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In this episode, we sit down with Jonathan Fisher, a cardiologist, mindfulness teacher, and expert in holistic heart health. Drawing from his personal journey through anxiety and burnout, Jonathan shares insights from his book Just One Heart, revealing seven timeless traits for vitality and well-being. We explore how he bridges the gap between Western medicine and Eastern wisdom, offering practical tools for reducing stress, fostering emotional health, and leading with compassion.

Jonathan Fisher is a cardiologist.

He discusses his book, Just One Heart: A Cardiologist’s Guide to Healing, Health, and Happiness.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Jonathan Fisher. He’s a cardiologist, and we’re going to talk about his book Just One Heart: A Cardiologist’s Guide to Healing, Health, and Happiness. Jonathan, how are you?

Jonathan Fisher: I’m doing great, Kevin. I’ve been such a fan of yours for about a decade now, so thanks for fighting the good fight and getting our word out there into the world.

Kevin Pho: Well, thank you so much, I really appreciate that. I see you a lot on LinkedIn as well, on my LinkedIn feed. Congratulations on your book, and we’ll talk about that. So tell me a little about your story for those who don’t know you, and what are some of the reasons you decided to write this book?

Jonathan Fisher: I’m from a medical family. Dad, who’s still alive, he’s almost a hundred years old, living in the house I grew up in, and that house was the town doctor’s office. So townspeople would come into the first floor of my house, they would meet the secretary on the ground floor, and they’d see my dad, and he was the cardiologist, the oncologist, the hematologist. So in my house still we have a treadmill from the 1950s and 60s. He used to spin his own blood, do his own chest X-ray. It was back in the day.

And one by one all of my brothers and sisters, and there’s six older brothers and sisters, went with Dad on house calls. His doctor’s bag was in the back from the 1920s. And I saw them ahead of me and I said, this looks awesome, I want to be like my dad, I want to be like my brothers and sisters, I want to help other people. And I’m also scientifically minded.

So I went through the training, I went through medical school, did my residency, and I figured out that for me, because I had a passion for physics, my mom was a physicist, cardiology offered me everything. I got to think about the mechanical heart, electromechanics, fluid mechanics, dynamics. And I went into cardiology, and that’s kind of the pretty version of the story.

The not so pretty version of the story is I’m naturally a pretty neurotic, anxious guy. I was a little kid who used to worry all the time about being perfect and getting straight A’s for my parents to love me and approve of me. We’ve heard this story before. And so I had to get into the top of the class, I had to get into Harvard for my residency, and all of that got me to a certain point until I realized, I looked around, I said, I don’t have any really close friends except for a couple from high school, I don’t have any romantic relationships, and I’m really not living a life outside of medicine. And I was pretty unhappy, Kevin.

Kevin Pho: Yeah, so how long were you practicing before you came to that realization that you wanted a little bit more in life?

Jonathan Fisher: Well, it started just after medical school. I was really open-minded, openhearted, enthusiastic, and I didn’t know it was happening, but as I would go on my rotations, particularly the surgical rotations where we would walk around the halls for hours on end and then go into the operating room, you weren’t allowed to take breaks for the bathroom, you certainly couldn’t scratch your butt if you wanted to. It was suddenly like what used to be things that I felt the freedom to do, I realized that medical training involved stripping away of those freedoms, including the freedom to feel whatever the hell I wanted to feel.

So for me it was even before going into practice, and it was actually during my residency at the Brigham and Women’s Hospital, when at the encouragement of someone who really saw how bad things were getting for me, I secretly looked up a therapist. And I snuck, I literally popped up the collar of my trench coat in the winter, I would hide my face so that nobody could see me. I was afraid of what my residents would think, my senior resident, my patients. But fortunately, through lots of tears and lots of sweat, I did one year of deep therapy to figure out why was I so unhappy and why was I struggling with anxiety.

That wasn’t the end of the story. Things really got worse over the next 10 years actually, when I discovered what the real world of medicine was like, with RVUs and competition within groups and between groups and very little rest and Q3 or Q4 call and very little time for myself, for romantic relationships.

So the first part was in residency where I sought help, and the second part was just within the first five years of practice at Mount Sinai Hospital, my best friend and guide, my sister Andrea, who was a radiologist, was diagnosed with a glioblastoma at the age of 40 with a young child. So Kevin, that’s in a nutshell about 25 years of some really wonderful, amazing experiences in training and some really, really hard times.

