Episode Transcript

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Daniel Lobell: (00:00)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only, and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs.

Daniel Lobell: (00:19)
Hello, and welcome to the Doctorpedia podcast. I’m your host, Daniel Lobell, and I’m so honored today to be joined on the line by Founding Medical Partner for Doctorpedia Dr. Joseph Bennett. How are you Dr. Bennett?

Dr. Joseph J. Bennett: (00:32)
Doing great. Thanks Daniel.

Daniel Lobell: (00:33)
We got to talk for a minute before we started recording and you told me you’re in Delaware in the freezing cold. So I appreciate you in this tough inclement weather, making time to… Hopefully we’ll warm you up with this conversation, but.

Dr. Joseph J. Bennett: (00:48)
Yeah, absolutely. Well, I’m stuck inside. So what a better opportunity than to speak with you.

Daniel Lobell: (00:54)
Yeah, well, you’re always welcome to come out to LA if you need some sun. We have it over here.

Dr. Joseph J. Bennett: (01:00)
On the way.

Daniel Lobell: (01:01)
Before we go into what you do, I like to get a sense from the doctors about the beginning, how it all started, and hear a little bit about your childhood and what inspired you to become a doctor in the first place. So where did you grow up?

Dr. Joseph J. Bennett: (01:17)
I grew up in New York, in Westchester. It was just me and my sister and my mom, and I grew up sort of that science dork, and when other people were playing video games, I would run out to the local pond and pick up something to put underneath the microscope, and I’ve always just had this love of science and biology and this crazy sense of curiosity. And just always loved taking everything apart and putting it back together again. So that’s sort of the way I grew up and the way I’ve approached everything.

Daniel Lobell: (01:53)
Well it seems like the perfect prerequisite for going into surgery.

Dr. Joseph J. Bennett: (01:57)
It sure was, it was the natural progression.

Daniel Lobell: (02:00)
As long as you’re putting it back together the right way. [Daniel laughs]

Dr. Joseph J. Bennett: (02:03)
Absolutely. [Joseph chuckles] No other way. I hate complications.

Daniel Lobell: (02:07)
So were your parents in medicine also?

Dr. Joseph J. Bennett: (02:12)
My grandfather was in medicine, but I never met him and I was named after him. And even though I never met him, he was a big influence in my life because I had heard stories from my mom and my grandmother about what he had done. He was a practitioner like a family practitioner, back in the days when you would literally get paid with chickens and milk, and he would both suture lacerations and deliver babies and take care of colds. And he was the true family doctor and would make house calls. And I remember being a really young child and hearing these stories and just thinking that he was the most amazing person when it came to medicine. And that was really a big influence on me.

Daniel Lobell: (02:58)
That’s pretty wild. Getting paid in chickens. That’s not… [Both chuckle]

Dr. Joseph J. Bennett: (03:03)
Yes.

Daniel Lobell: (03:05)
So what did your parents do?

Dr. Joseph J. Bennett: (03:08)
Well, I guess fortunately and unfortunately, never really knew my dad very well. And I say fortunately because it made me a very strong person and established a real great relationship with my sister and my mom. And my mom sort of struggled when I was younger which taught me some amazing ethics of hard work. And eventually became a patent and trademark expert and now works for a top law firm in New York City.

Daniel Lobell: (03:43)
Wow.

Dr. Joseph J. Bennett: (03:44)
Climbed her way up.

Daniel Lobell: (03:47)
And if it’s not too personal to ask, and you can tell me if it is, did you not know your father because he wasn’t with you on this planet anymore, or he just wasn’t involved? Or…

Dr. Joseph J. Bennett: (03:57)
No, no. It was just an unfortunate divorce, and my father really just wanted to separate himself from the family, which is amazing to me as a father myself, that a parent would wanna abandon their children. And I haven’t had much contact with him since I was in my early teens, and I’m not embarrassed about it. I’m proud of how I overcame it. And we still talk about it sometimes in my family, but it taught me a lot about who I wanted to become. And really sort of gave me a certain approach on life, a skepticism, but also a hunger to succeed as well as an individual. And also recognizing that there are unfortunately sometimes few people that you really can count on, but when you have amazing people in your life to count on, then really to cherish them.

Daniel Lobell: (04:51)
And how interesting you became somebody that people really count on, and have been somebody who lives up to those expectations.

Dr. Joseph J. Bennett: (05:01)
Absolutely. And I mean, I thrive on it and I’m sure a psychologist or psychiatrist would have a field day. [Daniel chuckles] And I would make Freud a very busy practitioner if he were around today. But again, these are the things who shape who we become later in life, how we’re raised, and they shape our values and our views on the world around us.

Daniel Lobell: (05:25)
Well, I did some research on you as I do for all my guests. And I was just so impressed by all the incredible achievements that you’ve… Achieved. [Both chuckle] But I mean, you graduated summa cum laude. I mean, you’ve got these great board certifications, you’ve held these prestigious positions. And in a way it’s a testament to being able to overcome adversity. I mean, I’m sure there are many people in your situation who would say, “Look, I was raised without a father, I resigned myself to having less opportunities in this world.” But you took it the other extreme.

