Choosing Happiness

“The Doctor’s Art” is a weekly podcast that explores what makes medicine meaningful, featuring profiles and stories from clinicians, patients, educators, leaders, and others working in healthcare. Listen and subscribe on Apple, Spotify, Amazon, Google, Stitcher, and Podchaser.

In 2015, New York Times journalist John Leland set out to follow the lives of six people over the age of 85. What Leland learned shattered his preconceived notions about aging, loneliness, and loss. The resulting 2018 book, Happiness Is a Choice You Make, became an international bestseller and delved into how these older individuals found wisdom and joy in the later stages of life.

In this episode, Leland joins Henry Bair and Tyler Johnson, MD, to discuss the lessons on living well he learned from his subjects.

In this episode, you will hear about:

• 1:41 How a college music reviewer came to write for the New York Times
• 5:04 How Leland’s exploration of aging began when he was initially — reluctantly — assigned to write a series of articles on old age and retirement
• 9:01 Reflections on how Leland’s expectations of aging — including loss, sadness, and loneliness — were transformed over the course of this writing project
• 11:38 How Leland discovers his interview subjects
• 14:44 A discussion of Leland’s book, Happiness Is a Choice You Make, and the lessons he learned from his subjects
• 26:19 Advice to young clinicians on finding moments of happiness in their careers
• 33:53 Leland’s surprising realization that elders are not “depressed all the time”
• 36:53 A discussion of Leland’s recent article, in which he documents the last days of Shatzi Weisberger, a nurse and prominent death educator
• 40:07 Reflections on how Leland’s relationships with older adults have changed his perception of death
• 45:03 Advice to clinicians on how they can better help older patients connect with what makes their lives meaningful

Following is a partial transcript (note errors are possible):

Bair: Virtually all of the guests we’ve had on the podcast are involved in the medical field in some capacity. You, however, are not. So can you tell us how you found your calling in journalism and how you became a reporter at the New York Times?

Leland: Well, I think most of us come here by entirely different passages. When I was in college, I loved music and I started writing about music for my college paper. And from there, some of the people I wrote for in the college paper went on to write for rock & roll magazines. And so I got into journalism sort of through a back door, and I got into it just by writing.

After a while, the Peter Pan syndrome set in. I didn’t want to be the old guy in the club anymore, so I just started to branch out a little bit and write about other topics, and I became an editor at Newsweek. At the end of the last century, I sort of took a more general approach to what I was doing. And so from there, since 2015 or so, I’ve been somewhat focusing on the lives of older adults. And that’s a little bit of what brought me to the stories that we’ll talk about today.

Johnson: So let me back up before we get to those stories, which we are going to talk about here in a moment. Can you just tell us — you know, I think that for many people who are in college or in medical school, certainly I know this was true in my medical school and is true where I work, at Stanford — now, the New York Times is the place to go, right? I mean, all the news that’s fit to print. But I think a lot of people look at it, you know, it’s called the “paper of record” and it’s supposed to be unassailable in its reporting of the facts and all of that. And so I guess I’m just curious, what is it like to be on the inside there? What’s it like to be behind the curtain and be one of the people who is engaging in an enterprise that I think many people consider to be so important?

Leland: I imagine it’s a bit like being at Stanford or being at Stanford Medical School — you get to be around the smartest people you could hope to be around and to be working with and to get the assistance from. I think one of the things that might surprise people about the Times is that it’s a very collegial place. We get along really well.

If I want to know something about housing in New York City, I can go to our housing expert who will know everything there is to know about housing. If I want to know something about the New York City Police Department, I can go to one of our police reporters who will know everything there is about police. And the same way you might go to someone in the history department and say, you know, “What do I need to know about Precambrian medical rituals?” And someone will say, “Well, here’s my book on it.” And so it’s a little bit like that.

Johnson: Yeah, it is funny that you mention it being collegial because I have this, I’m sure what’s a very tired stereotypical view, but of, I don’t know, editors running around with their ties barely loose and yelling at reporters to get their things in by the deadline. And I don’t know, something which probably has no resemblance to reality at all.

Leland: And there’s a ticker tape machine running in the background, right?

Johnson: Exactly. It’s like “All the President’s Men” all the time or something. That’s sort of the image that I have in my mind.

Leland: Yeah, we look more like the modern cubicle factory than that, right?

Johnson: And, of course, all of it is on print all the time, right? The internet doesn’t exist in my rosy-colored view of how a newspaper works. So let’s talk then about, well, the specific article that brought you to our attention, but also more broadly, this sort of focus that you have had over the last number of years on the lives of older adults. Tell us a little bit about both — you started to mention this before — but tell us a little bit about what brought you to that work and then tell us a little bit about sort of what exactly you have done in that space, what your experience has been like.

Leland: I kind of got roped into writing about older adults. Again, I wasn’t expecting to do this. I was, we were starting a kind of pilot project and we were going to have two reporters that were going to do it. We’re going to cover a couple of mini beats for 6 months or so.

Me and another colleague were the first writers in this, and they said, “What do you want to write about?” And I said, “Well, I want to write about gay life and the creative class.” And they said, “Great. You write about religion and retirement.” So. They weren’t the topics that were what I was dying to write about.

But I found that writing about retirement, I started off writing the stories about the kind of men in their 60s who don’t know what their identity is going to be when they leave their jobs. And they were interesting stories to do. But I gradually started to write about older people and under that beat, and I found that it was tremendously helpful because we’re all going to be old, we hope, and also tremendously informative and moving because the stories about older adults, people in their 80s, 90s, they kind of get to the emotional core right away.

When you’re talking to somebody in their 80s and 90s, when you’re talking to somebody who is the child of somebody in their 80s or 90s, you get to the emotional truth about life kind of right away. Some of the filters are gone. Some of the people don’t give a damn what you think about them in ways that they might have when they were younger. And I use that because somebody did something I did and said my life improved when I stopped giving a damn what people think about me. A woman in her 70s or 80s, I think it was in a computer course. So as a journalist, that’s just fantastic. People will invite you into this emotional heart of their lives pretty quickly in ways that they don’t always with younger people.

For the full transcript, visit The Doctor’s Art.

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