suddenly aware that the world
(24:15):
is objectifying you. And so I felt like the womb
was a really really exciting organ to look at some
of those things through and then just as the icing
on the cake. I also, for the BBC went to
Sweden to see a womb transplant being performed. That was
(24:35):
just kind of mind boggling in a wonderful way as well,
to see like in adjoining operating theaters, you know, a
mother's womb being carried down a corridor in a dish
to be put inside the pelvis of the daughter who
had been gestated in that womb herself. Just so cool,
you know, just like those moments again where I'm kind
(24:59):
of maybe thinking to myself, in this moment, I should
be having a sentimental reaction, but actually I'm just blown
away by how exciting it is and how kind of
existentially deep it is. And you know, so that was
really like a terrific experience as well.
Speaker 1 (25:18):
I don't have the words. It is the coolest thing.
And it is also you know, earlier you mentioned and
I wanted to circle back to this. Earlier you talked
about how it wasn't like you went into medicine because
you wanted to help people or because you had this
like altruistic this is what I was put on this
earth for. You love the huge and I feel like
that is the expectation to feel that way, to feel
(25:40):
like I went into medicine because I want to save
the world and make the world a better place, and
I feel like it is it is challenging then, or
is maybe viewed as sometimes not acceptable to say I
really just thought this was fascinating and I wanted to
do this.
Speaker 2 (25:56):
I mean, I definitely feel sometimes when I was a
jenior surgeon that I would be so excited in an operation,
I'd kind of think, I'm glad I've got a mask on,
because then they you know, they're not going to see
how excited I am. I mean, obviously there is a
limit to how much a patient wants to see that
on a person's face. But we would prefer all of us,
I think, to have our doctors really into what they do.
(26:19):
And I definitely think for writing about the body, like
there are lots and lots of places to get facts
about the body, and I think it's I still feel
that it's very political writing the truth about the experience
of being inside one. I still feel that that is something.
(26:42):
Women can keep writing truthfully about their experiences of being
inside their bodies till the cows come home, and it
will not be enough, you know, the deficit.
Speaker 1 (26:54):
Let's take a quick break here, We'll be back before
you know it. Welcome back, everyone, I'm here chatting with
the wonderful Gabriel Weston about her book Alive. Let's get
(27:18):
into some more questions. So Skin is an incredible organ.
I mean again, like they all are. I say this
about all the organs, but I really appreciated how your
chapter encouraged readers to see skin not just as the
thing that holds us together, not as a barrier to
the outside world. And you talked about some of the
things that skin can show, what it can reveal, as
(27:40):
well as what it can hide, and I was hoping
you could just elaborate a little bit more on that.
Speaker 2 (27:45):
Yeah, I just so, I think, again, like with all
of these organs, I'm always sort of after something literal.
You know, what does the skin do? What is its
function as our biggest organ? And I guess its main
function is letting sunlight in and heat out in the
most basic way, but it's kind of it is a
barrier and a protective barrier, but it's also like a
(28:06):
filter because your skin doesn't work well and if it's
completely impermeable, it wouldn't be doing the things that has
to do. But also I got, of course thinking about
skin more symbolically as the thing that marks out where
I end and the world begins, which is again kind
of going back to the more philosophical sense of like
(28:29):
what is a self? Where are we inside ourselves? And
where do we touch the outside world? And we do
that through our skin. So it was a chapter that
I felt was kind of a really interesting chapter to
examine themes of time through. So one of the things
I did in this chapter was kind of take a
(28:50):
bit of a like a spread of members of my
family from at the time my twins were like toddlers
right up to my parents in their eighties, and have
these kind of moments where I'm stopping my usual physiological
inquiry into the skin to just look at the skin
of these loved ones, you know, of my little kids
and my teenage kids, and my middle aged husband and
(29:12):
my elderly parents. And then I also had this amazing
opportunity to visit one of the immigration removal centers near
one of our airports in London. So these are kind
of like hidden places with no signposts, and basically it's
where tens of thousands of people who don't have their
asylum papers are left, often for years while those papers
(29:36):
are processed. And I managed to get access with a
GP who goes in there to kind of assess some
of these asylum seekers claims for asylum. I managed to
go in with her and had this fascinating day where
I realized that this particular young man who we were
seeing that his job and the job of the GP
(29:58):
who'd come to visit him, was to document all of
the scars on his skin, which were his evidence that
he had come from a place where he had been
traumatized and tortured. And so since really fascinating, like turning
on its head of how we usually want our skin
(30:19):
to be, particularly again women aging, we want skin to
be sort of perfect, like the perfect flawless canvas. And
yet here was this young man at pains to show
all these kind of traumatic blemishes because he knew that
if we could document enough of them, and if he
could get them to match the story that he was
(30:41):
telling us, that that might be the ticket for him
to be able to stay in the UK. So that
was the kind of way of acknowledging the complexity of
skin as a political organ without treading on ground that
didn't feel like my ground to tread on.