Dr. Joseph J. Bennett: (06:07)
Yeah, absolutely. I think that’s very well said. I live in the world of extremes. If I’m gonna do something, I’m gonna do it at the extreme. So yeah, so I sort of approach everything from being a dad to also how I approached medicine and surgery, and approach it with a tremendous amount of passion and grit and perseverance, and still even continue to pursue new things today. And throughout my career, I, always, I’m looking for a challenge. Otherwise I think life can get boring. I just never really wanted to just sit and be complacent.

Daniel Lobell: (06:45)
I mean, that’s… First of all, good advice for all of us, and more so, I’m kind of curious, what do you think it is about you that you have that drive, that you’re able to push yourself in that way?

Dr. Joseph J. Bennett: (07:02)
Good question. I really do think to some degree, it goes back to childhood, and I think what drives me sometimes is fear. I think just growing up not having, and just the fear of being helpless, and, we grew up with financial difficulties, that just gave me a sense of grit and passion to succeed. That just stayed with me. I think some of it may also be biologic. I think it’s just sort of the way I’m hardwired to some degree, but there are definitely some environmental factors that fostered that.

Daniel Lobell: (07:42)
Maybe we all just need to be more afraid.

Dr. Joseph J. Bennett: (07:46)
[Daniel laughs] Yeah, I think, you know…

Daniel Lobell: (07:47)
I’m gonna go watch a horror movie after this.

Dr. Joseph J. Bennett: (07:49)
I guess fear drives people. Even in surgery, I don’t like complications because it’s painful to have complications. I want my patients to do well, but when patients don’t do well, it’s sickening for me. I lie in bed at night, I can’t sleep, I can’t think. I try and minimize that pain. Of course I also want my patients to have great outcomes and I don’t mean to sound too pessimistic saying that, but I think trying to reduce pain and understanding your fears is a helpful motivation for a lot of people. We just don’t sometimes look at life that way.

Daniel Lobell: (08:27)
Can you walk me and the listener through maybe what would go through your head in a surgery situation where you become panicked?

Dr. Joseph J. Bennett: (08:36)
Where I become…?

Daniel Lobell: (08:37)
Well, I was saying panicked, but maybe that’s not the word you would use, but when you fear that things are not going the way you want them to go. What is the thought process?

Dr. Joseph J. Bennett: (08:49)
So this is like… I talked about passion. I’ve done a lot of research on this as well, and I think we have to define what really is panic and what’s choking. And panic is really when you’re way outside your zone of comfort and you just don’t know what to do. And I think as a surgeon, you just don’t wanna be in that situation. And if you find yourself in that situation, then you have to recognize it as quickly as possible and call for help. Because by definition, panic is you really have no idea what to do. And there are studies that have looked at this. There’s a zone of comfort where we all function in life, and in surgery, a lot of that is technical. And then there’s the zone of learning, where it’s not an easy operation, but you’re comfortable, but you’re pushing your limits.

Dr. Joseph J. Bennett: (09:37)
And when you break outside of that, you get into the zone of terror and you do start to panic. And I’ve definitely been in situations where I may have hit a blood vessel, where I got into a situation where I was out of my element. And recognizing it, taking a deep breath, pausing, stopping, recognizing that you’re not thinking properly, recognizing literally that a different part of your brain has taken over. It’s not the rational frontal cortex anymore, it’s the amygdala. And when that brain, that part of your brain takes over, it’s the fight or flight response. You just don’t think properly. And recognizing that and calling for help is really important. Now, with that said, in surgery, you don’t wanna be in that situation. So all surgery starts in the office wherever you meet the patient. And it starts with making sure you’re doing the right operation on the right patient at the right time. Making sure that the patient’s in the most optimal shape possible to do a surgery. I tell my residents a lot of the time, complications start well before the surgery. Sometimes there are technical complications, but these things have to be thought out well in advance. And you have to be nimble in the operating room to understand how different findings in the operating room can be dealt with when they’re not necessarily what you expected.

Daniel Lobell: (11:02)
Hmm. That’s really interesting. And I’ve never heard that articulated before, but yeah.

Dr. Joseph J. Bennett: (11:09)
It’s not always in the medical literature. A lot of it is in the literature on survival and survival instincts and how I survived. And there are a lot of books on that that I’ve read and I find a tremendous amount of analogies between dangerous situations that people may have, stranded in the desert or a fighter pilot who’s trying to land in the middle of a storm onto an aircraft carrier that’s moving. And the same things that happen to your brain in those situations can happen to your brain in the operating room when things don’t go well. Of course, a straightforward hernia or gallbladder operation should be something that’s almost muscle memory. You’re thinking about it, but it’s so rote, you’ve done it hundreds or thousands of times. But these other difficult situations we find ourselves in require great insight for the surgeon to understand what’s going on in their own mind, as things don’t go the way you want.

Daniel Lobell: (12:16)
Hmm. So maybe a good thing, two lessons you can learn from this are one, make sure that the doctor who is working on you if you’re in that situation is doing everything they can to prepare you properly for the surgery and that you’re doing your part of it. And two, try and scare them and see how they react [Daniel laughs] if they keep their calm. [Both laugh] But I mean, how do they handle stress? I mean, that’s a big part of it, I think.