Kevin Pho: So before we get into your book, tell me about that reality of medicine and how that contrasted with what you thought your ideal of medicine was when you were a young child and seeing what your dad did.

Jonathan Fisher: I thought my dad was like the old-fashioned painting where it was a smiling doctor and a smiling patient and everything is hunky dory, and I kind of wanted that. I wanted to have just me and the patient in a room together, connected.

And what I started to realize is that there was this machine, and there was a culture, and I knew very little about culture. I think the word wasn’t used once in medical school outside of our infectious disease class, and there they were referring to a culture. It’s not that much different. We are raised and taught in a medical culture that teaches us not to lean on other people, not to view teamwork as important, and that it’s all about what I can do, and it’s all about sacrifice and continuous activity and very little rest.

So there was this, I would say, if you were looking at a randomized control trial, and if the ideal state were my dad’s practice, and he describes it as such, there was a gradual but eventually very wide split from the dream of what I thought it would mean to be a doctor in the 21st century, to the life that I had where I was balled up on the floor of my New York City loft weeping because my sister was diagnosed with cancer, I hate going to clinic every day, and I’ve got to see 40 to 45 patients, on weekends rounding beginning at 4:00 or 4:30 in the morning. There was a wide split.

Kevin Pho: Your book is Just One Heart: A Cardiologist’s Guide to Healing, Health, and Happiness. So why did you decide to write a book? Tell us about the events leading up to this book.

Jonathan Fisher: It started out as self-help in a sense. My therapist, 20 years ago, said why don’t you keep a journal. So I started writing a journal, and I’ve got lots of journals back there. I’ve got more than 2,000 notes that I’ve collected doing personal therapy, what’s called cognitive behavioral therapy. I learned to look at my anxious thoughts and look at what was keeping me from the life that I wanted.

I also was taking notes on what it was like to be on call and getting called out of my bed fast asleep, leaving my wife and my small children at home, having to go into the hospital dealing with life and death situations. And it really, Kevin, initially was my attempt to put on paper the challenges I was facing, how I was dealing with them.

And then as I started to get help, everything I learned along the way I put it on paper. That included going to therapy, deciding whether to take medications for anxiety and depression, going to learn how to do meditation on various retreats, eventually a weeklong retreat at a Zen monastery in total silence, going to courses on positive psychology.

Eventually I wanted to share this with other people. My colleagues saw that I was changing, they saw I had gotten coaching. So I wanted to create a book that was a resource for every possible way of getting ourselves out of this dark place on the one hand. But I also realized that I’m not always unhappy, I’m happy most of the time now, so I also am interested in how can we go from good to great, those of us who are staying in medicine for example, and we want to change the system and we want to change the culture, we want to become leaders, but we were never taught how.

So part of my executive work in addition to cardiology is I train future leaders. I train students and residents, and I also lead classes for the CEO and the CFO of our 38,000 employee organization. I’m fortunate to have that role.

So I wanted to put all of that in a book, in a very accessible sort of plain language way, which is rooted in the science of human flourishing. What does it mean to have a well-connected, happy, fulfilled life? And so I go over the science of positive psychology, the science of mindfulness, and the science of how are our minds and our hearts connected. There’s a lot of woo woo talk out there in the spiritual world, I get frustrated by that as a cardiologist, and so I also wanted to put on paper how all of this is good for our cardiovascular health as well.

Kevin Pho: So it’s been quite a transformation for you, and the painting that you described earlier on about how you were lamenting your role in our health care system and it wasn’t quite what you imagined it to be when you were a little kid, that’s the story of a lot of physicians I read, right? So of all the things that you had mentioned, and you don’t have to give away the whole book, but tell us some of the most effective things that led to your transformation, just so other doctors that were in your position years ago can take away from it.

Jonathan Fisher: The first thing is to realize that at the root of a lot of the burnout stories that we hear is a shift, in people who are proud of their accomplishments, who can do almost anything if they put their mind to it, to a sense of hopelessness.

