The Explainer: Stephen Lieberman, MD

 

[0:00] And I found that the same way that I coached my kids playing soccer applied to how you coach a resident becoming a good doctor, a good urologist, and a good surgeon.

[0:14] Music.

[0:20] Paging Dr. Cook. Paging Dr. Cook. Dr. Cook, you’re wanted in the OR.
Dr. Cooke, you’re wanted in the OR.

[0:26] Music.

[0:50] With your host, Dr. Randy Cooke.
Hello everyone and welcome to Prescription for Success. I’m Dr. Randy Cook, your host for the podcast, which is a production of MD Coaches, providing leadership and executive coaching for physicians by physicians.
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My guest today served 27 years as chief of urology for Kaiser Permanente in Oregon and Washington.
He retired from practice in 2014, but he has remained very active in the MAVEN Project in addition to authoring three very informative books on urological topics of interest to the lay public.
So let’s hear my conversation with Dr. Steven Lieberman.

[1:53] Music.

[1:59] We have a very interesting conversation today with Dr. Steven Lieberman, who has had a really rewarding career as a urologist for many, many years, and has remained very active in retirement.
And I’m looking forward to hearing about all of that. Steve, it’s so nice of you to join us today.
Thank you so much for being here. Really nice to be here. I’m looking forward to our conversation.
Well, same here. So let’s get underway.

[2:28] Always like to start this show at the very beginning and that means talking about your very early life. Tell me a little bit about where you grew up. Was it in a medical family or what was your early life like? I grew up in St. Louis in the western suburbs of St. Louis in a town called Creve Coeur. I went to public school and I had really no family members that were doctors. I did have my share of very minor interactions with doctors. I had a great pediatrician. I had the usual fractures and lacerations which prompted visits to the ER.
Sign of a healthy childhood. Yeah, I did almost every sport imaginable. By the, time I got to high school, I kind of focused on tennis and baseball and I I thought that I wanted to become a professional athlete.
Really? Yeah. And I realized sometime in high school that that probably wasn’t going to happen because I wasn’t that good.
And I remember my father sat down with me one time. I think I was in junior high school and he said, when are you going to start studying?
I said, I don’t need to study. He goes, yeah, you do need to study.
You need to start getting better grades if you want to go to college.

[3:51] I said, I’m not worried about going to college. I’ll go to college.
He goes, how are you going to go to college when you’re just making B’s and C’s and a few A’s?

[3:58] Your sister on the other hand is making all that. My sister never got a B in her life, never got a B in her life.
And she’s two years younger than me and I was always being compared to her in terms of school.
And I never really worked very hard at school until that conversation when he said, I said, I’m going to go to college on a basketball scholarship.
And he goes, no, you’re not. I see.
Why do you say that? I think I am. And he goes, well, you remember that game you had against that kid a couple weeks ago? It was the first time I’d played against a black kid. And I said, Dad, I’m averaging over 20 points a game. And he goes, yeah, but you remember that game? I said, yeah. He goes, how many points did you score in that game? I said, I don’t remember. He goes, I do. I was there. You scored four points. How many points did he score? I said, I don’t remember.
All I remember was looking at the bottom of his shoes.

[4:49] And he said, he scored over 30 points. He might go to college on a basketball scholarship.
You are not going to college on a basketball scholarship, not even community college.
So, if you really are serious about wanting to go to college, you better start studying.
And that was like, you know, tough love wake up call for me. And I started studying and I started, I realized that I was pretty good in math and science and I was interested in math and science and I was always a reader. So, I did well in math and science and I liked reading, so I did well in, English and stuff and I wound up getting accepted into Northwestern.
Darrell Bock Yeah. Tell me a little bit more about your dad.

[5:38] What did he do for a living? My dad was in business, he was a shoe, started off as a shoe buyer for a big department store in St. Louis.
And then he got a promotion to merchandise manager and then ultimately moved to Los Angeles to be a merchandise manager and vice president for a store called Robinson’s, which was a large department store.
And then he became vice president of the Broadway department stores.
They had about 30 department stores Southern California. So I went to high school in St. Louis and graduated from high school in St.
Louis, but he had moved out to Los Angeles during my senior year.
With my mother and brother and sister. So I’m going to guess that he was a child of the depression.
Yes, he was. Definitely. So he knew some things about what it takes to be successful and had a very good lesson in that regard. Do you think that had an effect on the wisdom that he offered for you?
Oh yeah. He definitely wanted all of his kids to go to college. In fact, we all did and he paid for it. I mean, we didn’t get any scholarships. And so, he paid for me to go to Northwestern, he paid for my sister to go to Colorado College, and my younger brother went to Stanford.

[6:52] And he footed the bill for all three of us. So, there’s a lot of value in that financing and that process. And it was always very encouraging about when you realize that I was good at math and science, and I was really interested in it. I mean, I was fascinated by it, in fact.

[7:13] When I was a senior in high school, in our AP biology class, we had some live rats in the back of the room that we did experiments on, and we did some thyroid experiments. And then, we got a hold of this study. It was done at UCLA. It was investigating memory in rats.
So, we taught these rats how to do a certain task in a Skinner box, and we sacrificed them, took their brains out, centrifuged the brains, and extracted the mRNA and injected it into other rats to see if they would learn the thing.
Because we thought, oh, memory is transferred by… It was this crazy high school, but we did it, and it was kind of fascinating to me.
And then when I went to college at Northwestern, I really enjoyed all the science courses.
And they were easy for me.
So, did you, when you, and I apologize for the interruption, but when you got there as a freshman, did you really have your eye on anything in particular that you thought would be a career at that point.

[8:20] I probably, yeah, I had it in the back of my mind that I wanted to go to medical school and I wanted to be a, I was a pre-med and you know how it is in freshman chemistry with 200 other people in the class. The professor says, look to your left, look to your right, only one of you is going to go to medical school. And I’m kind of a competitive guy by nature and I thought, oh yeah, that’s going to be me. I’m going to be the one. I’m going to work my ass off and be the one to go to medical school. And it turns out that I really didn’t have to work that hard at math or calculus, which is what I took when I was a freshman, or freshman chemistry. And then when I got into the upper levels, it became more fun. I mean, I enjoyed organic chemistry, I enjoyed molecular biology. I found it all real. Yeah, I really liked it. I liked biochemistry, I liked even physical chemistry and physics. I was fascinated by it.
You’re the first person that I’ve ever had a conversation with that told me they enjoyed P-Chem. I really did.
I’m beginning to worry about you, my friend. We’re going to have to talk about this some more.
Well, you know, at Northwestern, they have the six-year med program for super smart people, and I was not in it.

