A Terminal Diagnosis Confirmed the Beauty of Life He’d Already Built | Dr. Bryant Lin

When Stanford physician Bryant Lin was diagnosed with stage four lung cancer, a friend gave him one piece of advice about his own prognosis that he still credits with how he’s lived every day since.

Bryant Lin is a Clinical Professor of Medicine and Director of Medical Humanities and the Arts at Stanford, a fourth-generation physician who spent two decades in primary care before his own stage four diagnosis in 2024. He built a medical school class around his experience that drew coverage from the New York Times and CBS Mornings, and he’s the author of Sunshine: An Exploration of Living When You Are Dying.

In this conversation, you’ll explore:

The advice from a fellow doctor that changed how Bryant thinks about his own prognosis, and why he stopped looking at the numbers everyone else obsesses over A simple filter he now uses to decide which commitments are worth keeping, and what needs to go Why he changed very little, even after learning how much less time he likely had Why he chose to teach a Stanford class, narrating his own cancer journey, while going through chemo in real time What a good life means, once you learn you have a lot less time to live it.

It’s a conversation for anyone asking themselves what’s actually worth their time, whether or not a doctor has given them a reason to ask.

You can find Bryant at: Website | LinkedIn | Episode Transcript

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Episode Transcript:

Jonathan Fields: [00:00:00] So two years ago, a chest X-ray showed fourth-generation Stanford physician and medical professor Bryant Lin something abnormal. By the time additional scans were done, doctors had identified stage four lung cancer and then counted a further 50 lesions in his brain. His condition was terminal. And yet, as he told me, he considers himself the luckiest man on the planet. Bryant talks about it almost matter-of-factly, and then explains why almost nothing about his daily life after that actually changed. And our conversation, you’ll discover why he refuses to look at his own survival statistics and what a friend actually told him instead. That really helped. You’ll hear how he decided what to tell his teenage sons, and why he chose complete transparency over protecting them from the news. You’ll learn what made teaching a class about his own cancer, literally narrating his chemo in real time feel less like a burden and more like an act of kindness, both towards himself and his students, and you’ll hear his answer to what it actually means to live a good life, drawn straight from his own parents and apply to the time he has now. In addition to being a physician, Bryant also is the author of Sunshine, a book about what happens when you focus on what really matters. So excited to share this moving conversation with you. I’m Jonathan Fields and this is Good Life Project, and we’ll jump right in after this short break.

Jonathan Fields: [00:01:30] You are, if I understand correctly, a fourth-generation physician teaching at Stanford Med School and practiced clinically for the better part of two decades when I when I see that especially, I’m I’m so fascinated by the phenomenon of fourth-generation physicians. What was your journey into medicine? Was it just like this is what was tracked from birth? Or did you kind of rebel and then come back?

Bryant Lin: [00:01:56] It’s funny, you know, I like to joke around that my mother has some kind of brainwashing power, you know? So all the physicians are on my mother’s side. She’s not a physician, but half of her brothers and sisters are. And their spouses and. And then I found out later, actually, after I was already a physician, that my great-grandfather went to the first medical school in Taiwan, Western Medical School in Taiwan. So, you know, yeah, I’ve got this illustrious history. But, you know, I never grew up thinking I was going to be a doctor. Never. I was like, I like, you know, figuring out machines, I like computers, I want to be an engineer. I hated it. It was soul depriving experience for one year. It was unpleasant. Um, and then I decided to go into medicine. So that’s kind of definitely a roundabout route. Well, that was not me at all. I mean, what I loved about medicine was, was the people working with people. So, you know, can’t get closer to people than primary care. Um, but yeah, no, I and I’ve been in medical devices for 20 years as well. So I, I still, I’ve been lucky, I’ve been fortunate. I’m grateful I’ve been able to kind of scratch all those itches, you know, work, do develop devices, make, create inventions, work on companies, but, you know, see patients and do everything I love. It’s, I’ve been lucky. I look back at my life all the time and think about how lucky I’ve been.

Jonathan Fields: [00:03:23] It does seem like you were wearing multiple hats for so long. You you have your primary care practice. And there’s also this really strong, it seems like entrepreneurial impulse in you that says, okay, there’s a problem. And I can also, you know, switch on my, my engineering hat and my problem solution hat in a different context. And maybe we can build something around that and scale the impact of what we’re doing beyond the, the, the primary practice.