And so my real piece of advice, and what the book is meaning to do, is to give a sense of hope that even though we’ve learned that, you know what, I can’t control my call schedule, I can’t control how many patients I see, I can’t control this damn EHR, and so we end up in this place where we feel very little control in our lives, the message of the book is that once we see that, and once we’re willing to accept how painful it actually is, this difference between the life we dreamed of and the life we’re living in, we can practice.

And that’s really hard to do, and we need to practice mindfulness. You actually have to be able to sit still in the junk, in the crap essentially, and learn how to just be there and look at it, rather than do what so many doctors do, and what I did, which was to run away towards all sorts of other distractions and addictions, etc., including addiction to anxiety. I didn’t realize that I was addicted to having worrisome thoughts. It was something I knew.

So once I realized that I actually had some choice in my own life, that may have meant leaving a practice, which I did. That may have meant saying no within a large health care system to certain responsibilities even though everyone demanded it of me, which I did.

So I would say that at the root of it all is recognizing that though we feel like we may have lost hope, we may have lost power, we may have lost our personal agency, it’s there, it’s there, and we just have to rekindle it by looking for people and resources who are there to support us.

Kevin Pho: So in terms of those resources, is it coaching, is it therapy? What are some immediate next steps that physicians who find themselves in a place that you were, that they can take, of course other than reading your book?

Jonathan Fisher: Yeah, so Kevin, part of what I get to learn is how do we help people who are at different stages in the spectrum essentially. So as a cardiologist for example, if someone comes to me and says, how do I protect my heart, well, it depends. Are you having a heart attack, or are you running for the Ironman Triathlon and you want to do it better?

So the way I think about it, Kevin, for our colleagues is, where are you right now? You can’t have a one-size cookie cutter answer. I don’t think everybody should have a coach. No, I don’t. Some people should, I do, and actually I am a coach, but that’s not the whole solution.

So I would say that if there’s a spectrum of well-being in general, and specifically within health care, on the one hand we have colleagues who are suicidal, and we know that 400 physicians die by suicide each year. On the other hand we have doctors who are saying, I’ve been there, I don’t need help with that right now, I want to become the CEO of this company, I want to become an entrepreneur on the side.

And so to answer your question, for those that are really struggling right now, need to get help, we need to ask for help. There are worries about disclosure of mental health conditions. About 25 states have changed their policies. Fortunately organizations like the Lorna Breen Foundation are lobbying Congress, and we have the Lorna Breen Health Care Provider Protection Act.

So on the deepest end of the well, Kevin, I would encourage our colleagues that even though you may feel ashamed about getting help, just ask for help. Tell someone, say I’m really down, I’m thinking of leaving, whatever you’re feeling. Find one person, and know that it’s OK, it doesn’t make you broken, it doesn’t make you bad.

Towards the middle of the spectrum, if you don’t need a therapist right now and you don’t need that, maybe you can do it yourself. So you go into the self-help section. I would say start with basic mindfulness. And mindfulness is not going to fix our health care system, don’t get me wrong. I’ve taught more than 5,000 people how to meditate, but I don’t teach it so that I’m pretending like all the problems don’t exist. What mindfulness can do is it helps us see our own experience and thoughts and feelings in a completely new way. We then become the observer of our thoughts rather than someone who gets carried away by them, and we become a lot wiser, a lot more clear.

And then at the high end of the spectrum, Kevin, let’s say we’re in that sort of athlete’s mindset, I would really dial down on lifestyle medicine. All this applies to all stages, but I would then start to lock in, am I getting seven to eight hours of sleep, am I eating a plant forward, whole foods diet, am I exercising 20 to 30 minutes most days of the week, do I have strong social relationships, am I invested in that as much as my medical career? So that’s kind of how I would approach someone depending on where they are on that spectrum of well-being.

Kevin Pho: One of the themes in your book is mind-body health, and in your book description it says that you’ve consulted with dozens of experts in mind-body health. So tell us some of the transformative lessons that you’ve learned from these experts, and how physicians can apply those lessons.

Jonathan Fisher: I interviewed more than 55 experts. I thought I was going to sit down and write a book. Kevin, we have a lot of people say I’m going to write a book and I’m just going to put it on paper and put it out there. That’s not how this happened. I thought that was going to happen, but the first nine months of this project actually was just me setting up my calendar and reaching out to people in kind of a courageous way. The chairman of mind-body medicine at the Herbert Benson Institute at Harvard, Gregory Fricchione. Dean Ornish, godfather of mind-body medicine. People who are in the mindfulness space. And so I set up 55 interviews, so 55 hours of interviews before I wrote the book.