[9:38] But after my freshman year, they had three people drop out, and they contacted me and a couple of friends of mine.
And I said, you wanna be in the six-year med program?
And all three of us said, no, we’re having too much fun in college.
We don’t want, it would mean two years of college and then going down to the main campus at Northwestern Medical School for the four years of medical school.
Well, all three of us declined. So I went and took physical chemistry as a junior with the six-year med people.
And there were only two of us that were in that class, two non six-year med guys that were in that class of physical chemistry.
It was a bear a bit, it was still, I enjoyed it.
Well, now, getting back to the decision about it’s going to be medicine, is that simply because you thought that that would be an interesting place to be a scientist?
Or did the inspiration come from someplace else? I’m trying.
Yeah, actually, you sound like such an incredible student of the pure sciences.
And I guess if I had known you at the time, I would have envisioned a guy that wants to get a PhD in the second electron orbital and whatever element.

[10:48] And write papers the rest of your life, but you wanted to go to medicine.
Where did that come from?
Well, getting back to my childhood, I was playing football one day and some kid put his finger next to my eye and opened up a laceration and I had to go to the emergency room to get it sewn up.
And I went in there and the guy goes, Hey, we got to get you back on the field. Let’s get this done quickly.

[11:12] That was such a great thing for somebody to say to me. And then I think I read two books when I was in high school. One was called The Making of a Surgeon, and the other was called The Making of a Psychiatrist.
Darrell Bock Yeah. David Schawel Sure, when Newland wrote that Making of a Surgeon, I think.
David Schawel I don’t remember who wrote it. I could Google it and find out.
Darrell Bock Not important. I know the book, though.
The Making of a Psychiatrist takes place in New York City at Bellevue Psychiatric Hospital and The Making of a Surgeon, I thought both books were really cool.
I thought, God, I could do this. I could be one of these kinds of doctors.

[11:52] So those were really inspiring, believe it or not. I mean, those two books, I thought, this is a cool job.
I can see that. The Making of a Surgeon is one that I read and I found it very compelling.

[12:05] Yeah, it was. And if you ask me, I mean, I never had really thought about it too much, but if you are asking me where that motivation and that desire came from, I would have to go back to those two books.
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[13:22] We’ll get back to our interview in just a moment, but right now I want to tell you a little bit about Physician Outlook.
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So it sounds like, from what you’re telling me, that once you got settled in medical school that you felt very comfortable there.

[14:41] I did. Those were great. I loved medical school. I really just thought it was the greatest experience.
From beginning to end. And again, I think that’s a little bit unusual. I hear a lot of stories about how basic science has almost ended it for me and that kind of thing.
It sounds like you enjoyed the entire ride. But at what point did you begin to think about what your career was actually going to be.

[15:10] Once you got that MD?
Tom P. Let me go back to being in college. When I was in college, I had sort of a side interest in literature, namely Russian literature, and Soviet literature, and an author by the name of Nabokov.

[15:28] And at Northwestern, there were two professors who were incredibly interesting, engaging, and brilliant.
One’s name was Erwin Weil. He taught Soviet Russian literature and Russian literature.
And the other one was Alfred Appel.
Who was an expert in the Bokov. In fact, Alfred Appel wrote a book called The Annotated Lolita, which is just an amazing book. And so, I took many classes with those guys. And those classes were difficult for me because I’m not as good at those kinds of things as I was in my science classes, but I like them nevertheless. And I’ve always had sort of a passion for reading too.
So, when I went for my medical school interviews, one of my first interviews was at USC.
I wanted out of Chicago because it was too cold and I wanted to go to the west coast.
And I didn’t want to, I didn’t even apply to Northwestern Medical School.
And most of the places I applied to were in California. In fact, all of the places that I applied to are in California, except for University of Pennsylvania where my two best friends ultimately went.

[16:40] So, one of my first interviews was at USC, and the person that interviewed me was a scientist.
She was a biochemist, and she was from Eastern Europe, and her favorite author was Nabokov.
And we spent the entire hour talking about Nabokov. Darrell Bock What a happy coincidence.
David Zaharoff It was, and that was the first medical school that I was accepted into.
And I told him right away, yeah, I’m coming. I subsequently got into a few of the other UC schools.
In fact, I remember that my first day at USC Medical School, I got a phone call from UCLA and the person said, you’re on the waiting, I was on the waiting list.
They said, you were the first person on the waiting list and somebody just dropped out.
Would you like to come? And so I thought, oh my God.
I mean, I was all set up in an apartment in South Pasadena.
I had my books purchased. I had my first day of classes. I had met a few friends.
And so I called my dad and I said, dad, I just got into UCLA medical school.
What should I, what do you want me to do? He goes, what do you want to do?
I said, well, I want to stay here. But UCLA is a lot cheaper. The tuition at UCLA at that time was, $700 a semester. I think at USC it was like $4,000. And since my dad was footing the bill, I thought, well, I better clear this with him. And so, he said, look, do what you want. So, I said, I’m going to stay here. I really like it here. I’ve made some friends and.

[18:09] I think it’s a great, it seems like it’s going to be a great school. And so, that’s what I did.
Turned out to be a great school. So, during my first two years of medical school, I mean, I was.

[18:21] I liked everything. It was an organ system based. So, you did three weeks of hematology or three weeks of blood, this is blood system, then three weeks of musculoskeletal system, and three weeks of endocrine. And I thought, I could do any of this stuff. But my whole thing was, for some reason I kept thinking, I want to be a psychiatrist.
This is kind of crazy because I would go into anatomy and there were, you know, you have four people to each cadaver. And there were two of us who were really into it.
I mean, we really liked it.
And there were two other people, one would become a radiologist, the other an anesthesiologist. They just hated it.
So they left. I mean, they didn’t stay around to do it. there’s just the two of us for this one body. And he became, he’s like the, I think he’s the head of cardiothoracic surgery somewhere in LA at Cedars-Sinai. So, I even like that stuff. So, this whole time I’m thinking, I’m gonna be a psychiatrist. And then I did some research between my first and second year of medical school in psychiatry, which required me to be.

[19:34] In the psychiatric emergency room that there’s a big six-level psychiatric hospital at LA County.
Wow. And so, I was in the emergency room doing these surveys for one of the attendings who was studying the relationship between acute psychosis and menstruation.

[19:55] He eventually published this. His name is Dennis Munjack. He’s since passed away.
But Dr. Munjack and I were doing this study, and my job was to take a menstrual history after the psychiatric resident was finished doing their input exam to these floridly psychotic women who were coming into the emergency room.
It was really a learning experience. I learned a lot about the anti-psychotic drugs, but I can’t say much about what being a real psychiatrist is like.

[20:29] So then I started my second year and I’m thinking, I don’t know about the psychiatry stuff.
My first rotation was in psychiatry and my clinical third year and it was okay, but I really wasn’t very enthusiastic.
My second rotation was in neurosurgery and that was fantastic.
I mean, I just, I was really into it and at LA County, medical students got to do a fair amount.
I did that and then I did, I think my next rotation was OB-GYN.
I got to deliver about 30 babies on my own and that’s what third year medical students do at LA County in those days.
And then I did general surgery and that was a wild experience, as you might imagine, big county hospital, lots of trauma, lots of gunshot wounds, lots of stab wounds and I was just having the time of my life, it sounds crazy, but I loved it.
I was doing a cut down on an addict who didn’t have any veins and I didn’t know, but one of the residents was standing behind me or looking.