Bryant Lin: [00:03:47] Absolutely. I’m always looking to say, hey, how do I identify the problem? What’s the need? What’s the unmet need? Let’s try to figure it out. Let’s try to solve it. Of course, you know, you try something. Maybe one time out of ten, you’re lucky and you can figure out how to. But you know, to me, the attempt is worth it, right? I mean, you can help people. I mean, that’s obviously there’s this, you know, with entrepreneurship, you think about making money. And definitely I thought about making money. It was not, you know, especially when I started young, you know, kids were coming, started to have kids and got to feed the kids. Um, but, you know, as time went on, it really, you know, became more about the meaning of the role, you know, how do I have, how do I help people in many different ways directly in clinical practice, but, you know, through inventions, through technology. And, you know, I’m happy that somehow I’m, I’m wired that way, I guess, to kind of think about, you know, if there’s a problem, how do we, how do we solve it?

Jonathan Fields: [00:04:43] Yeah. At some point you start teaching also, um, Stanford med school, what’s the impulse behind that?

Bryant Lin: [00:04:49] I never thought of myself as a teacher like that. If you had asked me 20 years ago, even even maybe ten years ago and said, hey, Bryant, you know, you’re going to spend a lot of your time starting new classes and teaching not just med students, but undergraduates at Stanford. I would have said, no way. You know, clinical teaching. Yes. You know, we all doctors do that, right? You go through training and you teach med students and you get, you know, you learn from great mentors and, and senior faculty. And I was the beneficiary of that. But, you know, I never thought I would be a classroom teacher that was farthest from my mind. And yet somehow I got into it. You know, I think it was roughly about ten years ago. I started my first class at Stanford. And, you know, I haven’t looked back since I’ve started, God, maybe eight plus classes since then. And it’s really been enjoyable to be able to take that different view of education, of education and educating people, right? We do that with patients all the time, right? We’re trying to relay what we know about medicine and teach them something. And, you know, um, you know, we do that in the clinical setting with, with residents and students. But, you know, the classroom, I have to say, has been very satisfying to, to be in the classroom.

Jonathan Fields: [00:06:06] So you’re, you’re building this, this life. Um, and along the way also, you get married, you become a dad, you have kids and practicing, researching, teaching, getting involved in consulting. It sounds like an incredibly full and rich life. 2018 was an interesting year. Also, um, tell me if I have the timing right. I believe that’s the year that you co-founded the Stanford care, um, program. Take me into this.

Bryant Lin: [00:06:35] Yeah, it’s it’s interesting, you know, at the time I had the same exactly what you said. I felt like I’ve gotten to be able to accomplish so many things, do many great things. And I felt like it’s time for me to give back. You know, I don’t have many regrets in my life, but I think looking back now, maybe one regret I have is I should have focused on giving back sooner rather than waiting until 2018 or, you know, in a larger way. So it’s interesting. I had a patient, um, he actually had a bad outcome from something I did. I gave him a drug, common drug called allopurinol for gout. So gout is a common common problem. It’s inflammation of usually one joint at a time. Usually it’s the big toe and it’s very painful. Uh, basically crystals deposit in the joint. And, you know, you can have these episodes, these flares. And if you get them too many times, we give you a medicine to try to prevent the gout. And I gave him this drug called allopurinol, common drug costs, you know, pennies, you know, very cheap, cheap, inexpensive drug. And I didn’t know at the time that people of Chinese descent can have a severe reaction to this drug. And in. Most American doctors don’t know this. This patient of mine, lovely gentleman, you know, and he’s told me to share this story widely. He had a severe reaction. He ended up in the hospital. He had to be put on high dose steroids.

Jonathan Fields: [00:08:04] Wow.