Dr. Joseph J. Bennett: (12:48)
I mean, we all help each other. I work at an institution where there’s lots of surgeons, there’s dozens of surgeons, and there are surgeons even within my own specialty in general surgery who sometimes call me into the operating room to help. And they’ve gotten into one of these panic situations. And when you walk into the operating room, you can sense and feel the stress in the room. And I’m always so happy that they called, because they’re not thinking properly and I recognize that and I’ve been in those situations myself. And it’s really important to make sure that that doctor realizes you’re there to help and not to make them feel bad about themselves. They did the right thing by calling, and to calm down the situation. And then the person who’s called in to help is thinking with the rational part of their brain to come in and fix the problem. And I’ve made a lot of friends and colleagues and gained a lot of respect doing that. And I also respect a lot of the colleagues of mine who come in and do the same for me in those situations.

Daniel Lobell: (13:55)
Absolutely. I wanna get us back to your early life because we got sidetracked, but for a good reason, I mean, it was very interesting, but when did you decide for sure I want to go into being a doctor and I wanna narrow my focus to oncology and surgery. How did that transpire and why were those decisions made?

Dr. Joseph J. Bennett: (14:19)
Yeah, absolutely. I went to college specifically to go into medicine. So there was really no other question about doing anything else. I’m sure you’ve heard the saying “being a doctor is a calling,” and I tell medical students or even college students, if there’s anything else you wanna do, go do that. [Daniel chuckles] Cause medicine is not something that you should do unless it’s the only thing that you should do. I went to college specifically to be pre-med. I went to become a doctor. I loved chemistry because it was very analytical. I was a chemistry major. Got into medical school. Absolutely knew I wanted to be some sort of surgeon because I’m always so interested in fixing things. I like the immediate results. I do have a technical interest, like I said, even from when I was younger. So it was an exploration process in medical school to decide to go into surgery. But I looked at orthopedics, I looked at neurosurgery, I looked at general surgery, and then ultimately decided on general surgery and applied for a residency.

Daniel Lobell: (15:37)
What made you decide on general surgery? Why did — was there one factor specifically that jumped out at you and said, this is the way to go?

Dr. Joseph J. Bennett: (15:47)
Yeah. Being a general surgeon sort of defined why I wanted to become a doctor. That was a great exploration process in medical school, we’d do our rotations, the first two years was mostly textbook and then the second two years is rotating through all the specialties. And I found that general surgery really defined why I wanted to become a doctor. They were fabulous doctors, really took care of the sickest patients, had to have a tremendous understanding of anatomy and physiology and pathology, and also were very hands-on. So that’s what really excited me. It was the excitement, the hands-on, seeing immediate results. And I just was thrilled to learn everything about all parts of the body. General surgeons are really complete physicians. We first learn the entire body and then go on to specialize. But the training was just absolutely phenomenal. Never do anything else.

Daniel Lobell: (16:52)
So technically you could probably do surgery on anything, is what you’re saying, but you wound up focusing on surgical oncology and pancreatic surgery. Is that correct?

Dr. Joseph J. Bennett: (17:04)
Yeah, I do a lot of GI, mostly upper GI, surgical oncology, pancreas, liver, stomach, gastrointestinal, and also a lot of melanoma and sarcoma. There are other aspects of surgical oncology I don’t do, I can only do so much. And as I’ve progressed in my career, I’ve sort of narrowed it down a little bit. But during my residency, it was an exploration as well. I started out wanting to do trauma surgery and then cardiac surgery and transplant surgery, and ultimately decided to do surgical oncology. So you can see that my mind was always sort of trying to figure this out. I love surgical oncology because it’s probably among the most complex abdominal surgery I really needed and wanted that challenge.

Daniel Lobell: (17:54)
What makes it so complicated? Sorry, and I’d like to hear what you were about to say.

Dr. Joseph J. Bennett: (17:58)
Yeah, absolutely. Well, it’s a very complex, a very long surgery. The anatomy is not always what you expect. When you combine tumors with the anatomy, everything gets distorted. You really have to have an amazing sense of what’s going on in the body. It requires a tremendous amount of 3D visualization to understand what’s on the other side of a tumor, to understand before the surgery, looking at MRIs and CT scans, what’s going on, tremendous amount of planning in the operation. And then a lot of the operations, like for example, pancreatic cancer, which you brought up, it’s a long, complex, four hour surgery with thousands of steps. And that just, even though I’ve done hundreds of them, I still find them extremely challenging and very exciting, very difficult. And that provides me with a great sense of accomplishment at the end of my day.

Daniel Lobell: (18:55)
Mhm. And what are the success rates for people who have pancreatic cancer surgeries? Is it…

Dr. Joseph J. Bennett: (19:02)
Well, it’s getting better. Unfortunately, about 80% of patients who have pancreatic cancer are not candidates for surgery, because the disease is too aggressive or has spread. So those 20% of patients we can potentially operate on, that’s really the best option for cure. And combinations between surgery and chemotherapy, we have increased the survival rate for patients up to about 10% to 20%, five year survival, which may not sound very good, but 10, 15 years ago, their survival was about 5%. So we have made some significant progress.