[21:34] Looking over my shoulder, he said, hey Lieberman, so what? He goes, you’re pretty good at that, you’ve got good hands.
Well, nobody has ever told me that before. I mean, I thought I didn’t know how good my hands or I didn’t know anything about it. You know, I thought, well, maybe I do have good hands.
He goes, yeah, you really do have good hands. That’s an important observation.
Yeah. And then I did, you know, I did ENT at LA County. You got to sew up all the facial lacerations and I really enjoyed that.
And then I decided when it came time to apply for internship, that’s what we did in those days. And I think you’re about the same age as me.
That’s right. But we applied for internships and you applied for either a rotating internship or a medicine internship or a surgical internship.
So I applied for a surgical rotating internship and I matched at Oregon, which was perfect, because it allowed me an out.
You know, it allowed me to, if I changed my mind about being a surgeon, I could maybe work in an ER or do something else.
In my fourth year, I did what was probably the best rotation of my entire medical school career.
And that was in pediatric surgery at LA Children’s Hospital.
And those were probably the best six weeks of my education period.
I was the only medical student.

[22:59] There were four senior residents And there were two, what they called super chiefs at that time, which would now be called fellows. And the fellows were, one guy was a guy that had just returned from Vietnam.
He was a surgeon in Vietnam.
And the other guy was a guy named Michael Harrison who was at UC San Francisco.
And Michael Harrison, I think he trained at Harvard. He did his residency at Harvard and then he came to do his pediatric surgery at LA Children’s.
And Michael Harrison probably has no idea who I am now to this day.
But he was really cool. I mean, the guy was brilliant.
He was the first one to do intrafetal surgery.
I think he put a percutaneous nephrostomy tube into a fetus with hydronephrosis.
He’s had quite a very good academic career at UC San Francisco.
However, that rotation was just amazing because there were six residents, including the two super chiefs and me.

[23:58] And there were 10 operating rooms. So, the first day of the rotation, they gave me this clipboard that had about 50 kids on it.
And they said, here, when you get done with all the scut work, which included putting little butterflies into neonates in the NICU and doing, gathering all the labs and getting ready to present on rounds.
When you get done with all the scut work, you can come down to the OR.
Well, it took me several days to figure out what to do, Good.
But after a couple of days, maybe a week or so, I was able to get down to the OR at 10 o’clock, 11 o’clock in the morning, and then I’d go from one room to one room and see which room didn’t have an assistant. And I’d go into the room and I’d introduce myself as the medical student, and I’d ask if I could scrub in. And frequently they would say, I mean, the attendings who had no assistants would say, sure. So I wound up getting to scrub in on an amazing number of various surgeries. You know, I would operate with urologists, operate with the ENT guys, I’d operate with the pediatric surgeons. And I have to say that the pediatric surgeons.

[25:06] To me, did the most interesting stuff. And I found it was a real challenge taking care of these sick babies in the NICU. I can’t describe what a great experience it was for me to be able to do that. It was a real privilege. I want to get you to talk in a little bit more detail about that, because you said something that I find fascinating, because it underscores something that I think is often overlooked. And that is, it sounds like on that fourth year rotation, you were surrounded by a really amazing group of house officers who, you know, I don’t I don’t wanna imply that they tried to make things easy for you, but they gave you some great opportunities to kind of step out there and do some things on your own and be responsible for some things.
And when you succeeded, they rewarded you with bringing you into some places that you might not have wandered into. Am I reading that correctly?
Absolutely, that is so absolutely correct.
And it turns out that the association with enthusiastic, responsible house officers was really critical in determining my…
Career. I mean, they were really influential. I certainly agree with you on that. And to me, it brings up something that I think is.

[26:36] Profoundly overlooked, and that is of all the endowed faculty members, and you see their statues in the hallways and things of that nature, and they’re these great teachers.
But I would say probably 60 or 70 or maybe even 80 percent of what I learned in medical school came from the house staff and it seems like you were having a similar kind of experience.
Yeah, yeah, exactly true. You know, and really, they’re not just good teachers, but they’re coaches. Absolutely. There’s a certain way I later learned in life that there are real differences in coaching strategies and coaching philosophies. You know, you can have the coach that beats up on people and degrades them and thinks that that’s going to make their players better.
And then there’s the other opposite coaching strategy that is more positive and more encouraging and more mentorship.
Yeah. Yeah. I think it’s being an example.

[27:38] You know, if we jump forward a little bit to my job as an attending and as a coach or or mentor for residents, urology residents.
At the same time, I was coaching soccer, and I coached fairly competitive girls’ soccer for about 12 years, and I became a member of this thing called Positive Coaching Alliance, which is based out of Stanford.
I’m one of the charter members, And there’s a very specific coaching philosophy.
And I found that the same way that I coached my kids playing soccer applied to how you coach a resident becoming a good doctor, a good urologist, and a good surgeon.
And I found that when the residents would come as fourth year residents to where I was working at Kaiser, and then they would go back to the university, And if they got involved with a mentor who was, let’s call him a negative coach and would berate them and make them feel inadequate, then when they came back to Kaiser, they would be like.

[28:42] What happened to you? I mean, you were decent. You could do this. What happened?
Dr. John Gallagher Yeah. Well, I think it’s an important conversation to have. And you’re right, we could probably do a four or five or six part discussion of that very thing. But I think it’s something that’s just profoundly overlooked because of what I was saying before. For all the talk about the endowed professors and what they do and that sort of thing, so much of the teaching comes from the house staff. But I want to move us along to the point where you made a decision about where it was going to be urology for you. Can you tell us about that?
Oh, sure. I went from LA County Hospital to Portland, Oregon and was an intern at Oregon Health Sciences University. Surgical rotating internship where we did eight months of surgery and surgical subspecialties, two months in the ER and two months of internal medicine.
And I had done an away rotation in Colorado at the University of Colorado or CU Colorado University in radiology because I was a skier at that time and I thought, well, radiologists don’t work that hard.
I’m going to go do radiology and it turned out that every day after like a two o’clock, I would put my skis in the car and drive up to the mountain and either cross-country ski or downhill ski for the afternoon.
And it was there that I met my girlfriend who became my wife.