Bryant Lin: [00:08:05] So he was significantly ill. He was in the hospital several days. He didn’t blame me. He didn’t say, hey, doctor Lynn, you messed up, right? He didn’t say that. And he said, hey, I know doctors in the US don’t know about this. He’s from Taiwan. He’s like, I want you to spread the word. I want you to to, you know, raise awareness that that, you know, this can happen. And then I reflected and I said, well, there are a lot of things that happen to Asian, uh, our Asian population that are unique or different, uh, to Asian Americans and Asians. And I said, hey, this would be a great time to start a center. Uh, so centers have a special place at Stanford. And usually they’re started with, you know, a big grant or a big donation. We had none of those. Uh, we had a lot of spirit and hopes and, and a lot of support from everybody, from all the faculty, from the administration. But, uh, looking back also just in my personal life, I realized later I didn’t think about it at the time. My grandmother died from a disease that disproportionately affects Asians, hepatitis B, so she had hepatitis B and liver cancer from the hepatitis B, and she died from that. And I never thought until maybe a couple of years after the founding, I was like, wait, there’s something else in my background that that led me to, to help start this center. So yeah, it’s been an amazing experience to, to start the center and help grow it. And the staff have been incredible. Um, and, you know, as part of my way of giving back, giving back to my community that’s supported me and that has been, um, you know, under-resourced, honestly, from, from a healthcare funding and research point of view. Um, we always quote the source. Asians are, you know, 30% of the Bay area, 60% of the world, but NIH funding is around 0.17% of research. So so hopefully we’re moving the needle on that, that part at least.

Jonathan Fields: [00:10:03] Yeah. I mean, it is interesting. I think if you probably talk to the like the average layperson, the average person on the street and you say, hey, you know, like think about any of the, like the big scary diseases or conditions and do you think they would affect any one population differently? Most people would probably say probably not. I don’t know, like, isn’t everyone just sort of equally at risk? So it’s fascinating to hear that it’s completely untrue that, you know, like that. In fact, there are very different risks for different populations.

Bryant Lin: [00:10:36] Yeah, absolutely. I mean, you know, your background, your family history, obviously, we all know family history is important, but, you know, the genetics come from the group of people you’re from, right? So, you know, we have shared genes across those racial ethnic groups. Um, and, uh, you know, all sorts of issues that can disproportionately affect Asians and other groups. So we know that in other groups like African Americans with prostate cancer. Um, so, you know, it’s, it’s not just Asians, it’s, it’s many different groups.

Jonathan Fields: [00:11:08] And we’ll be right back after a word from our sponsors. This is what your life is looking like. It’s you’ve got so much going on. There’s it seems like there’s so much purpose, so many beautiful relationships in your life and a very full, abundant life. We come into May of 2024 and everything starts to change for you. Take me there.

Bryant Lin: [00:11:32] Yeah, it’s what I remember this distinctly because my son was a junior. It was a spring of his junior in high school, and we were going to do college touring, right? Like every every family does. So we said, you know, he really wanted to stay in California. So we said, hey, let’s drive down to Southern California and visit a bunch of colleges. And I had a cough at the time. And then, you know, I remember walking on, on the college tours and being like, God, it’s kind of like not easy to get around. I’m coughing and maybe a little bit, you know, uncomfortable. And, uh, you know, we drive back and, uh, it doesn’t go away, you know, and I kind of get tired. And luckily I’m in primary care. My primary care doc is like two doors down from me in the office. So I have the ultimate access. His name is Doctor Paul Ford. He’s been at Stanford for 30 plus years. And you know, I say hey Paul, you know I’ve been coughing. I’ve tried, you know, Flonase, Zyrtec, Claritin. So we try some inhalers. You know, maybe it’s maybe it’s asthma from allergies. Didn’t work. Uh, tried albuterol, tried a steroid inhaler didn’t work. And finally he gave me some antibiotics. You know, after several weeks of this didn’t work. And then it was a Tuesday late May. Um, and, you know, went to get a chest X-ray. And of course, at this point I’m like, oh, it’s going to be something bad. It’s going to be something bad, right? So get the chest X-ray and it’s abnormal. You know, I’ve got this kind of white area, maybe lymph nodes enlarged.

Jonathan Fields: [00:13:06] And as a as a physician, when you just see that it’s our bells going off already.

