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We welcome Jennifer Obel, an oncology physician, who shares her personal journey of retiring from a fulfilling medical career due to Ehlers-Danlos Syndrome. Reflecting on the recent presidential debate and the health concerns surrounding President Biden, Jennifer draws compelling parallels between her experience and the challenges faced by leaders in the public eye. We delve into the importance of transparency and accountability in assessing the health of political figures, the implications for national security and public trust, and the balance between personal health and public responsibility. Jennifer’s insights offer a unique perspective on the intersection of medicine, leadership, and the difficult choices that come with chronic illness.

Jennifer Obel is an oncology physician.

She discusses the KevinMD article, “My body’s decline forced me to leave my job. Joe Biden needs to do the same.”

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Transcript

Kevin Pho: Hi, welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Jennifer Obel. She’s an oncologist. Today’s KevinMD article is “My body’s decline forced me to leave my job. Joe Biden needs to do the same.” Jennifer, welcome to the show.

Jennifer Obel: Thank you so much, Kevin, and it’s an honor to be here.

Kevin Pho: So let’s start by briefly sharing your story and journey.

Jennifer Obel: I was trained at Northwestern and University of Chicago and developed an expertise in GI malignancies. And from that, I became very interested in quality of life near the end of life. And my research focused on talking to patients about their goals when trying to make end-of-life decisions. And I developed resident curriculums to teach them how to do that. And I investigated how specialties approach end-of-life care. And that was really my passion and love in oncology. It was really about the ethics of end-of-life treatment.

Kevin Pho: All right. And you graciously wrote this KevinMD article a few days ago and I published it, and we are now talking on Friday, July 19th. As we know, President Biden is under tremendous pressure from the Democratic Party to withdraw his nomination. Your KevinMD article is titled “My body’s decline forced me to leave my job. Joe Biden needs to do the same.” For those who didn’t get a chance to read your article, tell us what it’s about.

Jennifer Obel: I was very passionate about my career. It was a big part of my identity and my life. And it’s what I thought about all the time.

I had some neck pain and underwent a cervical fusion, which was in retrospect not the right treatment. And when I was trying to go back to work, I was unable to give my best. When you’re living with symptoms in the background, it affects how you interact with patients.

So I struggled with the decision, but made the decision that I needed to do what we were all trained to do. Be a doctor first. And that meant actually leaving the profession. Because I couldn’t give 100 percent most of the time. You don’t give 100 percent all the time.

And I was watching him on the debate screen, and I was seeing a man who was unable to give coherent answers. It’s not 100 percent. He was functioning at 30 percent. And I saw a parallel between our situations.

Being a doctor is not being president. But for every patient I see, I am fully responsible for their life. And I take that to heart. Which is why I decided, if my body was not capable to keep me there, I had to leave.

And in the article I described my empathy for President Biden. It took me 10 years to accept what’s happening to me. I was finally diagnosed with Ehlers-Danlos syndrome. But acceptance of decline, when you are a high-functioning person who’s successful, is one of the hardest journeys we will have. So with compassion, I know what he’s going through.

My family has trouble accepting it as well. So people talk about Biden’s inner circle. They adore that man. And they don’t want to see it either. So why is his advisor not saying it? Because it’s painful. Can my husband accept that I can’t go out to dinner? He can’t. Because it hurts him too deeply to accept it.

So I could see parallels between our lives, and that I wanted to share. I also researched a bit about his health summaries, and we can talk about that in the future. But I think it was just a call on the president that you need to take care of yourself first. You need to always make sure you’re up to the job.

And even though it’s painful, and even though I grieve every day for what I lost, I believe I did the dignified thing by leaving my beloved career.

Kevin Pho: Of course I want to get your opinion on what President Biden is going through in a little bit. But first I want to ask you about those 10 years, where you said that it took you that long to decide to leave the profession of medicine, a profession that you said was part of your identity.

Jennifer Obel: Well, let me clarify this. I was in a back to work program where I worked and saw half my caseload, lots of accommodations. So President Biden’s accommodation is to work from 10:00 to 4:00. My accommodation was dictation, rest breaks, and seeing half my load.