[30:12] And we decided to move to Oregon together. So she and I moved to Oregon and she got a job at Nike and I was an intern.
And so before I left Colorado, those were the days when you applied for your residency while you were an intern.
Right. Remember that? Yeah, I do. So she wanted to go back to Colorado.
She said, let’s just be here for a year.
And then I wanna go back to Colorado where her family is. I said, all right.
So I applied for radiology in Colorado and got accepted.
And then after about two months of my internship, I told her, I said, you know, I really like it here.
I don’t want to go back to Colorado. I don’t want to be a radiologist.
So I’m going to tell them no.
So I called them up and said, I’m not coming.
I don’t want to be a radiologist.
So then I’m going through, well, I’m going to have to decide.
Pretty brave on two fronts. And I, you know, there’s one thing about making this big career decision for you, but how does your wife feel about that?
Well, she was enjoying Portland too and she had a really good job at Nike.
And she made a lot of friends and didn’t miss Colorado so much when I did make that decision.
She agreed to not go back to Colorado. We didn’t know where we were gonna go at the time, but she agreed that, okay, you don’t have to be a radiologist, that’s fine.
So it wasn’t as difficult as it might’ve been. No, no. No, no.
All right. So I continued to do my rotations and I felt, well, I gotta pick something.

[31:39] And so I thought, well, I’m gonna apply for ENT. So I applied for one residency at Stanford in ENT, and I went down there and interviewed and I got accepted.

[31:52] And then I came back and was doing my internship thinking, oh, okay, I’m all right with ENT.
And then I did ENT. And as you said, you know, the house staff can be very influential in your decision. And these guys were not very happy. And it didn’t seem like they liked ENT.
And I thought, well, if they don’t like it, how am I supposed to like it? And they were doing all all this microscopic surgery and I like big surgery. I mean, I like opening an abdomen and I like big surgery.
Right.
I thought, well, maybe I’m not really cut out for an ENT. So I called Stanford and I said, no, I’m not gonna come.
Sorry, I’m gonna do something else.
So then the rotation after ENT was neurosurgery. And I thought, well, neurosurgery, they operate on kids.
And I mean, they have, there’s pediatric neurosurgeons and I thought, well, maybe I’ll do that.
So, I talked to the chairman of the department. He said, yeah, we’ll take you if you want.
And then I had dinner with a bunch of the residents and they were sitting around saying, this specialty sucks.
All of our patients have back pain. We don’t get anybody better.
They either have back pain or they’re in a coma and operate on kids.
My God, these kids are so sad and all we do is put shunts in them and they were just miserable.
I thought, oh God, I can’t do that either.
So now I have like three months left in my internship.

[33:17] And I’ve already abandoned the idea of being a radiologist, ENT, neurosurgery, nope, not going to do any of that. I thought, well, maybe I’ll just work in an ER for a year and figure out what I want to, do. Or maybe I’ll do the Indian Health Service.
And so, my girlfriend, future wife, four years later, still is my wife, 40 years later, I said, you know, I think I’m going to do pediatric surgery.
She goes, oh, that’s fine. So I went to, there’s like three months left in my internship.
So I went to the chairman of general surgery, a guy by the name of William Kripain, who, was an incredibly nice man.
And I said, Dr. Kripain, I have no idea what I want to do, but I think I want to do something that has to do with pediatrics, probably pediatric surgery. I had this great experience at LA Children’s Hospital in pediatric surgery, and I think that’s what I want to do.
He goes, okay, you want to be a resident here? I said, I would very much like to. He says, okay, you’re in, starting in July. Wow. I said, okay. So, there I was, a general surgery resident.

[34:22] Signed up, ready to go. The last rotation of my internship was urology. I was two weeks into the month-long rotation and the residents were just great guys. I mean, they were really good guys.
They were hard workers, they were intelligent, they were excellent surgeons.
We did a lot of what I thought was really cool surgery, you know, retroperitoneal lymph node dissections for testis cancer, radical cystectomies.

[34:52] Weren’t doing many radical prostatectomies then, but even the turps, one of the residents was doing a turp and he goes, you know, this is so much fun.
It’s like doing underwater sculpture. sculpture. It’s an underwater sculpture. What you’re doing, you’re operating through some guy’s penis and you’re doing underwater sculpture. It all seemed very.

[35:13] Bizarre, but anyway, I was standing around one day after rounds and the chairman of the urology department, a guy by the name of Clarence V. Hodges, Clarence V. Hodges wrote paper with a guy named Charles Huggins in the early 1940s about the relationship between prostate cancer and malhormone testosterone. That work won Dr. Huggins. I knew I should remember that name.
He won the Nobel Prize in Medicine. So, Dr. Hodges was this renowned, incredibly respected, he’s like a grandfather person. And I got along with him really well. I got along with all the attendings really well. I got along with all the residents really well. So, one day I’m standing there after rounds, he goes, Lieberman, what are you doing next year? I said, general surgery. He He goes, where at?
I said, here. He goes, really?
I said, yeah. He goes, what do you want to do after that? I said, pediatric surgery. He goes, oh, great.
He goes, do you ever think about being a urologist?
I said, not really. He goes, you’d make a good urologist. Why don’t you think about it? I said, okay.

[36:25] He goes, I need to know by Monday.
I said, what? This was on a Friday. I said, you need to know what? He goes, I need to know whether or not you want to be a urology resident here. I said, oh my God, are you offering me a job?
He goes, I am. He goes, you can do your year of general surgery and then the year after, which was 1979 or 80, he goes, you can start your urology residency and you’ll be a junior resident with, there were three guys that would be my chief residents, Avery Seifert, Mike Kroger and Roger Wicklund, all three great guys.

[37:02] And we were sitting around the cafeteria table one night with the neurosurgery residents and these guys were arguing back and forth which was the best specialty, trying to convince me to do one or the other and the urologist won.
I came home, I called my future father-in-law, who is an anesthesiologist in Colorado, and I said, Jim, what do you think?
General surgery or urology? He goes, no question, you should be a urologist.
Their patients are happy, they are happy, they’ve got a great lifestyle, they do cool surgery.
Goes, the general surgeons work their butts off, they’re not happy, do urology.
So I said, okay. A lot of truth in that, and you just heard that from a retired general surgeon, so.
Yeah, I think. I’m impressed.
So, I wound up doing urology and it was the best thing I could have done. It was great.
Dr. Reilly Well, clearly, once you got firmly ensconced in your urology training, you felt like you were in the right place.
Dr. Miller Yeah.

[38:04] Dr. Reilly And you’ve done very well with it. Talk to us about where you focused your career both clinically and administratively during those years.
When I was a fourth-year resident, I wanted to stay in Portland.
My wife, I wasn’t married then, but she decided that she wanted to go to law school.

[38:25] So, she started law school at Lewis and Clark during my third year of residency and we both finished at the same time. She finished law school at the same time that I finished my residency.
And she was working at Nike and ultimately became an attorney at Nike, first female attorney at Nike. Wow.
And she had an amazing, I mean, we could talk about her job for an hour, but it was an amazing ride. I don’t know if you saw the movie Air.
Have you seen the movie Air? I have not.
I need to put it on the list. I’m getting way behind on my movies in my retirement. You think it’d be different. Yeah, but she she was right in the middle of all that that movie’s about Michael Jordan being signed to a.