Bryant Lin: [00:13:11] Oh yeah. Yeah. So you think it’s a weird infection or it’s cancer. Like those are the two things you think about first, especially in a guy. I was 49. I’m 52 now. I was 49 at the time. You know, otherwise healthy, not on any medicine, nothing like that. So I’m like, oh geez. So, you know, I they order CT scan. It’s a Tuesday, chest X-ray, Wednesday CT scan, I get it. And there’s a big white patch. It’s like eight centimeters by five centimeters. Huge, huge white patch and again lymph nodes. And again the radiologist says, geez, it could be some weird infection or cancer. And you know, by then I’m like, oh geez, I hope it’s some weird infection. I’m like praying for the weird infection. And then I get a bronchoscopy. So that was a Wednesday, the Friday. Again, I’m very privileged. I’ve worked at Stanford for 20 plus years. And you know, I can call people I know they get me in on a Friday. I get a bronchoscopy to get a biopsy. So they go through it’s like a, you know, fiberoptic scope, sort of like the colonoscopy, but it’s for the lungs. And they do a biopsy. And then slowly over the weekend, you know, the results come back. All the infectious tests are negative, negative, negative. On the Monday I get the result.

Bryant Lin: [00:14:28] And and it’s they did like six biopsies, you know, six needle passes and and each one said, you know, metastatic non-small adeno non-small cell adenocarcinoma of the lung. So, Yeah, it was just I was I was hoping for something else. I was hoping even for a different cancer. I thought, oh, lymphoma has a better prognosis than lung cancer. Um, yeah. And I mean, of course I was crushed. I was it wasn’t an immediate because I kind of knew it was going to happen right over the week. It was in the back of my mind. And obviously I knew about lung cancer and Asians, something my center’s been, you know, supporting for eight years at that point. So yeah, it was, it was it was immediately went into the stages of grief. You know, in med school, we learned about the stages of grief. But, you know, until you experience them to this degree, you don’t appreciate how rapidly they can cycle and turn and go in different orders. And, you know, it’s an incredible, you know, probably not so much some depression, you know, bargaining, not so much bargaining, um, anger, some anger, you know, denial. Definitely some denial. And, um, you know, definitely acceptance. Uh, luckily it came quickly. Took a couple of weeks. Um, I, during which I finally came to acceptance of my diagnosis.

Bryant Lin: [00:15:57] And part of that’s because I later got, you know, more data, more information spread to my brain, 50 spots on my brain, poor radiologists. I kind of always joke around. I’ve never seen the radiologist count 50 of anything. Poor radiologist. I could have felt bad 50 spots of cancer in my brain and, uh, you know, spread to my bone, to my liver, my adrenal glands. It was all over. I was just lousy. I even had little lumps under my skin that I could feel that actually had the pathologist needle biopsy and, um, aspirate. Uh, and, uh, they were cancer. They weren’t lymph nodes. They were like pure cancer. They were just lumps of cancer under my skin. So I got my molecular testing back, which showed I had the classic Asian mutation. So Asians get this mutation called EGFR. 50% of the time if you’re not a smoker. Whereas other groups get maybe 20% or less of the time. Um, that was a good thing because we have a treatment for that. So once I kind of got that news, I think that helped me because I knew there was a plan. There’s a treatment that works, at least temporarily. So that helped me, I think, arrive at acceptance through all those stages of grief.

Jonathan Fields: [00:17:15] You know, as you’re describing this, um, there’s a book that I’ve reread so many different times when Breath Becomes Air by Paul Kalanithi. Um, I had the chance to actually sit down and have a conversation with his wife, Lucy a couple of years back. And I remember in the book, you know, when he got a diagnosis. And for those who haven’t read it, you know, there’s this sort of like brilliant rising neurosurgeon who gets a cancer diagnosis also. And, and he kept saying to his oncologist, he kept demanding on seeing sort of like what? I can’t remember the name of the chart, but like, what is the chart for life expectancy for me? And, and his oncologist kept refusing to show him and saying, like, that is not what we need to focus on. I’m wondering where your mind went with that.

