#10 - Survive and Breathe: A Physician's Journey through Medicine and Cancer

Host Krishna introduces Dr. Brian Whitson, an experienced pulmonologist with board certification across multiple fields (pulmonary, sleep medicine, palliative care, internal medicine, formerly critical care). Dr. Whitson has practiced predominantly in rural Oklahoma (Enid) for about 31 years and blends clinical care, education, and community service. Dr. Whitson recounts formative experiences: working as an orderly/aid in an osteopathic hospital in Tulsa after high school, early exposure to physical therapy from sports injuries, and mentorship/friend groups in high school that encouraged medical careers. He completed undergraduate studies at OSU, medical school at OU, internal medicine training at Baylor, and pulmonary/critical care training at LSU Shreveport. Dr Whitson explains the practical reasons for pursuing multiple boards: in rural practice one often must fill many clinical gaps; palliative care training improved symptom management (beyond pain control) for nausea, constipation, anxiety and dyspnea; sleep medicine credentialing became necessary to properly interpret studies and prescribe therapies; critical care experience reflected past practice needs (he intentionally let critical care board lapse to avoid ICU calls). Dr Whitson emphasizes that combined training enhanced his ability to treat complex patients holistically. He also discusses the demands and rewards of practicing in Enid: often alone covering broad needs, coordinating with regional hospitals and sleep labs (e.g., Norman Regional), and participating in community organizations such as a local nonprofit hospice (Hospice Circle of Love). He describes efforts to mentor and develop local healthcare workforce (e.g., sponsoring phlebotomy training for high-school grads, encouraging early clinical roles like MA or nurse aide). He also shares his own diagnosis, which was discovered incidentally after cardiac evaluation and gallbladder ultrasound revealed a mass and liver nodules. Initially thought to be neuroendocrine carcinoma (which influenced early treatment decisions), pathology later characterized it as pancreatic cancer with neuroendocrine features. He underwent extensive surgery including a Whipple procedure and right hemicolectomy with good post-op recovery, followed by six months of chemotherapy. Notes that CA 19-9 tumor marker was never clearly helpful in his case. He describes his long-term follow-up as somewhat individualized—periodic imaging and tumor-marker checks guided by his oncologist—and credits faith and perceived miracle for his survival. He details how he introduces palliative care: reframing it as a model that emphasizes comfort, symptom control, and quality of life rather than "giving up." He tailors conversations by comparing curative vs. comfort models, clarifying goals, and arranging hospice or home-focused support when patients wish to avoid hospitalization. He also gives examples (COPD patients with recurrent admissions) where low-dose opioids eased air hunger and anxiety, improving function and quality of life. He reflects on the challenge of suggesting palliative transitions to long-term patients and on having candid discussions with family members (including his own father) about hospital preferences and goals of care. Dr Whitson distinguishes two post-COVID populations: (1) patients with severe, post-inflammatory pulmonary fibrosis and clear radiographic/functional damage (some requiring lung transplant), and (2) a larger group with persistent dyspnea and debilitating fatigue despite normal imaging and pulmonary function testing—often consistent with post-viral or autonomic dysfunction. He recommends gradual, extremely low-intensity exercise rehabilitation (incremental walking plans) and symptomatic management, acknowledging limitations: many patients have low energy and motivation, and there is no single proven pharmacologic cure yet. He is skeptical that a universal panacea will emerge; long COVID may overlap with chronic fatigue-type syndromes and require a multifaceted approach. He advises trainees: get early, hands-on experience (medical assistant, nurse aide, phlebotomy) to build communication skills and practical clinical ability. "Showing up" and doing frontline work accelerates learning and helps confirm career direction. He highlights the value of phlebotomy as a tangible skill that can open doors and strengthen clinical judgment. Dr. Whitson expresses gratitude for survival and continued ability to serve patients. Krishna thanks him for his ongoing availability to local clinicians and the community, and for sharing his cancer survival story and clinical insights. The episode closes with an invitation to return Where Health, Society, and Innovation Intersect   Connected by Health is a forward-thinking podcast built on a simple but powerful truth: healthcare is not a cost to be cut — it is an investment that shapes the future of everything around us. 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