[39:07] Deal with Nike, but she was squared in the middle She’s not in the movie, but she knows everybody in that movie and was right in the middle of it Anyway, she had a great job at Nike. I I wanted to stay in Portland, she wanted to stay in Portland, and I started looking around for a job during my fourth year.
And I was offered a job in private practice at a couple of private practice places.
I was, the people at the university were talking to me about coming back to the university and being on the staff there.
We rotated during our fourth year residency through both a private hospital, Emanuel Hospital in downtown Portland and Kaiser.
And so I went to Kaiser during my fourth year and I just thought this is kind of a neat way to provide medical care.
I really liked it. And the attendings again there were very influential in letting me do a whole lot of stuff.
And I loved doing a whole lot of stuff. And there were two Kaiser hospitals at that time.
One was downtown Portland, the other one was in the suburbs.
And the chief of urology at Kaiser in the suburb hospital called me and said, would you like to come help me do a nephrectomy?
And I said, sure. I had never met him before. And I went out there and he let me do the nephrectomy.
And he goes, at the end of the operation, he goes, Would you like to work here?

[40:31] I said, you know, I think I would. I think I’m very interested. Do you have a job? Yeah.
So, I thought, well, that’s what I’m going to do. I’m going to work at Kaiser.
And that’s where I started to work and worked there for 31 years.
Marshall Barber Talk a little bit about what it was about Kaiser that you found appealing.
Richard Diller Well, there wasn’t a lot of pressure to.

[40:53] Publish and to do clinical research, but I could still do it if I wanted. We had residents.
So I could still teach, which is something that I wanted.
And the lifestyle that it offered was appealing because we had just had, well, we weren’t married until I was there for a year or two, and then we got married, and then a year later, two years later, we had our first daughter, and then another two years later, we had our second daughter.
And so the lifestyle was appealing to me, and the way that they provided medical care without any financial burdens or incentives to do unnecessary surgery, just to be able to put my kids through college was appealing to me.
And there were, at the time, there were seven urologists. So I was only on call one out of every seventh weekend, and once every seventh night.
So that was appealing.
And the guy that hired me sat me down and said, Okay, you’re going to come work here.
What would you like to do?
I said, what do you mean? He goes, well, what kind of special interest do you have?
I said, well, I’d like to do all the big cancer cases. I’d like to do radical cystectomies.

[42:08] At the time we weren’t doing hardly any radical prostatectomies that later changed, significantly after PSA was produced in the mid 80s. But I said I’d like to do all the big stone surgeries. I want to learn how to do percutaneous nephrostomies. I want to learn how to do and I, want to do all the pediatric urology if I can. He goes you got it. I said I got what? He goes you got all of it. We’re tired. We don’t want to do any more radical surgery. You can do all all the cystectomies you want, you can do all the nephrectomies you want, you can do all the radical retroperitoneal lymph node dissections that you want.
We are tired.
You got it all.” I thought, wow. I was like a kid in a candy store. I thought, okay.

[42:51] I thought, I’ll do it. And so, I did and after, let’s see, I was there five years and then the same chief, Dr. Halpert, Lewis Halpert, who was like a second father to me, came up to me and said, how would you like to be chief? I said, really?
He goes, yeah, you can do my job, I’m tired, why don’t you be chief?
I said, oh, all right, if you want me to be chief, I’ll be chief.
So I was chief and I was chief from 1987 until 2012, at which time I thought I needed to retire.
So I turned that over to one of my other partners. And during that time as chief, I was able to hire probably 15 urologists.
So we had our pick of all the good residents and all the good applicants and we built a really great department, which is one thing that I’m probably very proud of.
And at the same time, my practice was a lot of cancer and a lot of stones and most pediatric urology until we hired a fellowship trained pediatric urologist about five years before I retired or six years before I retired.

[43:57] But I’d go up to the university and they shut down the pediatric service at our hospital, at the Kaiser Hospital, and we had to go up to the university to do big, you know, open pediatric urology.
But I had an awesome, really very interesting career.
Dr. Marshall Sounds like the timing was really very good in terms of urology in general.
Could actually potentially do curative operations on prostate cancer, which was a relatively new thing and uh…

[44:30] And you got to live those years until things began to be taken over by robotics and such as that.
Am I reading that correctly?
That’s correct. I mean, if you go through all the things that urologists do, the evolution of those things, for example, care of stones, the evolution is really remarkable with the development of ESWL, the development of endoscopic laser surgery, that that in and of itself is a fascinating story.
Same thing with PSA and prostate cancer, fascinating.

[45:06] Same thing with bladder cancer. I mean, we didn’t know what a neobladder was for 10-15 years into practice.
Nobody was doing neobladders, but I got to do that.
I got to learn that.
In fact, I was thinking of all the operations that I did as a resident, there weren’t many things aside from the circumcisions, the vasectomies and simple bladder tumors that were things that I did in practice.
So it’s a phenomenal evolution. Dr. Darrell Bock Something to be said for being in the right place at the right time.
Dr. Michael McBride Absolutely. Dr. Darrell Bock And you certainly seem to have hit it during the golden age.
What was your reaction to the arrival of robotics?
Well, robotics came around when I was 50, early 50s, and in my department there were 18 other urologists, and I thought I was at the time I was doing about two radical prostatectomies a week.

[46:02] That’s a lot. It was pretty busy. We were busy.
And, you know, there’s a whole story behind what the effect that PSA has had on the care, of prostate cancer patients, something that I’m really very interested in and have written quite a bit about, actually. Anyway, so I was doing a couple radical prostatectomies a week and the robot was there and I thought, oh, this is really pretty interesting, but I’m too old to do this.
Even though there was a part of me that said, I really want to do it. I just thought, no, I’m going to turn this over to other younger guys. And we had just interviewed a guy that had trained in robotics at Indiana University and we hired him. And so he and another younger.

[46:49] A guy that’s 15 years younger than me, I said, you guys take this on. And then there were two others who were interested, both younger. And I said, go down to California, learn how to do this, come back and we’ll start our own program up. And in the first year they did 400 robotic radical prostatectomies and they are now of course very good at it. They have two robots at one of the Kaiser hospitals and they’re great at it. And I think looking at the data, I think there are.

[47:20] Significant benefits to using the robot laparoscopically or doing an open prostatectomy or even a straight laparoscopic prostatectomy.
Dr. Marshall So it would seem, and interestingly the language that you used to describe that, I’m not sure if the words that you used was, I wasn’t very good at it, but I think you would probably admit that when you did your very first radical prostatectomy that you probably were not so good at it either. But in a relatively short period of time, the skills began to accumulate, and that’s what you had. You know, that was what your three decades or so in practice gave you.
And then at the time the robot arrived, you had people who hadn’t really developed their skills to any degree to speak of. And there was something new for them to work with. So, it kind of worked out well for everybody, don’t you think?
Dr. Kelly Yeah, it did. When the robot came around, it was also the same time that cryoablation of the prostate was being done. I thought, I could learn how to do that. So I did.
Well, let’s talk a little bit about retirement. How do you make that decision?
Well, that’s when you work at Kaiser, there’s two retirement programs and one of them is like a defined contribution and the other one’s like a pension.