Bryant Lin: [00:17:55] Absolutely. Every doctor will go. These are like the survival curves, right? These are like the like the, you know, like on the y axis is like you start at 100% of people. They’re alive, right? And the x axis is time. And so, you know, of course it goes like this. And so you’re like, how many people, you know, common thing in studies is like, how many people are still like, when are half the people still alive? So what’s the average life expectancy? And for and actually, it turns out, yeah, I have the exact same kind of cancer that Paul Kalanithi had. That’s the same type of lung cancer. Um, I know his widow Lucy, fantastic person. Um, and yeah, it’s kind of again, ironic at the same type of cancer, like specifically the same type of cancer and. No, absolutely. It’s funny though, and I looked at them without a doubt. And, you know, you looked at the look at the published data across all lung cancer. It’s about a 12% survival rate at five years, 12%. So, you know, one out of ten people are still alive at five years with advanced advanced lung cancer. So if you catch it early, survival rates are much higher. I looked at those, of course I knew those. I didn’t even have to look, honestly. I mean, I still looked, but I knew that I knew the data.

Bryant Lin: [00:19:14] But it’s interesting. I talked to a friend of mine from med school. He’s a pulmonologist, lung doctor. He said, hey, why don’t you talk to a buddy of mine? He’s also pulmonologist, but he had stage three lung cancer and I talked to him. He was very nice. Um, and I talked to him and he said, don’t look at the survival curves. Don’t look at it. It’s not going to help you. Right? Because that’s the average person. You’re not the average person, right? You could live longer. You could live shorter. You know, for a in medicine, we’ve got all this data and technology, but I can’t predict things on a single person basis. So that helped me. I was like, yeah, you’re right. It doesn’t help me at all. It doesn’t help my mentality. It doesn’t help my spirit to kind of focus excessively on that number, which it may or may not apply to me. Right. If there are 100 of me. Sure. You know, that’ll be that’ll be the average. But it doesn’t say anything about me as an individual. What’s going to happen? So so that helped a lot talking to him and thinking about those survival curves. Um, you know, it really helped a lot to not, not do that and not obsess about it.

Jonathan Fields: [00:20:17] Yeah. But I could see the, you know, your brain wanting to say like, let me immediately get an understanding of what this looks like.

Bryant Lin: [00:20:25] Absolutely.

Jonathan Fields: [00:20:25] And then the counter is, I wish I, it sounds like it was so compelling to you like that, you know, that’s a cross-section of a wide number of people. You are one person here. You know, your unique individual outcome is going to be as varied as you are. Um, so let’s just focus on you and on that. So in, in the weeks after that, as you’re processing this and sort of saying, okay, so this is what’s going on as you describe, like there is this identified treatment for it. Um, so you start to like explore what are the treatment for? Um, you make some really interesting decisions also both about what you want to keep doing and not doing.

Bryant Lin: [00:21:05] It’s, I always say funny, I don’t know why I use that term all the time. It’s not ha ha funny, but it’s interesting. You know, I, I’ve always tried to live my life where I’m doing, you know, what I want to do, right? And kind of nothing was more affirming that I was actually doing what I wanted to do than getting a cancer diagnosis, advanced cancer diagnosis, a terminal cancer diagnosis. Uh, theoretically, because stage four lung cancer is not considered curable. And fortunately, most of life didn’t change, you know, because I was doing things that I wanted to do. I really did examine my life and said, hey, what can I cut out? What should I cut out? And I did cut out some things. I had a lot of extra meetings and, you know, a lot of coffees, which, you know, I enjoy, but I cut, cut those out, those kind of extra things. And, um, but, you know, I, I really still was working with care Asian health center, uh, still seeing patients, um, you know, still teaching in the resident clinic, still teaching classes. Um, I was doing all these things. I was still also the director of medical humanities in the arts and still doing all these wonderful activities because there’s so much fun. Like I found they’re, they’re fun. They have a lot of meaning to me. Um, but yeah, I did, I did stop doing things, which I felt like didn’t have an end point, meaning there’s no like indefinite, you know, I did a lot of projects before that are indefinite, so I tried to stay away from projects that have no clear ending, except I made the exception for anything to do with lung cancer so early on it wasn’t a conscious decision.

Bryant Lin: [00:22:48] But, you know, I thought, hey, I’m in such a position. I’m at Stanford, I’m, I’m, you know, a direct dissenter. Co-direct the center. You know, I really need to put my story to work, um, to bring awareness that lung cancer happens to so many people. Number one, cause of cancer, death in the country and the world. And 20% of people who have lung cancer have never smoked. You know, a lot of people assume it’s I’ve never smoked, I’ve never puffed anything in my life. I’ve smoked a lot of brisket, but that’s about it. Um, yeah. So. 20 so I wanted to raise awareness and to really push the whole field of screening, prevention and treatment so that I was like, that can be open ended because that I, you know, I probably won’t see the end of in my lifetime or multiple lifetimes, but you know, that I wanted to put my story to work. Um, you know, to see if it’ll help people.