Speaker 1 (30:59):
It's sort of runs parallel in some ways to some
of the challenges that people face and the range of
challenges that people face when seeking healthcare in general, and
one of those being communication and being able to adequately
receive care and attention and explanations from their physician and
(31:24):
This is something that you touch on in your chapter
on the kidneys, some of the ways that doctors just
aren't always the best communicators. Why do you think communication
still poses such a challenge and there's still so much
room for improvement.
Speaker 2 (31:39):
So I think in the UK, the primary difficulty is
one of the resource of time. So in our NHS,
which is free at the point of access and kind
of on its knees now as a system which is
just totally overrun with need and insufficient resources to meet
those needs. I genuinely think that if hospitals and medical
(32:04):
schools could take whatever paltry funding they have that they're
diverting into communication skills courses and just somehow enable that
to manifest itself as a couple more minutes per consultation
for each doctor, a lot of the communication problems would disappear.
So I think, you know, if you can imagine, like
(32:24):
if you were trying to talk to your partner about
being unhappy in the relationship, or you know, talk to
one of your kids about their drug problem or whatever,
if someone said you've got ten minutes to do that,
it would be absolutely impossible. And yet that's what doctors
and nurses are expected to do with highly complex patients
(32:44):
who they've never met before. It's just totally extraordinary. So
I think time is one thing. I think the other
thing is we have such an embedded kind of distance
in the way that we're taught as doctors, the kind
of ancient ways of treating patients from on the other
(33:05):
side of a desk, from above. You know, if you've
got through medical school, you're someone who's really good at
learning facts. You're probably someone who's come from a pretty
advantage background with all the assumptions that go with that.
And I just think there's still such a distance between
doctor and patient so much of the time, and you know,
(33:27):
that's a really complex thing to fix. But I think,
certainly in my own experience, I think having become a patient,
and perhaps more importantly, the mother of a patient, I
have just really experienced now how awful it feels to
(33:48):
be in a doctor's room or in a hospital where
you're terrified, you feel like no one is listening to
the thing that you need them to know, and this
kind of awful sense that you somehow have to kind
of behave yourself in order not to irritate the people
who you need to look after you, and I think
(34:09):
a lot of those problems are probably quite British problems
and quite entrenched in the fact that our healthcare system
doesn't involve any exchange of money in the way that
it does in other places. So it's almost as if
any motivation for a doctor to be nice to a
patient that might have anything to do with patronage or
(34:33):
reputation that doesn't exist here. And so in a way,
all you're left with is these very overworked, exhausted healthcare
providers who are just going to get paid what they're
going to get paid regardless. And yeah, I just I
think the dual problem of this kind of culture of
(34:55):
superiority combined with real time deprivation is the problem of
communication between doctors and patients.
Speaker 1 (35:04):
Now, I think it's also not helped by some of
the as you kind of touched on, this entrenched way
that physicians see patients, where we've incorporated more quantitative tools
to assess a patient's condition, or you know, we have
these scans, we have blood tests, we have all of
these these ways to look at the individual parts of
(35:26):
a patient that can sometimes then make a doctor lose
sight of the person as a whole, not just as
a patient or as a patient's body part. What role
do you think that plays, and how can we maybe
strike a better balance between using these quantitative tools not
just as something that's shaping the entire narrative.
Speaker 2 (35:46):
Yeah, it's really tricky, isn't it. I mean in an
area like, for example, psychiatry versus neurology. I mean, that's
quite interesting. Those two specialties were the same specialty until
the late nineteenth century, early twentieth century, and then as
neurology became I guess a more sort of objectifiable form
(36:08):
of medicine, it kind of split off. I mean interestingly,
Freud I think, was a neurologist to begin with, and
then became a psychiatrist. And once he started, you know,
developing ideas of a kind of psychological and psychiatric self,
those two things split. And now we're in a situation
where as you say, the quantitative tools that have gone
(36:28):
so far with neurology have given people with neurological conditions
a kind of status in a way that is very,
very different from the continuing stigmatized low status of psychiatric patients.
And I think it is really interesting that, you know,
(36:49):
if you think the brain is the site where schizophrenia,
bipolar depression, you know, all that stuff is coming from there,
and the brain tumors and all the neurological stuff. And
yet I know from my own experience one of my
son had a brain tumor. You know, it was an
awful time. But you couldn't imagine a situation where people
(37:12):
would be nicer than a children's hospital with a brain tumor.
But by comparison, I have a very close family member
who's been very acutely psychiatrically well for a long time,
and I've walked through that path with that family member,
and all there is is stigma and low status. You know.