[48:38] And there’s an age at which you’ve been there a certain number of years. There’s this rule of 80 where if you’re there, your age plus number of years over 80, you can retire with full retirement benefits. So, I reached the rule of 80 at age 60 and then they give you this.

[48:57] Spreadsheet that has how much money you’re going to get at retirement according to your age and how many years you’ve been there. So, I just looked at the spreadsheet and I thought, That’s the maximum amount of money I’m going to get. So that’s what I’m going to retire.
So it’s just a matter of doing the math.
Yeah. And so that I said, I’m going to be 62. And if I retire when I’m 62, I’ll have time to enjoy my life and play golf.
And at the same time, I thought I was going to go back to work.
I said, I’m going to retire, and then I’m going to go back to work at 50%.
And they had this rule where after you retired, you had to sit out for several months before they would rehire you back.
But a lot of guys did it.
They would retire, they’d come back and work as a local tenants for like 50%.

[49:47] So one of my partners and my very good friend who we had grown up together in Kaiser, we decided he’s the same age as me and we decided to retire at the same time.
And then we were going to come back and job share 50%. And I was telling all my patients, I said, you know, I’m going to retire in March, but I’m coming back in August and I’ll be happy to see you until I stop altogether and we’ll kind of get things wrapped up and transfer you over to another urologist.
And I wasn’t planning on doing any surgery other than outpatient stuff and vasectomies.
And so I had this all arranged when I decided to retire because I was still the boss at that time and I could do that.
I could arrange it. And a year before I retired, we got a new medical director and he came up to me at a chiefs meeting and said, I can’t believe you’re going to retire.
You’re too young. I said, no, I looked at the numbers and I’m going to retire.
He goes, well, what are you going to do?
I said, well, I’m going to play golf. He goes, you can’t play golf every day.
I said, watch me. And he said, well, I really don’t want you to retire.
I said, well, I really do want to retire. So I’m going to retire.
And he said, well, why don’t you come do my job?
I said, no way in a million dollars a year would I do your job.
I don’t want to do your job. I want to retire, and then I want to come back and work.

[51:10] At part-time and kind of phase out and he said I’m not gonna let you do that. I said why not?
He goes because I want to downsize your department. I said you’re going to downsize our department from 18 to 16? He goes yeah. I said you’re going to kill those guys that are left behind.
I said you’re not going to survive. You’re going to and so that’s what he did. He said I’m not going to rehire you. When I came home and told my wife he’s not going to rehire me he said okay, we’re out of here. We’re going to go find some place warm in the winter because I’m tired of Portland rain. I said, okay. So, he didn’t rehire me. He didn’t rehire my partner who wanted to come back and work also. And I retired in March and I started writing because the weather was bad in Portland and we hadn’t decided where we’re going to go in the winter. And so, I wrote this thing which was designed to be a shared decision-making manual for patients with newly diagnosed prostate cancer and I found that I enjoyed writing. I had about 80 pages and I presented it to one of my old buddies who was the chief of urology in Southern California Kaiser.

[52:22] And I said this is something that I wrote for patients to be given to them after they’ve received the diagnosis of prostate cancer after their biopsy and it’s going to save urologists untold amount of time.
And it’s something that we can all agree on. And so, when I would make a diagnosis of prostate cancer in somebody, I would, you know, spend an hour with them going over the stage and the grade and the anatomy and the options and the risks and the complicated.
And to do that, it requires a full hour.
So I thought, I’m just going to write this down.

[52:57] And so, they can give it to the patient, say, here, go home and read this.
Come back in two weeks, we’ll talk about what you’re going to do.
And so they had some common ground for having this so-called shared decision-making conversation.
So I wrote it and presented it. And Kaiser in Oakland, the national Kaiser people liked it.
And they said, we want to buy this from you. We’ll buy the licensing and the copyright from you.
And we’re going to change it so that it’s understandable for people with an eighth grade education. I said, great. I mean, that’s what I wrote for.
So they said, we’ll also illustrate it. I said, even better.
So they did, they bought it, and a copywriter and I worked on this thing until it was ready to go.
And then I had this idea, I said, I’m going to write a script for a 20 minute video, so, that we can give them a DVD, and they can watch a condensed version of this thing, because a lot of people aren’t going to read 50, it turned out to be 55 pages.
Well, I wrote the script, I sent them the script, they liked the script.
And I went down, they hired an actor.

[54:03] I went down to L.A. and they have a multimedia center at Kaiser in Pasadena.
And we made this 20-minute video on what to do if you’re diagnosed with prostate cancer.
It’s called Action Plans Prostate Cancer Choosing the Right Treatment for You.
So they published this manual, this booklet, and they made DVDs and urologists, Kaiser, urologists all over the country.
Which serves eight million people. They started giving this thing to their patients with newly diagnosed prostate cancer.
It went over really, really well, I think. Apparently they’re still using it.
They had me write a revision update in 2020 right before the pandemic started, which I did.
And they put that, it’s now on the internet. You can see it on the internet at kpactionplans.org.
But they’re still using it.
And in fact, one of my neighbors, who’s a radiation oncologist, came by.
He’s a new neighbor, he knocked on my door, and he goes, hi, I’m so-and-so.
I said, I’m Steve Lieber.
And he goes, you’re the guy that wrote Action Plan.

[55:04] I said, who are you? He goes, I’m a radiation oncologist at Kaiser, and we use it all the time. I said, great.
So anyway, I did that, and then my wife and I went on a road trip in April, looking for a warm place to become snowbirds.
And we went to Mexico, and we went to San Diego and Sonoma, California, Phoenix, Palm Springs, Tucson. We wound up in buying a place in Phoenix, north of Phoenix, and that’s where we spend our winters from about end of October until May. Good place to be.
It was. It was at the time that I retired, I was seriously considering trying to become a better golfer than I was at the time. And so, I really set my mind to being in a place where I could play golf every day. So, we moved into this golf community of about, I think there’s 3,000 houses and two golf courses and very active men’s club. And I wound up playing competitive golf before the pandemic and I was in the men’s club had a competition twice a week and there was there’s.

[56:16] A group that you can play in every day in a money game there so I did that and I played in the Southwest seniors and the Arizona seniors and anyone when the pandemic came much of that went away yeah after about a year of retirement I found out about Maven and I started working volunteering at MAVEN. Yeah, and that’s something that I really want to know more about, so I’m glad that you brought us to that. So tell us about the MAVEN project. Well, you’ve interviewed Jill Eisenberg, or Einstein. Yep. And you’ve interviewed Scott Abramson. Yep. And you’ve interviewed Loanne Nguyen. They’re all MAVEN colleagues of mine. MAVEN stands for Medical Advice Volunteer Expert Network. MAVEN, based in San Francisco, was started at UC San Francisco. I found out about it at a retirement physicians meeting. And I said, if you’re looking for volunteer opportunities, this is an interesting thing. And so I called them and applied and got accepted and started doing urology consults. And what MAVEN is, is it’s a nonprofit organization that serves serves over 300 clinics in the United States in over 20 states.
And the people in these clinics that MAVEN serves are all primary care clinicians.