Jonathan Fields: [00:23:44] I mean, it’s, it’s such an interesting moment, right? Because when you get a diagnosis like this and you have the time to let it settle, and then I’m sure conversations with your wife, conversations with your kids at some point, um, a lot, I’m sure there’s this process of reckoning, you know, like if I know that, you know, we all know that we have a finite time on the earth, but you have a stronger sense that yours may be significantly less than you thought, like a couple of weeks earlier. What what do I want? And so many people, I would imagine, hit that moment. And they say like, there are big changes that I want to make. There’s a whole bunch of things that have been centered in my life that I’m going to jettison. And there are a whole bunch of things I’ve been putting off that I’m going to start saying yes to. It seems like you did that analysis and the vast majority of things you held on to, because it looks like you were looking back at your life and looking at the present life you had and saying, so much of what I do is exactly what I want to be doing, which is incredibly rare.

Bryant Lin: [00:24:43] I do think I’ve lived my life to try to do that always. You know, I always thought, am I even when I decided to go to med school, you know, I had many choices, right? I could have gone to engineering business. I could have gotten an MBA. Um, but yeah, I made the decision. I’m like, hey, if I went to med school and, you know, something would happen, would it be a worthwhile experience for me? And, and I thought, hey, it would be, you know, I would do, you know, it’s just such, such a unique thing to go into med school and to learn about people and to talk to people from all backgrounds and to try to help them. And, you know, I think I’ve tried to live my life that way. I didn’t really know until this, this diagnosis came out that it turned out, hey, I really, really am living my life the way I wanted one of my colleagues and good friends. She said, hey, are you going to quit? And, you know, travel the world and, you know, get your get your travel bucket list out. And, and I was I’m not a, I’m not that kind of bucket list guy. Like, you know, here are the, you know, top ten places I want to go in the world. Uh, I mean, part of that’s I’m lucky I’ve been able to travel a lot, but part of that’s, you know, I, you know, I think there are many things here, you know, with my family and, and with my work that I love doing. And I’ve been privileged that, um, yeah, I, I’ve been able to do them and continue to do them.

Jonathan Fields: [00:26:10] There’s also something that you added up into this, something new that you added into what you’re doing on the teaching side of things. Yeah. Um, so as you.

Bryant Lin: [00:26:20] That was crazy.

Jonathan Fields: [00:26:21] Right? But I, I want, I want to wrap my head around this like you’re starting treatment, you’re in chemo, you’re like, okay, so I need to take care of of my body. And then you’re like, I need to share this in real time.

Bryant Lin: [00:26:34] Yeah. I looked up my emails because I’m like, God, it’s all a blur, right? You look black back and it’s all a blur. And I was feeling lousy and I’m like, God, why the heck did I decide to start a class about my own case at Stanford? This kind of. I saw that I have a tool. My story can be used as a tool to educate students to educate the next generation. I thought this was a unique opportunity. And, you know, I joked around, it’s like, you know, I kind of have this mindset of turning, turning lemons into lemonade, right? And another friend of mine said, well, maybe a better way to say it is to turn crap into fertilizer. So yeah, maybe, maybe that’s better. Um, yeah. So I thought, geez, I need to share my story, what I’m going through because students don’t get a lot of continuity in med school, right? You see patients kind of sporadically. And, you know, you may see a patient for a few days or, you know, randomly over a few months. Uh, but I thought, hey, this is a great experience. I can share what I’m going through in real time. And they can learn from experts in the field. So it wasn’t just based on my story. So we created this class called From Diagnosis to dialogue, a doctor’s real time battle with cancer. And you know, I said, hey, every class, ten lectures, ten, ten, ten, ten meetings, I’d start with what’s going on with me. So talk, share my experience, what I was going through with chemo, talk about my diagnosis.