And within nine months it was obvious to me, that I didn’t want to realize it, but my doctor told me he didn’t believe I could practice. And my chief of oncology is one of the most ethical, upstanding people. And he knew too. He accepted it. He wanted me to be successful. We all wanted me to be back, I was doing research that was funded. But we all decided as a team that my body was not capable to sit in front of a computer screen for that amount of time.

So I left within nine months. But to accept it, and then it took me six years, because things are never perfect in medicine, no one ever has all of the symptoms. And while it’s obvious in retrospect that I have Ehlers-Danlos syndrome, it took me six years to find the diagnosis, and I was relentless.

And then it took me probably a total of 10 to actually accept that this is my body, that I need to honor, and I need to do things differently than the rest of the world. And it took me that amount of time to grieve the loss of who I was. And I think I still grieve. I don’t expect it to leave.

Kevin Pho: Tell us about that process of you accepting that. You went from your doctor, the chief of oncology, telling you that you’re not able to do what you love. Tell us some of the back and forth that was going through your mind, your family’s mind, during those years before you made your decision.

Jennifer Obel: So I made my decision within nine months, and I immediately accepted it. I think I knew I was failing. And I actually needed to hear it from my doctor. The same way Biden says, if my doctor, Kevin O’Connor, tells me, I will leave.

So subconsciously I knew I was not going to be able to go back full-time. And I also did not believe you could be an oncologist without being full-time, because your patients need you 24/7. So when they said it, I had shock and sadness, but I knew it was the right thing to do, because I never wanted to make a mistake that would cause someone harm.

I then had to deal with it, but I always put my patients in front of my identity. And that’s how, I didn’t really, I just accepted it, the decision to leave. But acceptance internally is a very different thing.

Kevin Pho: Like I said, we’re speaking on Friday, July the 19th, and as of now President Biden is still the Democratic nominee. And from what I’m reading and from his interviews, he’s still adamant about staying as the Democratic nominee. Tell us what you think about that decision, based on the parallels from your own experience.

Jennifer Obel: I think one has to go inside and evaluate your performance. So I think it’s important to really be honest with yourself. And I think if you’re honest with yourself, you can see your decline.

I think another is that, again, your identity is about your job, so it’s hard to leave. Who wants to be at home alone and lose your power? Who wants to give that up? As a doctor, we’re in the middle of a cancer center. There’s activity, we’re engaged, we have purpose. Biden’s in the center of the world. No matter what level he’s performing, why would he want to give that up? But again, you have to be able to be honest.

Kevin Pho: What’s the responsibility of President Biden’s physician? I’m sure he’s seeing the same debate performance, and in fact he probably has more behind-the-scenes insight than we in the public have. What’s the responsibility of his physician, Dr. O’Connor?

Jennifer Obel: Actually, what’s interesting is, I think when we see our patients, we see them in the exam room. We don’t watch them walk in, we don’t watch them walk out. They’re sitting on a table. It’s a very structured environment.

I was an oncologist to a community. So they were my patients when I saw them walking in the hall, and they were my patients when I saw them at a drugstore. And I could actually see that they had looked worse, from an interaction, from a bump-in. And I would say to the patient, I need to get you in.

So Dr. O’Connor is President Biden’s doctor when he’s watching him in the debate. And I think it’s his responsibility to ask, why did he have this performance? What further tests do I need to do, now that this has happened? Why did he call his defense secretary not by his first name, but by his race?

When we are a doctor to a patient, we’re a doctor to them 24/7. And sometimes the best we can learn is not from the clinical interactions, it’s those spontaneous ones. So I think his responsibility is to ask.

I read his health summaries. I read his health summary from 2024, and Dr. O’Connor’s health summary of Biden in 2023. He never mentions cognitive issues. But it’s obvious on the television that he’s having some cognitive issues. Whatever basket you want to call it, normal process of aging, Parkinson’s, dementia. He’s having cognitive issues, and it’s his responsibility to the patient to do the right tests and ask the right questions. Not the patient’s job, or those around him.

I always had to give bad, hard advice. What is your job as a pancreatic cancer doctor? I would spend two hours with patients trying to explain, through a language they could understand, that they were dying. No one wants to hear that. I’m sure Biden and his family do not want to hear that there is a decline. But it’s our job as responsible, strong, resilient physicians to talk about what is difficult with our patients, and be direct and honest. So I think he has that responsibility.