Daniel Lobell: (19:35)
Yeah. Are there any things on the horizon that look promising, from studies you’ve seen or research, anything you’re excited about, innovation in the field that you think is gonna change things?

Dr. Joseph J. Bennett: (19:52)
Well unfortunately, pancreatic cancer is so aggressive and it’s so resistant to so many therapies, it seems to lag behind unfortunately what works with other therapies. We’ve seen a huge explosion with the use of immunotherapy in so many different types of cancer. That doesn’t seem to be working for pancreatic cancer unfortunately, but the chemotherapy agents that we use now didn’t exist when I started in my practice 15 years ago, we had very ineffective chemotherapy. Now we have chemotherapy that shrinks tumors 70% of the time. So there is progress, it’s just a little bit slower. And there are some other techniques to try and treat. I use a special electrical ablation technique to try and improve outcomes at the areas of margins where the tumor may get close to blood vessels, or for patients who are not candidates for surgical resection. That’s fairly new in the last several years. So it’s progressing, but not as fast as we’d like to see, given the gravity of the disease itself.

Daniel Lobell: (21:00)
Got it. So you said you also do abdominal surgeries. Does that mean like elective ones as well or gastric bypass type things? What type of abdominal surgeries?

Dr. Joseph J. Bennett: (21:12)
Well, as far as the general surgery is concerned, cause I’ll still do some general surgery, gallbladder surgery, not bariatric, that’s its own special date. And we have some amazing surgeons at our institutions who focus on that. I would say about 80% of what I do is mostly cancer related and it would be liver resection for liver cancer, for colon cancer that has spread to the liver, gallbladder cancer, bile duct cancers, also gastric cancer, which is stomach cancer or other stomach tumors, small intestinal tumors. And then, again, the soft tissue tumors like melanoma and sarcoma. But all of those other organs are in the abdomen and involve complex resection and reconstruction. And, again, are these three-four hour extensive operations.

Daniel Lobell: (22:09)
So almost everybody you meet has a cancer diagnosis right off the bat. My guess would be that these are emotional patients and difficult situations to navigate on a interpersonal level. What do you think are some of the techniques that you’ve used that have been most helpful in the doctor patient relationship?

Dr. Joseph J. Bennett: (22:39)
That’s a great question. And it’s also why I like surgical oncology. I’m constantly reevaluating how I speak to patients, what works, what doesn’t. I am fairly transparent with patients, but also like to give hope, but don’t wanna be dishonest. So that’s very difficult sometimes to find that balance. And you have to get a sense of who the patient is. I’ve read a lot of books on dealing with patients with different personalities, because some patients like an engineer, very scientific, wants to know all the details, wants to literally know what the sutures I’m using are made of. And then other people say, “Doc, you do whatever you want. I don’t wanna hear about it.” So you have to get a sense for the patient. Unfortunately with COVID, things have been difficult, because we can’t always have visitors and it’s hard because you want patients to have family support.

Dr. Joseph J. Bennett: (23:32)
When you talk with them about difficult diagnoses. We’ve been able to do that with telehealth and with just having phones in the room on speaker phone. But that’s something that I’m constantly reevaluating. Learning how to speak to people. I’ve taken courses on how to deliver bad news and how to deal with the reactions of patients. There’s not really one answer. I can’t just tell you there’s one technique. But it’s something that I’m very cognizant of. And when I’m giving somebody a new cancer diagnosis, I always pause outside the room before I talk with them. And I do have to take a deep breath. I’ve been doing this for a long time, but I don’t like giving bad news. But I want the patients to recognize that I’m there for them and I’m going to help them through this and I’m going to guide them. Even if it’s not surgery, I wanna make sure patients are headed in the right direction, that they have the right medical oncologist or radiation oncologist and the next specialist is ready to see them. And I’m gonna try and help them get them there as quickly as possible.

Daniel Lobell: (24:38)
Right. What are some of the things in these courses that you’ve learned about how to deliver bad news that resonated with you or that just stick out? Because I’m kind of curious myself.

Dr. Joseph J. Bennett: (24:53)
One of the most important things is to listen and to hear what’s important to the patient, because what we may wanna tell a patient is not necessarily what’s important to them. And a great example may be, once you understand what somebody wants, you may find out that their child is going to give birth in three months and their priority is to be healthy enough to see the birth of their grandchild. And once you understand what their goals are, it’s very helpful to try and help navigate that. Some people approach with anger, some people approach with tears, there’s all the stages of grief. But I think it starts really with listening and letting the patient speak. And once you understand what’s important to them, then you can offer your own recommendations. But what we think that the patient wants in our mind is not always what they want. And I’ve learned that to some degree the hard way over time. Just listen. We have two ears and one mouth. So just listen more than you speak.

Daniel Lobell: (26:01)
That’s very good advice and probably would do me good as well. Especially somebody who is in the business of listening. I always remind myself, “Listen, listen. Be quiet and listen.” But I also have to keep the interview going.