[57:34] There are internists, family practitioners, nurse practitioners, and physician’s assistants.
And whenever they have a question of a specialist, whether it be urology, dermatology, psychiatry, They have, I think, over 50, maybe even over 100 specialists on their staff, all volunteers.
So whenever these primary care people have a question or a consult that they need, they’ll send us the consult on this platform.
And I get a message on my phone, says you have a MAVEN consult.

[58:14] I go to my computer and see what the consult’s about. I’ll spend anywhere from 15 minutes to a half hour addressing the concerns or the questions, and then I send it back to them. And it’s been a, incredibly, it’s an incredibly great and interesting way to provide specialty consultation to these patients and providers who otherwise have no.

[58:39] Access to such information or care. A brilliant idea and I just have to imagine that it’s been quite rewarding for you to be able to continue to take advantage of your skill and your knowledge and help in a way like that.
It has. It forces me to keep up to date. It forces me to stay interested and it also has provided another source of inspiration for me And that involves talking about my books.
I don’t know if you want to talk about my books. Well, I was just about to say you’ve got two additional books that I want to hear about.
Interestingly, one for the men and one for the women. So do fill us in on that.
Okay, happy for the opportunity. So here I am in Arizona playing golf every day and working for Maven.
The golfers that I play with find out that I’m a urologist and they all got questions.
They all got issues. I bet they do.
And most of their issues, I think, center around the prostate, but some have questions about stones.
Some have had urinary tract infections. Some have had hematuria.
Some of them have had other related problems.

[59:57] And so during this process, the community finds out that I know a fair amount about prostate cancer.
And so I get calls from these guys who I didn’t know, and they said, hey, I just got diagnosed with prostate cancer, can I buy you a beer?
I don’t know what to do.
Wow. So I’d send them the thing that I wrote for Kaiser, and I’d sit down and have a beer with them.
I’d say, make sure you come with your path report and any relevant x-rays if you have copies, and so they did.
And I did that several times with people.

[1:00:31] And I would also be doing Maven consults. And a lot of the things centered around PSA questions.
One, I remember I was playing golf with a guy who was very high up in the military. He was an admiral.
He had a very important job during the Vietnam War, commandeering a ship.
Great guy, very intelligent, great golfer.
And one day we were playing and I was riding in the cart with him And he said, hey, I just got my PSA back.
I said, yeah, what was it?
So it was 5.4.
I said, oh, how old are you? He said, I’m 70. I said, have you had PSA before?
Oh yeah, I’ve had tons of them. They used to do them in the Navy once a year since I was 48 years old.
I said, great, what was it before? goes, Oh, it hasn’t changed at all.
I said, oh my goodness. I said, have you ever been biopsied? He said, no. I said.

[1:01:29] Who’s your urologist? He said, oh, this guy trained at USC as a matter of fact. I said, well, you mind if I call him? He kept saying, no, my doctor says I don’t need a biopsy.
He says there’s nothing on rectal exam. I said, well, mind if I call him? Because I really want to know why he doesn’t want to biopsy you.
So he goes, I’ll do you one better. I’ll send you a record of all my PSAs from when I was 48 years old. So the next day, in my email inbox, I see this note from him. And I’m looking at all these PSAs, you know, all 22 of them. And 0.1, 0.25, 1.4, nothing over 2. I’m looking for 0.54. So I thought, well, maybe he meant 0.54 and he told me 5.4. I don’t see anything 0.54. So I went back and I said, Hey, I thought you said your PSA was 5.4. He wrote me back and he goes, Oh, I’m really sorry. I apologize. That wasn’t my PSA. That was my hemoglobin A1c.
Oh my God. So with that, you know, and I had lots of other questions from both Maven and other people in the community. The fact of the matter is it prompted me to write another thing.
And so I wrote, should I get a PSA?
And that became one of the chapters in the man’s book.

[1:02:50] And then I thought, with all the questions I’m getting from these people, I’m gonna write a book called Urology for Dummies or Urology for Idiots.
And I made an outline. I made an outline and I sent it to my old chairman Urology at Oregon Health Science University. John Berry.
And he wrote back and said, good idea. That was it, good idea.
I had nothing written.
And so I thought, well, what am I gonna do? And so I started talking to people about how to write a book.
And I talked to a couple of agents and they said, we don’t wanna talk to you until you write the book, write the book first.
So then I started writing and I had read a chapter on hematuria.
I’d write a chapter on stones. I’d write a chapter on something.
It was really like a hobby.
I really thought, there’s no way I’m gonna write a book. I don’t have the energy to do that.
And besides, I like playing golf too much.
So I would write a chapter. And then when I’d get a consult from one of these Maven people on say, hematuria, I just send them the chapter that I’d written.
Say here, this will give you a little more information in case you’re interested.
Or if they had a PSA question, I’d say here, here’s a chapter on PSA.

[1:04:01] No intention of writing a book. Well, then the pandemic came.
Thought, hmm, maybe I really should write a book. And so, when the pandemic came and I had more time, I started writing in earnest. And by about two years ago, I would say, I had about 400 pages of stuff of content and 80 illustrations. And I thought, well, what am I going to do with this? I had no idea what to do with it. And so, my brother’s girlfriend, My brother’s wife died about five years ago from a horrible adenocarcinoma of unknown primary, but.

[1:04:39] He’s got a new girlfriend. The girlfriend is a writer and producer. And I was talking to her, and she goes, there’s this woman at Stanford who I just took a course from on self-publishing, why don’t you call her? And she’ll help you figure out what to do with all your stuff.
So, I called this person, Holly Brady is her name, and she wrote me back and said, I don’t have time for you. So I wrote her back and I said, look, you come so highly recommended by Victoria. I really would like to hear from you.
To just pick your brain for 15 minutes. So she wrote me back and said, well, call me during office hours on Wednesday. So I did, and we had about a 90-minute conversation, which was fantastic. And she turned me onto this website that was like a clearinghouse for book agents and publishers and writers, copywriters, editors, all this stuff. So I go to this website.

[1:05:34] And it was, they had a search field, I searched self-help medical books.
I got a list of all these people that do self-help medical books.
I wrote emails to about 15 of them.
Eight wrote me back, I picked out three, I interviewed three.
One of them had had a nephrectomy for renal cell carcinoma and she was very interested.
Another one had a father who refused having a cystectomy for invasive bladder cancer and wound up dying from bladder cancer. So she had an interest. Well, I wound up working with her and she was a copywriter and she says, I think you really have something here. And she goes, but you have too much content and we got to really narrow it down. Who is your audience? I said, well, my audience are, patients with urologic problems, and primary care.
Clinicians who are taking care of these patients so that they can have an informed shared decision making conversation of whatever it is that’s bothering them. So, she and I spent a year.