Kevin Pho: In the mainstream media and on cable news, there’s no shortage of experts who are speculating on potential diagnoses for President Biden. I’m looking at an article from The New Yorker about doctors being increasingly worried. What are your thoughts about these speculations about his diagnosis, just through the television and reading in the newspaper? Is that fair to President Biden? What are your thoughts on that?

Jennifer Obel: You know, there was the Barry Goldwater rule, where the American Psychiatric Association said we can’t diagnose people from media. But how do we conduct the majority of medicine now since COVID? Through telemedicine.

And there are certain symptoms that are classic for certain diseases. I think I would diverge from the mainstream, and I think you can tell a lot from watching him in a debate. Because certain neurological degenerative diseases have classic symptoms, like loss of facial expression, a stiffened gait. And I believe with telemedicine we become good at it. So I find no problem with that.

What was interesting about the New Yorker, which is what I found, is that no doctor gave their name. They were all anonymous. This is why I wrote the article. Right after the debate, I called, and they said, yes, he has X, yes, he has Y, but I’m not going on the record.

It’s very hard for me to write, and it’s very hard for me to use a computer. But I found so many people who believed there was something wrong, and this is day one, hour one after the debate, but no one wanted to come forward. The same thing with the New Yorker, there’s no name of a doctor on there.

And I believe as physicians, when we’re dealing with one of the most powerful people in the United States, we have a right, like CNN’s Dr. Gupta, to raise the question about further testing. I believe that’s our responsibility. And that’s why I wrote the article.

I’m not a neurologist, but I’ve had to retire. So my commonality with him was having to let go. But I only wrote it because no one else would go on the record. So I felt like, well, I’ve been there, I can go on the record at least, because I have an illness that is chronic, and there’s days I’m better and there’s days I’m not. I was disappointed that very important neurologists would not come forward, and so that’s why I wrote my piece. And even the New Yorker, they’re not quoted by name.

Kevin Pho: If you were in President Biden’s inner circle, given your story and your experiences, and you could talk to President Biden, what would you tell him?

Jennifer Obel: I think I would tell him what they see, and be frank and honest. There are two issues at play here.

There is whether he’s electable and what the polls are showing, and the fact that he is against Trump, who, you know, President Biden has said is dangerous. So I think there’s two. One, the fact that there’s no donations coming into his campaign, the youth vote is not going to be voting for him and feels like they’re stuck between two bad choices.

And two, it’s what’s best for him as an individual, having to make a decision in the middle of the night that could be so crucial for our country. I know that I couldn’t do that with my body. And I wonder how he can. So I think it’s really about those two spheres, that they need to be direct and honest.

Kevin Pho: We’re talking to Jennifer Obel. She’s an oncologist. Today’s KevinMD article is “My body’s decline forced me to leave my job. Joe Biden needs to do the same.” Jennifer, we’ll end with some of your take-home messages that you’d like to leave with the KevinMD audience.

Jennifer Obel: I think I would like to leave a couple with the clinicians out there. I’m not sure I would be in this mess that I am physically if I had spent some time doing self-care. I stopped working out when I became a doctor. It became all my life. And I think that contributed to my illness. So if you love your profession, make sure you take care of yourself. And make sure you work out, take time to let your nervous system rest. I think that’s very important.

I always knew what I did was special. But I think today, in our current climate with all the pressures on doctors, we can lose sight of the intimacy we develop with our patients and the vulnerability we see. So try to still remember the honor of our field, because once you can’t be in it, you tend to realize what you’re missing. So even though there’s all the noise of medicine today, still remember that it’s about the patient.

And I believe my diagnosis would have been made correctly if people would have listened to me. I had a lot happen to me that shouldn’t have, but I was giving a perfect story for Ehlers-Danlos syndrome and instability in my neck, and it was missed. So listen to your patients. They will tell you what is wrong. Look up from your computer and listen. And appreciate the moments you have with them and your colleagues. I think that’s it.

Kevin Pho: Jennifer, thank you so much for sharing your story, time, and insight, and thanks again for coming on the show.

Jennifer Obel: Thank you, and it was a pleasure.