Dr. Joseph J. Bennett: (26:18)
Absolutely.

Daniel Lobell: (26:19)
What do you wish your patients knew, coming in?

Dr. Joseph J. Bennett: (26:27)
What do I wish they knew? I’ll tell you. I wish more what they don’t know. And I don’t mean that in a bad way, there’s so much bad information out there and misinformation. I feel like sometimes the office visit is trying to undo bad information that the patient may have been told or read or searched online. That derails what we really should be talking about. So I think it’s very hard for patients to know where and how to get good information. And when somebody’s given a cancer diagnosis, of course, they hit the internet and come to the office asking me for treatments that don’t necessarily apply to them. And that may not be the best use of our time.

Daniel Lobell: (27:20)
Mhm. Well, you brought up the online health space, which is a perfect lead-in to talk about Doctorpedia. What attracted you to Doctorpedia and how do you feel Doctorpedia is best assisting the online health space?

Dr. Joseph J. Bennett: (27:35)
I think it’s going to help solve this problem. And once it gets tremendous traction, I think it’s gonna really enhance the doctor-patient relationship, but also patient education. I’m hoping that Doctorpedia will be an extension of my office as well. A source not only for patients to go to on their own, but doctors can send patients to Doctorpedia because this is really good information by physicians who are experts in the field. The information has been vetted and it’s reliable. And unlike information that a patient may find online, you don’t know who even wrote that. You don’t know if that’s a physician, you don’t know if they even treat that disease. When somebody’s speaking about something on Doctorpedia, that’s what they do, day in and day out, and they’re an expert in that. So I’m looking forward to patients having a really good source of information and for me to be able to send them to that source in between one visit and the next, and that really resonated with me. And that’s why I wanted to become a founding medical partner. I needed to be part of this.

Daniel Lobell: (28:45)
Yeah. And we’re excited to have you involved.

Dr. Joseph J. Bennett: (28:49)
Thank you.

Daniel Lobell: (28:49)
I read that you also innovated some medical devices yourself. You developed a novel modular vessel sealer with your biomedical engineering colleagues. I don’t know what that means, but I’m very curious. [Joseph laughs]

Dr. Joseph J. Bennett: (29:05)
When I first came to Delaware a few years into being at my hospital, we had a relationship that we started with University of Delaware with their biomedical engineering group, and students every year would rotate through the Department of Surgery. I had them visit with different surgeons every day and try and come up with a problem that they wanted to solve, that is an engineering issue that we have, such as a camera keeps fogging or an instrument doesn’t have enough of an angle to make it useful, or a stapler is misfiring. And one of the projects I had come up with was a vessel sealer with interchangeable tips and pieces that allowed the surgeon to have more flexibility during an operation. And we designed a prototype and actually had a patent pending on it for quite some time. But unfortunately it didn’t gain traction as a single person doing this and not having corporate support, just couldn’t keep it going, but it was an amazing ride for the 10 to 12 years I did keep it going.

Daniel Lobell: (30:22)
Wow. I’m sorry to hear that it didn’t ultimately transpire as you’d hoped, but still impressive. So…

Dr. Joseph J. Bennett: (30:30)
It was an amazing experience. I wouldn’t go back and say it wasn’t worth it. But sometimes things just have to have to end, otherwise they really derail you from other things that are going well.

Daniel Lobell: (30:49)
Yeah, I can relate to that in my own life in some ways. And it’s a tough thing when you hold onto these things that have to end, but I mean, put so well. I mean, really just what you said has struck a nerve with me in certain aspects of my life. Things that I’m holding onto that probably just need to end because they’re taking my energy away from where it should be. And it’s very tough to let go.

Dr. Joseph J. Bennett: (31:20)
Yeah, it’s exactly right. And my wife has been my support since my intern year and she was very involved with it and being able to bounce that off of her and for her to say, “Listen, I know you’ve given this a good try, but I think enough is enough.” And having somebody to bounce that off of was extremely helpful as well. Because sometimes we can be blinded by these things and you keep doing it, but you’re spinning your wheel, it’s just not going anywhere.

Daniel Lobell: (31:48)
Mhm. Yeah. Yeah. And it goes against all the societal advice of “never give up” and “keep pursuing” and “you will persevere.” And sometimes the answer is no, you do need to give up. That’s the thing they never tell you, but it can be just as helpful advice as the other advice that you get, because sometimes you gotta know when to fold ’em, you know?

Dr. Joseph J. Bennett: (32:14)
Yeah, and giving up is not the same as quitting. I didn’t quit. I tried it and it wasn’t working. And so it was just a waste of resources. So everybody has limited resources. Money and time and energy. And I allocated as many resources as I had, for as long as I could. And then I moved on. It was just replaced with other things. It’s not like I just started watching more Netflix.

Daniel Lobell: (32:39)
Right. What have you learned from being around so many people who are in end-life stages? Have there been any takeaways that you’ve learned about life or your own mortality from dealing with so many people who are facing their own?