[1:06:36] Writing two manuscripts that became, she said, why don’t you just pick one of those audiences? I said, okay, lay people, patients. She goes, okay, let’s make two books, one for men and one for women. I said, okay. So, we wound up writing two manuscripts, and then I had no idea what to do with manuscripts, which is, it was a whole process that I had no idea about how to go about, about how to do it. And so, actually, LoAnne Nguyen, who you’ve interviewed, and one of her.

[1:07:08] Colleagues, Barbie Loeb, they had published a narrative medical writing book and published it on Amazon KDP. And they were incredibly helpful in pointing me in the right direction and how to turn these two manuscripts into two self-published books, which I did. And they were published on Amazon in April. Oh, just recently then? Yeah, man. It’s been an eight-year process.
Yeah. And I’m going to guess particularly the one that was aimed toward the male population is probably very popular, and maybe both of them. What’s the score at this point, I guess, is the right way to answer that, ask that question?
David Kramer Do you know, I don’t know how popular they are. That’s not really the first important thing on my list of things. My main goal at this time is to provide the primary care clinicians in the Maven clinics with a copy of each book.

[1:08:10] And so, Jill Einstein and the people at Maven have just written a grant to purchase the books at my cost, so I don’t make any royalties on it at all. In fact, I just got my first royalty check and it was for $64. I don’t know how many books do you need to sell to do the royalty checks. I’ve been buying them at my cost and giving them away, sending them to people. In fact, I’ll send you a couple copies if you want.
I would love to see both of them as a matter of fact, but this, I mean, totally apart from any potential monetary gain, it sounds like this was a very self-rewarding, self-satisfying thing for you to do. Am I reading that correctly?

[1:08:59] Yeah, it was. It was rewarding. It was rewarding when I get feedback from people, other urologists, and other doctors who say, hey, it’s really pretty good. It’s very readable, I can understand it, and the illustrations are great. So that’s rewarding.
Dr. Darrell Bock And the titles are very, they look like they came from a urologist, which I find most of the urologists that I’ve known.

[1:09:27] Stone, are rather humorous people, and you have a curious man’s guide to urology, sex, stones, prostate, woes, and more.
And you have a curious woman’s guide to urology, UTIs, wet pants, stones, and more.
And let’s face it, if you live long enough, there’s a good chance that you’re going to have a big interest in those things that you just named there.
And you’ve put it into a form that sounds like it’s very accessible, I unfortunately have not had time to do enough research to take a look at them, but I’m very interested in seeing them.
It sounds like… Steve I would love to send you a couple of copies.
Dr. Marshall Well, I will look forward to it.
Well, you know what, Steve, I really enjoyed this conversation, but I think what I ought do at this point is give you an opportunity to talk about what’s on your mind. So I’m going to close my mic and Dr. Steven Lieberman is going to give us his personal prescriptions for success.
Okay, here goes. Be curious, be honest, be honest with yourself, be honest with your patients, your partners, and most importantly, be honest with the team of people who help you take care of patience. Be honest about your mistakes. But you’re human. You’re going to make mistakes.

[1:10:49] Learn from them, forgive yourself, and then move on. Be kind.
Be kind to yourself. Otherwise, it’ll be hard for you to be kind to others. Be passionate about something.
Usually, you’re good at what you are passionate about.
So enjoy the passion, share it, grow from it.

[1:11:08] Be willing to keep an open mind and try to see things from a different perspective, perspective, even if you may not agree. In medicine, you may often be sleep deprived, food deprived, time deprived, relaxation deprived. I often thought that I had five dog leashes tied around my neck being pulled in five different, directions, and it’s hard being compassionate and empathetic under those circumstances.
But, and this is a big but, try to find time to take care of yourself because it’ll pay dividends down the road. If you think something doesn’t sound or feel right, investigate. Get data. Slow down and analyze the situation in the data. If it still doesn’t seem right, don’t hesitate to speak out. I used to tell our residents that if you’re taking up the awesome responsibility and and privilege of doing surgery on another human being.
You damn well better be prepared or else I’m not going to let you do the operation.
The last one is sometimes difficult, but be persistent, but yet patient. Rather than being deflated and disappointed, don’t abandon your goals. Learn success from failure.

[1:12:17] Learn empathy from sorrow. We all know how hard it is, but be patient and persist.
I’d like to conclude by talking about a podcast I listen to called the Ezra Klein Show by Ezra Klein, who is a columnist for the New York Times. He ends each episode by asking three of his guests three books that they would recommend. And I’ve gotten some great book recommendations from this very diverse group of guests. And although these aren’t the three best books I’ve read in the past couple of years, because I mainly read fiction, and these books are nonfiction, I would like to recommend three books that I think are extremely important for anybody taking care of other people in the field of medicine especially.
One book is called Why We Sleep by Matthew Walker. Matthew Walker is a PhD in psychology who works at the University of California at Berkeley and he’s a sleep expert.
The book is fascinating and very important. important in fact that I sent each one of my daughters a copy of the book with, a note saying put whatever you’re reading down and read this first. The second book is called The Code Breaker Jennifer Doudna gene editing in the future of human race by Walter Isaacson. Jennifer Doudna and Emmanuel Carpentier won the Nobel Prize in chemistry in 2020 for their work on.

[1:13:43] CRISPR technology. The book again is fascinating and is a great read and the.

[1:13:48] Last book is a book called Sapiens, A Brief History of Humankind by Yuval Harari.
And that book is just incredible, an incredible piece of work, and just a joy to read.
And that’s all I got to say.
Thank you very much for having me on. I really enjoyed it and appreciate the opportunity.
Well, thank you very much for your thoughts. There’s so much wisdom there.
Be curious, be honest, be kind, be passionate, and keep an open mind.
I mean, you could, those are some rules to live by.
And I’m particularly interested in those books that you’ve offered.
So I thank you for the little bibliography, Sapiens, I actually have read, and I’m definitely going to look into the others as well.
This has been a lot of fun. Before we go, I want to give you the opportunity to tell our audience where they can find you or more about you.
So you want to offer websites, email addresses, or whatever you have to offer.
Richard D. Harris I was told that when I wrote the books I needed a website, so I developed a website.
The website is stevenliebermanmd.com, so stevenliebermanmd.com.

[1:15:12] And on the website is an email address, which is stephen, S-T-E-P-H-E-N, at stephenliebermanmd.
And there’s a lot on the website, including a video of me explaining prostate anatomy.

[1:15:29] Which is kind of, it’s fun for me to do it.
Anyway, there’s a video on the website.
Dr. Steven Lieberman, thank you so much for being with us today on Prescriptions for Success.
Thank you very much, Randy. I really enjoyed it.

[1:15:45] Thank you so much for listening today. If you enjoyed the show, you can help us reach more listeners by leaving a rating and a review, especially on Spotify or Apple Podcasts.
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And remember, be sure to fill your prescription for success with my next episode.

[1:16:36] Music.