(37:35):
It's and that is because I think because there isn't
a scan that shows what the problem is in a
way that kind of makes it easy to delineate. And
also I think when we can't find it's the same
with all these conditions where there's a little controversy over
whether the condition is a so called functional condition or
(37:55):
an organic condition. There's something that kind of brings out
the kind of nasty playground thing in us that is
to do with kind of this idea of a person
faking something or like why are they saying they have
these symptoms when there's nothing to correlate them with. And
(38:16):
so I think there is that problem in psychiatry that
because it's all in someone's head, so to speak, we
can't kind of corroborate it in the ways that we
seem to need to.
Speaker 1 (38:33):
You mentioned this really terrifying medical ordeal with your son,
and you begin that chapter on the brain by asking,
you know, did I think being a doctor would protect me?
And you discuss some of your roles as mother, as surgeon,
as patient yourself. How did those roles intersect during that time.
Speaker 2 (38:55):
Yeah, I mean it's so interesting. I try very hard.
Because a friend of mine who first came to see
us in the emergency department when we first realized that
my son he'd had headaches, and then they did a
scan and they discovered he had a map quite a
large mass in his brain. So, in that awful early
stage of realizing something was wrong, a friend of mine,
(39:18):
who was an edy doctor, said to me, just be
a mother here, Like, that's my one piece of advice
to you is don't try and be a doctor, just
be a mother. And I kind of tried to do that,
but I also feel in all honesty that there were
certain moments in that journey where the fact that I
was a surgeon helped me advocate for him in a
(39:40):
way that I think actually did make a difference. I mean,
I'll never be able to say whether it was a
life or death difference, but there were definitely a couple
of junctures where I was able to say to a
system that was not acknowledging how serious something was. You
know that I'm saying as to you as a mother,
(40:02):
as a surgeon, and with this other surgeon friend of
mine who's my kind of backup plan guy. So there
was a weird braiding of mother with surgeon in that time.
And I think if the healthcare system had been perfect,
I would not have needed to be a surgeon at all.
And I certainly I was astonished by my lack of curiosity,
(40:27):
like about the actual surgery my son had and about
the particular he ended up when they finally found out
what it was, because they thought he had something called
a medulla blastoma to begin with, but he actually had
a cavanoma, which is an abnormal cluster of blood vessels
in his brain. Once we knew what it was and
that he was going to have surgery. I amazed myself
(40:49):
with how like I did no research. I didn't go
on Google, I didn't look anything up. I said to
my family and friends, I don't want anyone telling me
anything outside of what the surgeon looking after him tells me,
Like he is my source of information and that's all
I want. So I really did the opposite of what
(41:10):
I do as a writer and a doctor in other circumstances,
which is to cast my net as wide as I can,
you know. But it was a very I mean, we
were very lucky because he came out of that surgery,
he's recovered, he's fine. It's given me a lasting feeling
for any patient who is in a situation where they
(41:33):
are completely terrified. And I don't think i'd realized before
that happened to me. You're not in your right mind
when you know, I mean, never mind that you're not sleeping,
you're like you're in an altered state. And the way
that I am with patients now when they're in the
early stages of discovering something very shocking, is completely different
(41:54):
than it was before in view of that. So, you know,
I'm grateful to have learned that, and I sometimes feel
I feel a little bit ashamed of the young doctor
I was. I don't think I was harsh, but I
think I was very disconnected, almost as if by being
a doctor. I don't know, I had some kind of
(42:16):
I mean, I can't ever have actually been that stupid
is to think that that was going to protect me,
But in a weird way, I think I did think
it was protecting me.
Speaker 1 (42:24):
Throughout your book, you also discuss you interspersed correspondence with
some of your physicians and recollections about your own heart condition,
and you end the book with a chapter on the heart.
Would you mind sharing a bit about sort of the journey,
sort of how you decided to intersperse those, and then
why you decided to end with the heart.
Speaker 2 (42:43):
Yes, so all the way, as you say, all the
way in between the organs, I have these little fragments
of clinical evidence in a way from my own heart condition.
I've got mutual valve regurgitation, so one of my heart
valves doesn't work properly and it's getting worse. At some
point on need to have open heart surgery for that.
So that was all kind of happening while I was
(43:05):
writing this book, And really what I wanted to convey
by interspersing these little kind of emails from doctors or
little kind of moments of almost like clinical text is
present to the reader, this very profound textual difference between
(43:27):
what happens when we tell a story and everything is
perfect and has jeopardy and it has a kind of
narrative arc and it goes up to a crisis and
then it kind of falls away and wraps itself up,
And on the other hand, the totally unshapely, inconclusive, disorientating
(43:49):
experience of being a patient in the middle of a
clinical story whose end you cannot predict. So someone who
reviewed my book said something like they felt that these
fragments in between were kind of a bit of a
letdown because they didn't rise to a sufficient conclusion. And
I thought to myself, well, no, like that's they're not
(44:12):
meant to.