Dr. Joseph J. Bennett: (32:59)
Yeah, absolutely. I mean, I probably think about it more than many other people, because I do have patients who are passing and going to hospice or have terminal diagnoses.. Certainly over the years and as I get older as well, makes me little bit more aware of just mortality in general. I mean, patients can get bad diagnosis out of nowhere, even though they live a healthy lifestyle and wanna try and live life to its fullest. And I think we get upset in general about things that really aren’t ultimately that important. And it’s made me just ask myself, is this really worth getting upset over? Because, God forbid I got diagnosed with pancreatic cancer, I don’t think any of this would really matter to me anymore. So we don’t wanna recognize that only when we’re faced with our own mortality and a terminal diagnosis. I think it’s important to recognize that. And as they say, smell the roses along the way and not live life right now thinking, “Oh, I’ll do that in 10 years. I’ll do that in 20 years,” to try and do a little of all of this along the way and appreciate what you have and who you’re doing it with.

Daniel Lobell: (34:20)
I think that’s beautiful. On that note, what kind of things do you do for fun, when you’re not in the surgery room? What are some of the roses that you’re smelling along the way?

Dr. Joseph J. Bennett: (34:30)
Absolutely. I love being outdoors at the beach, walking, hiking. I love bike riding, I have a mountain bike. I try and get out when the weather permits. Right now, it’s snowing so I can’t. But when the weather’s a little better, I’ll be out there. Also I exercise quite a lot. I have a Peloton, I’m an avid Peloton user. I try and do that a few times a week and do some other exercise videos. And I love photography and I’ve been doing photography since I’m about 10, 12 years old, and have recently got into drone photography, which has added a tremendous new excitement to the whole photography and videography hobby that I’ve had for most of my life.

Daniel Lobell: (35:19)
What do you think it is about photography that draws you to it?

Dr. Joseph J. Bennett: (35:23)
Well, it’s both art and science, and again, I just can’t get away from the science. [Both chuckle] And I like the geometry of it. And I like the composure, and there is a true science to what Ansel Adams had termed the zone system, and thinking about shadows and highlights. So maybe unlike other types of art, there is quite a science to it, but it also allows for a tremendous amount of creativity. And I love nature. I love the beauty of nature and I love capturing it. And I have some amazing pictures of lightning strikes over the beach and sunsets, just the sun setting behind a building or behind a pergola. There are just so many things that we take for granted and getting back to what we were saying earlier, you have to stop and smell the roses. Photography allows you to do that. You’re taking a beautiful picture of something in time that at one point was fleeting and now you’ve captured it permanently, and you can enjoy it, whereas it may have been just a memory or something you forgot. Now it’s there, permanently. And I really like that, that I could revisit that moment of beauty.

Daniel Lobell: (36:42)
Where can people see these photographs? They sound incredible.

Dr. Joseph J. Bennett: (36:47)
[Joseph laughs] Some of them are, some of them aren’t. The difference between a good photographer and a bad one is that the good photographer doesn’t show you their bad pictures. [Daniel chuckles]

Daniel Lobell: (36:58)
Are they available somewhere for people to see them? I’m intrigued.

Dr. Joseph J. Bennett: (37:03)
I haven’t really posted them. But actually I was going to give a few to Doctorpedia to post on my website. So you’ll see some of the drone photographs of the beach.

Daniel Lobell: (37:14)
Yeah. I’m looking forward to that.

Dr. Joseph J. Bennett: (37:17)
Yeah, absolutely. I’ll get it over.

Daniel Lobell: (37:21)
What is the biggest compliment that a patient can give you?

Dr. Joseph J. Bennett: (37:29)
I’m trying to think of some things patients have said to me that have really touched me, and patients have said, “Thank you so much for extending my life.” “Thank you so much for allowing me to spend the last five years with my wife.” It’s experiential. They say, “I now have been able to see my grandson graduate college,” or my granddaughter being born. I think when people really add a personal touch to it and they tell me why they’ve enjoyed the time, it really resonates with me. This is why I’m doing what I’m doing. This is why I work weekends and nights. And I think about things so often. So people can go on to have not only just more life, but high quality of life. So those are the compliments, when people say “Thank you,” but follow it up with, “Thank you but this is what I’ve done with what you’ve given me.”

Daniel Lobell: (38:29)
Yeah. Wow. You talked a little earlier about how your wife has been by your side and inspired you and encouraged you and helped you through difficult times as well, which would lead me to believe that you’ve got a beautiful and healthy marriage. Do you have any advice for folks out there with regards to relationships?

Dr. Joseph J. Bennett: (38:53)
Yeah, absolutely. I mean, we’ve had our ups and downs, like any couple. We’ve been married for 21 years, and we met when I was an intern. And there have been very stressful moments, very happy moments. And I think we just have always been able to stay connected and we make plans for today, tomorrow, plans for six months from now, one year, three years, five years, 10 years. I think we have both a short and a long term plan. And I wonder if, when people completely diverge, they never really planned it out like that. But I feel like we already have this, and I’m not saying I’ve completely written down everything we have to do, but we have a general idea of a life together for many more decades. And I just wouldn’t want anything to happen to that.

Daniel Lobell: (39:51)
I love that piece of advice because it really, it gives you another reason to be together, cause you’re working towards certain goals. It’s not just about being happy in the now. It’s about… I’m kind of curious, what are some of the goals, the long term goals, that you’ve set together?

