Dr. Sanjay Gupta: ‘Trying to Promote Empathy Through Clarity’

Is Sanjay Gupta, M.D., a doctor or a journalist? As Gupta made clear during a conversation with APA President Theresa M. Miskimen Rivera, M.D., during yesterday morning’s Opening Session, he’s very much both—a practicing neurosurgeon and chief medical correspondent for CNN. And he has thoughts about how the two roles inform one another. Here are five key takeaways from his remarks:

1. Neurology and psychiatry: “I’m a neurosurgeon, and so my career has been based on very specific areas of brain health. And I have felt for a long time that the conversations between neuroscientists, psychiatrists—they need to be strengthened in so many ways. There’s so many shared interests, and throughout my career those have become increasingly clear to me. I started to report more on that and think more about that. So, I am delighted and honored to be here.”

2. A doctor on TV: “One of the things that I think goes without saying is that you have to know what you’re talking about, which I realize may sound like a very obvious thing, but to be quite candid, there’s a lot of people who get on television and talk about these topics who don’t always know necessarily what they’re talking about. Even for me, if we’re reporting on topics in psychiatry, for example, we’re seeking out people who are knowledgeable in these areas and can talk about these things in a really clear way. To just give some context, if we’re doing even a five-minute television segment, we might spend days if not weeks preparing for that. It is a question of making sure every word has purpose. We don’t want to waste the viewer’s time.

“The second thing is, I think what surprises people a lot about medicine in general, is that there are absolutes within this field, but we work in a field that [also] has inherent uncertainty in it. Instead of trying to retrofit certainty onto it—because that just would be the easy thing to do—to lean into the uncertainty and to make people understand uncertainty and understand risk, which is challenging, requires nuance. It’s the hard work of reporting, as opposed to the easy work of social media, where accuracy gets downgraded, whereas accessibility, speed, and engagement get upgraded, and that can sometimes make a very dangerous combination.

“The final thing probably happens to you as well. When I’m seeing patients in the office, I think every visit ends with some version of the same question, which is, what would you do if this were your mom, if this were your daughter, or your husband? What would you do? And I actually think it’s a very fair question, because it’s causing you to not only reflect upon the literature that’s out there but also your judgment, your years of experience, and trying to promote empathy through clarity. When I’m doing television, I’m thinking that somebody is asking themselves, so what do I do with all this? You’ve just given me a lot of information, but how do you actually transform that information into something actionable?”

3. The physician-patient relationship: “It is the most sacred relationship in society. I mean, it’s part of the reason I continue to practice medicine. There is no other relationship like the patient-physician relationship in all of society. You may not even know your patient, but in that moment, you are the most important person in their life. It’s a sacred relationship, and to always lean into that, be humble about it, never arrogant—that really engenders a lot of trust.

“One thing we saw during the pandemic—and even before the pandemic—was that clinicians and scientists were increasingly being perceived as arrogant, as too didactic, as hierarchical, talking down. Obviously, I don’t like that. I’m sure you don’t like that as well. It’s not something I think anybody in this room aspires to, and yet it’s an important note that that was happening, and I think we all have the capacity to restore the faith in our profession.”

4. Artificial intelligence: “The headline is, I’m pretty bullish on it. Like most things in life, it comes with some caveats. I think in terms of what it’s doing already in terms of accelerating clinical research. I see my residents as they’re walking into patient rooms talking to AI platforms—you know, ‘At what point can I restart anticoagulation after a patient’s had a meningioma removed?’—and it’s looking at all this data from all these sources all over the world and arriving at the best conclusions for those patients.

“There were a couple things that surprised us when we really started to look at this data. If you look at a new technology and you say, what is it really doing for the clinician? What are they really getting out of it? ‘Well, we’re using scribes, we’re using all these agents now in the clinics. It’s going to save time and it’s going to improve efficiency.’ But when you really measure those things, at least in some of these early studies, it doesn’t necessarily seem to do that. People are not necessarily saving that much time, and part of the problem may be just like when we started using phones, we thought those were going to save us time, but instead we’re interacting with the technology a lot. At the same time, clinicians generally like having the AI scribe, and I think part of the reason is not so much a time or efficiency savings as it is what they call ‘cognitive burden’ savings. It’s like having an adjunct alongside you, somebody that you can depend on in a trust-but-verify model.

“Ultimately, what is the objective when you’re using AI? What are you really hoping to get out of it? I think anybody who’s starting to incorporate this into their practice needs to ask that question, and that's aside from the potential caveats of using it.”

5. Platforms of truth: “There’s starting to be an indication that, in a world of AI where people are increasingly unable to trust even the most basic facts, content will become more important. A very smart marketing person for [CNN] said, ‘You know what is wild now is that, let’s say it’s clearly raining outside. You could have some people who say, “It’s terrible that it’s raining outside, it’s going to flood the streets. I hate the rain.” And you have another group of people who say, “No, the rain is wonderful, it’s going to help water the plants and you get beautiful flowers.” You now have a not-insignificant segment of the population who simply says, “It’s not raining outside.” That's problematic.’

“When I grew up, we had platforms of truth. We may have had disagreements, but there were things that we could say, ‘Well, this is true, and now we can work together.’ You may have had different conclusions based on those facts, but the actual facts—those were agreed upon. We don’t have that right now, and I think you’re starting to see an increasing unease with that, especially among younger people. What happens to a generation of people who grow up without a platform of truth? They don’t want that, and I think that is makes your role that much more important. You’ve got to continue presenting that truth to people. What they do with it, that could be a different conversation, but at least they know the facts, and those facts are really, really important.” ■