Speaker 1 (44:13):
Like.
Speaker 2 (44:13):
What I'm trying to do, in a way is almost
destabilize my own narrative by saying, Okay, I've just written
this chapter on the breast or the skin or the liver,
and when you get to the last sentence, you'll feel
a sense of satisfaction that I have closed that chapter.
But here's the reality of me being in this body
where there's just these few facts and there's all this
(44:36):
space and all these questions that are not answered, and
it doesn't go anywhere. It's like it doesn't end with
me telling you what happens, because here I am, I
don't know what's going to happen, Like my valve is
still flapping around there with blood going in the wrong direction,
and I don't know. I don't know what the end
of the story is. And that's my experience of being
(44:58):
in a body, and that's the way that I chose
to tell it. So of course, at the end, I
then thought, I need a heart chapter as well, to
talk about some of the issues around really interesting new staff,
to do with how kind of stress and emotion actually
manifests itself in the tissues of our body, or the
(45:19):
really shocking statistics around women and heart health, and how
badly served we are currently in terms of our cardiology.
So I thought, at the end of the day, I'd
better provide that chapter, because there is all this really
interesting stuff and if I just leave these fragments, it's
like too big an organ to ignore. So I guess
(45:41):
at the end it was like starting with a dead
body and hopefully ending with this kind of integrated sense
of an organ that is a pump but also the
feeling center of ourselves.
Speaker 1 (45:53):
It touches on again this theme of honesty of this
is the reality, you know, sort of this how you
said there is no narrative arc to this, to your story.
There's no narrative arc to any of our stories. If
there is one, we've constructed it artificially. And that's fine,
but that's not necessarily the reality. And I'm curious how
(46:13):
you feel this honesty is or is not being accurately
portrayed or acknowledged in science communication these days, or how
we can all do better about incorporating honesty into science communication.
Speaker 2 (46:29):
I mean, that's such a big question, isn't it. And
I guess it just really depends on sort of what
area we're talking about. I mean, I think the introduction
of AI and machine learning has been really really interesting
in this regard, because now that AI is doing such
a good job of data gathering and kind of synthesizing
data in a way that you know, we used to
(46:51):
have to do for ourselves just a few years ago.
I think the lovely thing about that is it kind
of puts more of an onus, on each of us. Actually,
when we are communicating about science, to be doing it
in a way that is not a way a machine
could do, you know, in an authentic way, in a
disruptive way, in a way that doesn't feel nice or comfortable,
(47:12):
because the machine can do that stuff. So I prefer
the messy truth, and I prefer it in I prefer
it in lectures, I prefer it in books. I prefer
it in movies, I prefer it in people. I'm not
interested in the airbrushed version, but I am not like
I don't think I'm in the main stream there. I
think most people do prefer the polished version. So I
(47:35):
don't know what we do with that.
Speaker 1 (47:37):
Well, I'm excited to see what you do next. And
doctor Western, I just want to thank you for taking
the time to chat with me today. This was so fantastic.
Speaker 2 (47:46):
Honestly, it was an absolute thrill for me.
Speaker 3 (47:48):
Aaron, thank you.
Speaker 1 (48:08):
A big thank you again to doctor Gabriel Weston for
taking the time to chat with me. If you enjoyed
today's episode and would like to learn more, check out
our website This podcast will kill You dot com, or
I'll post a link to where you can find Alive
our Bodies and the richness and brevity of existence, as
well as a link to doctor Weston's website where you
can find her other incredible work. And don't forget you
(48:31):
can check out our website for all sorts of other
cool things, including but not limited to, transcripts, quarantine and
Placeibereta recipes, show notes and references for all of our episodes,
links to merch our bookshop dot Org, affiliate account, our
Goodreads list, a first hand account, form, and music by Bloodmobile.
Speaking of which, thank you to Bloodmobile for providing the
(48:52):
music for this episode and all of our episodes. Thank
you to Leana Squalacci and Tom Bryfocal for our audio mixing,
and thanks to you listeners for listening. I hope you
liked this episode and our loving being part of the
TPWKY book Club. A special thank you, as always to
our fantastic patrons. We appreciate your support so very much. Well,
(49:15):
until next time, keep washing those hands,
Hosts And Creators
Erin Welsh
Erin Allmann Updyke
Popular Podcasts
Las Culturistas with Matt Rogers and Bowen Yang
Ding dong! Join your culture consultants, Matt Rogers and Bowen Yang, on an unforgettable journey into the beating heart of CULTURE. Alongside sizzling special guests, they GET INTO the hottest pop-culture moments of the day and the formative cultural experiences that turned them into Culturistas. Produced by the Big Money Players Network and iHeartRadio.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.