Dr. Joseph J. Bennett: (40:12)
Well, a lot of it initially was about raising our family. Our children are now almost 15 and 18. So that was a big part of our life. When we met, we had absolutely nothing and we were in a small 600 square foot apartment in New York City and we had so many goals, and a lot of them we’ve achieved. So I guess the other nice thing is we’ve realized that together, we’ve been able to achieve all these wonderful things. We’ve built a home and a family together and we’ve traveled together and we’re looking forward to continuing traveling. I think that’s a big thing for us, although with COVID we haven’t been able to, but constantly talking about where we’d like to go and for how long and where we’d like to visit, and both really into experiencing other cultures and other foods. And we talk about that quite a bit.

Daniel Lobell: (41:06)
That’s great. I mean, just always having things to look forward to is so important as well. I always try to book a trip somewhere down the line for my wife and I, six months, eight months down the line. I’ve been taking it further than that, but now I think I will. Two trips! No. I think, I think…

Dr. Joseph J. Bennett: (41:25)
Absolutely.

Daniel Lobell: (41:25)
I think it’s really important what you’re saying, is to build goals and steps towards getting to them together. So you’re always working on something together.

Dr. Joseph J. Bennett: (41:36)
Yeah, absolutely. Again, it’s not like it’s a regimen or anything written in stone that you have to do, but there should be some sort of general outline of what you wanna accomplish. And I think we’ve been able to grow together and we haven’t grown apart for that reason, cause we’re definitely not the same two people that we were when we first met. We talk a lot and, and I share a lot of my happiness and also my hardships and, vice versa with her as well. So we really experience it together and then just haven’t really diverged. We’ve grown.

Daniel Lobell: (42:22)
You remind me of when I was doing another podcast many years ago when I was in college, I interviewed the late, now late Larry King and I asked him why he’d had so many wives. And he said, well you’re not the same person you are when you’re 20 and you’re not the same person you are when you’re 30 as when you were 20 and so on. And so he said, you grow apart and you’re not into the same things. And what you’re saying is kind of like the piece that he was missing, I think. Is that he wasn’t growing together with any of his partners. They were becoming different people. As you said, you both become different people over time, but if you become different people together, you can avoid that feeling of becoming distanced from the person who you love.

Dr. Joseph J. Bennett: (43:12)
Absolutely, absolutely. And along the way, we’ve become the other person for each other, where when something really bad happens, I feel better when I talk to her about it. And when something really good happens, I can’t wait to share it and let her know and vice versa. If she’s upset about something, it bothers me. I wanna know about it and try and help.

Daniel Lobell: (43:37)
And was it always that way or is that something you guys had to work towards getting to that place?

Dr. Joseph J. Bennett: (43:44)
Any relationship is a lot of work. Like I said, I think it’s silly to say people don’t put a lot of work into a long lasting relationship. But it wasn’t — yes and no. We were always that way at the beginning. We went through, I think also when people go through some hard times together, you hear that when people say they go to war together, it’s sort of a bond. We weren’t in war together, but going through surgery residency and having a lot of financial struggles very early on in our life when I was a poor resident and we were just trying to survive, really strengthened our relationship. And we went through a lot of other hard times together and that really brought us together in a way that, if everything were perfect all the time, doesn’t bring you together.

Daniel Lobell: (44:34)
What’s more difficult, would you say? A relationship or a pancreatic surgery?

Dr. Joseph J. Bennett: (44:43)
[Both laugh] Probably a relationship, because the pancreatic cancer operation’s only four hours long. [Both laugh]

Daniel Lobell: (44:56)
Oh man. How do you think technology is playing a role in changing health and wellness? And do you think it’s for the better?

Dr. Joseph J. Bennett: (45:07)
I think it can be for the better, but I don’t think it has been for the better. I think patients just, again, they have so much information at their disposal and don’t know how to vet it and it’s very overwhelming. And sometimes it’s hard even for me as a physician to know what to believe and what not to believe, but I know what obvious journals and websites to go to as a physician. But there was a patient who came to me very specifically wanting a particular medication for a tumor that I had recommended. And it was not indicated unless he had already failed three other lines of therapy, but he was sort of set on getting that medication because that’s what he had read online. So technology has hurt in that regard, but on the other hand, I am 110% in favor of patients being educated. I really think that’s the best way to build a doctor patient relationship. I want patients to be educated, just want them to be educated with the right information.

Daniel Lobell: (46:15)
Right.

Dr. Joseph J. Bennett: (46:16)
And it doesn’t have to be just the information that I give them. I would like patients to have other sources and they want second opinions, that’s fine. But technology has made things very, very scattered and very difficult, and it’s hard to find good information. That’s the problem with technology. You cannot tell the difference between good and bad information.

Daniel Lobell: (46:39)
What about in terms of the other kind of technology, like in the surgery room? How has that changed things?