And so to pick a single person, I’ll pick Gregory Fricchione, who’s the director of the Mind Body Institute at Harvard, and he wrote a book himself about the connection between emotions and our heart health. Now that’s my lane, right? I’m a cardiologist. So what the heck’s a cardiologist doing talking about this stuff?

So what he taught me, both through his book and our conversations, were that we do not appreciate in our current health care system how deeply intertwined our emotional well-being, our mindset, our attitudes, what impact they have on our health outcomes, both as patients but also on our ability to care for patients as doctors. And so that really gave me permission that I was not going out on some left field tangent here, and he said, please do this work, do this research.

Kevin Pho: We’re talking to Jonathan Fisher. He’s a cardiologist. He’s the author of the book Just One Heart: A Cardiologist’s Guide to Healing, Health, and Happiness. So Jonathan, you’ve taken a fascinating journey through your career, and you made a lot of changes obviously, shared your lessons in this book. Let me just simply ask, how are you today?

Jonathan Fisher: I’m great, I’m energized, Kevin. I’m energized because right now this is the most important moment in my life. I’ve got a wife, I’ve got three children, one went off to college. I’m a self-published author who was recently approached by HarperCollins, one of the biggest companies, to distribute the book to a billion people in India. I’ve got a lot of really cool things going on in my life. I just exercised, and I try to walk the walk.

But in this moment, Kevin, I’m talking to a physician who I’ve admired and respected for a long time because you took a stand for what was important. And so the big picture is, I get to do work that I love. I was on call for four days and four nights last weekend through Labor Day, called in twice for life-threatening emergencies. The next two days I put on my executive hat, looking as the clinical physician executive for a team of 38,000, how we can help nurses and doctors who are in trouble. And now on the day that I’ve carved out for myself, which is Fridays, I no longer work for anyone but myself. I get to do what I love, which is I get to talk to you.

Kevin Pho: Fantastic. And is this the career that you imagined as a physician, being more in control?

Jonathan Fisher: This is absolutely, I mean, this is, I could never have imagined the career that I have right now. I could never have imagined it 20 years ago. But five years ago I wrote it down on paper and I said, this is what I want. This is when I was still full-time, and I said this is how I want my week to look, and I want one day for myself. I didn’t think it was going to happen, I didn’t know how, but I decided it was going to happen, and we’re here today.

Kevin Pho: All right, and we’ll end off with some of your take-home messages that you want to leave with the KevinMD audience.

Jonathan Fisher: I would say that if you’re stuck right now, if you’re struggling, you’re thinking about leaving medicine, you’re frustrated, you’re just maybe even pissed off, there’s a few basic steps that you can take today, right now.

And the first is, don’t waste any more time complaining. Don’t waste any more time fighting or cursing the system, or cursing the third party payers, or cursing the EHR. Don’t waste any more time. Instead, can you just accept the fact that it kind of sucks, and just be with the suck for a while? So that’s the first thing.

The second thing is, once you can do that and just accept it and say I’m not going to make things worse by fighting it, can you learn a new skill, so that when you get frustrated and angry, whether it’s at your colleague or at your spouse, can you learn some basic skills about how to calm yourself down in the moment and to reframe your thoughts? Whether it’s breathing techniques, cognitive behavioral therapy, mindfulness, yoga, whatever it is. I go through all those in chapter six.

And then the third thing I would say is, once we’ve done those first two steps, can you remember what it was like when life was free and full of possibility? Maybe you were a kid, maybe you were a teenager, maybe you were in college. Can you remember that and hold on to a little bit of hope that it’s still possible to get there again? And in order to do that, it’s time for you to start making some hard choices. What kind of emotions do you want to feel every single day? Do you want to continue with resentment and frustration and doubt, or do you want to feel love, connection, and purpose? It’s totally up to you.

Kevin Pho: The book is called Just One Heart: A Cardiologist’s Guide to Healing, Health, and Happiness. Jonathan, thank you so much for sharing your story, time, and insight, and thanks again for coming on the show.

Jonathan Fisher: It’s my pleasure. Thank you so much, Kevin. Keep up all the great work.