Dr. Joseph J. Bennett: (46:48)
Well, that’s been amazing. And one of the great advances in the last several years was, I do some of my pancreatic and gastric surgery and liver resection robotically. And robotic surgery didn’t even exist when I was in my residency. And I had to learn that as a full fledged surgeon, and was among the early pioneers in my hospital in learning robotic surgery. And literally had to learn by spending hundreds of hours in a simulator, in going through classes with the company Intuitive that makes the DaVinci robot and started with smaller cases and with mentors who were coaching me and watching me, and then moved up towards doing more complex surgery, that has made a world of difference in patient outcomes and how the surgery goes for both patient and the doctor. So technology is advancing technically quite rapidly when it comes to the operating room. That’s been a joy.

Daniel Lobell: (47:50)
Can you do some kind of a 3D scan of the patient and then do a mock surgery where you’re not actually doing the surgery on the patient to see if any complications would arise?

Dr. Joseph J. Bennett: (48:03)
Well, that’s a great idea. So maybe we should look at patenting that. [Both laugh]

Daniel Lobell: (48:10)
And here comes the next 10 years. [Both laugh]

Dr. Joseph J. Bennett: (48:16)
I wouldn’t be surprised if that actually is in progress. And in the last two years, similar to the program I developed back in 2008, the American College of Surgeons has a combined meeting with engineers and surgeons. And these are the kinds of things that I hope would come out in a meeting of the minds where you have surgeons and engineers and computer and graphic designers who are coming together. I mean, it may sound silly, but you should probably have people from the video gaming world coming in and helping with these simulations.

Daniel Lobell: (48:50)
That’s what I was thinking.

Dr. Joseph J. Bennett: (48:50)
And I agree. Absolutely, absolutely. I would be surprised —

Daniel Lobell: (48:54)
Are we about to become billionaires? Did I just strike gold here? [Daniel chuckles]

Dr. Joseph J. Bennett: (48:59)
Absolutely. Never know.

Daniel Lobell: (49:02)
I mean, to me, that seems logical because why wouldn’t you wanna get to do a practice round, you know?

Dr. Joseph J. Bennett: (49:09)
Absolutely. And the simulators are quite amazing. So I would love to be able to have a CAT scan or an MRI inserted into a simulator and somehow figure out how to do a mock operation. There are 3D scans where we’re able to turn the image and you can look at it and completely turn it around. So I am using that 3D technology with MR and sometimes with CAT scans, ordering a 3D scan to really see the complexities of, for example, like a liver tumor. And that does help in surgical planning.

Daniel Lobell: (49:49)
Hmm. Wow. I can’t believe that the answer is that it was a good idea. [Both laugh]

Dr. Joseph J. Bennett: (49:59)
Don’t underestimate yourself.

Daniel Lobell: (50:00)
Wow. All right. I’ll try not to. But overestimating is also no good, I found out.

Dr. Joseph J. Bennett: (50:07)
True.

Daniel Lobell: (50:08)
I just have to estimate myself quite, just perfectly. [Both chuckle] Doctor, it’s been an absolute pleasure getting to chat with you over the last hour. I usually ask all the doctors to round off the interview by telling me what they do to stay healthy. I know you talked a bit about that with regards to the hiking and the Peloton. Is there anything you didn’t mention and are there any apps that you use to monitor your own health?

Dr. Joseph J. Bennett: (50:35)
I use the Apple Watch. I constantly am trying to look and make sure that I meet my exercise ring. [Joseph chuckles] I think that’s a great advance in technology. I do use the Apple Health app as well. I will tell you one thing I would like to get into, which is a little bit of a New Year’s resolution. I think I need a little bit more quiet time, and using some of these apps that help with meditation is something that I’d love to move into. As you probably aren’t surprised to hear, a lot of what I do, even to relax, is very active. I think it’s important to sit down and just chill out and I would like to get into meditation. That’s one of my New Year’s resolutions.

Daniel Lobell: (51:21)
Oh yeah, absolutely. I think mindfulness is — not that I have much of it, but I wouldn’t mindful. I wouldn’t mindful having it. I wouldn’t mind. [Daniel chuckles]

Dr. Joseph J. Bennett: (51:30)
Exactly.

Daniel Lobell: (51:32)
But I think that’s definitely a big piece of the puzzle. In fact, I recently spoke to a doctor, and the interview will be up shortly. Dr. Dana Tarcatu is her name. And she works in hospice and hospice medicine. She’s also part of the Doctorpedia network. And she just came back from a 10 day mindfulness meditation retreat that she thought was transformative, and talked about it on the interview. So maybe it’s something you’ll enjoy listening to, because I thought it was pretty inspiring.

Dr. Joseph J. Bennett: (52:13)
Yeah, it sounds great. I would love to be able to do that for 10 days. I was thinking about starting with 10 minutes a day, but 10 days would be a goal.

Daniel Lobell: (52:22)
You gotta start somewhere.

Dr. Joseph J. Bennett: (52:24)
Yeah. Right. [Both chuckle]

Daniel Lobell: (52:27)
Thank you so much for your time and for your wisdom, and I really appreciate and enjoyed this conversation.

Dr. Joseph J. Bennett: (52:34)
Yeah, me too. Thanks Daniel. Thanks very much.

Daniel Lobell: (52:46)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only, and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs.

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