Bryant Lin: [00:28:09] And then we’d invite a guest speaker who’s kind of an expert in the area. Um, but what I really wanted to do is not talk so much about the medical science, the clinical science. I want to talk about the patient experience because, you know, even though I’m a doctor, right? I knew, but I didn’t know and I wanted to really rebalance that experience to show that, hey, this is what’s important to patients. So not only do we talk about diagnosis, epidemiology, treatment, you know, we talked about, um, difficult conversations, we talk about nutrition, talked about spirituality, talked about access to care, um, talked about gratitude, you know, so I talked about mental health. So I really wanted to reposition and rebalance the story, you know, not away from medicine, but toward what the patient is feeling and going through at the time. And, and again, luckily I’d worked with several students in the past and they, we had three awesome students volunteer to be my free Tas arranged the class and it just came together wonderfully. But yeah, looking back, I’m like, wow, what was I thinking to do that, you know, to start that. But I think part of that was me also thinking, hey, maybe I’m not going to be around in six months, you know? So I’ll lose this opportunity. Maybe this fall is the only time that I can share my story. And to have an, you know, an impact on students and what they’re doing. So again, lucky, lucky it came to fruition.

Jonathan Fields: [00:29:42] Yeah. So it sounds like there’s a real sense of urgency then because you really things were so uncertain about your future. You know, you sharing also your lived experience being on the patient side after so many years of being on the other side, in the context of students who are trained to become doctors, um, hopefully most of them at least. Right. Um, I would imagine that was incredibly powerful, compelling for them. Have you had conversations with some of those students about how it affected them?

Bryant Lin: [00:30:15] Absolutely. I mean, there again, I’m privileged as a teacher to connect with them and to hear their stories. I was maybe I shouldn’t have been surprised. I was surprised by how many also came with their own personal experience of cancer, either in themselves or their family. Uh, and some of them, it was so powerful. That’s what brought them into medicine. Wow. You know, um, so I, you know, I, I was very, you know, just blew me away to think about these students who were, you know, vulnerable to me and sharing what was going through, what they were going through and taking the class seemed to help. Some of them also deal with their own experiences. And that was unexpected. I didn’t think that would be the case. Um, yeah, I, it was incredible. There was one student, you know, who shared with me his treatment as a teenager, uh, for, uh, you know, blood cancer. And, you know, it left him with neuropathy. So numbness, chronic numbness of his fingers. And he was not able to play the instrument he loved so much. Uh, I mean, he could play it, but not to the level at which he was, you know, very high standards.

Bryant Lin: [00:31:25] He kind of was. Sounded like a very, almost concert level performer. Um, but, you know, he still enjoyed it. He still found meaning in playing. And even though those goals were not accessible to him anymore, right. For him to become a concert level musician, you know, he still enjoyed doing, he still put in hours a day of practice. Um, so yeah, I was, I was lucky to be able to hear those stories and, and, you know, they’re sharing with me impacted me honestly, like I said, I feel like the students teach me more than, than I learned from the students. Um, so yeah, it was a powerful experience. I think all around everybody asked me, hey, you taught it and it was recorded and it’s on the class is on YouTube, uh, for, you know, through our continuing medical education office. And, um, people ask me, hey, are you going to teach it again? And yeah, it was very emotionally draining. Uh, I wouldn’t teach it again. I think it was, it was difficult to do. But now it’s recorded. It’s out there for posterity. I’m happy it’s available.

Jonathan Fields: [00:32:27] Yeah. You know, because in moments like that, often the, the, the advice or the impulse is to go inward and say, I need to conserve everything. I need to do everything that I can to give my system everything that it’s, you know, it’s capable of harnessing to heal. I’ve heard you describe your decision to do this also as you were trying to be kind and you I remember hearing you, you say, um, it’s easy to forget to be kind when you’re sick. But equally, I feel like it’s also easy to forget to be kind to yourself when you’re sick.

Bryant Lin: [00:33:02] Yeah. In a way it’s interesting. So some students were like, are you creating this class? Is this cathartic for you? Is this part of how you’re dealing with the cancer and creating this class? And I wouldn’t I don’t think so. I think, though, because it had so much meaning for me. To me, that was a kindness for myself. Like I, I do find yes, absolutely. I’m probably not the best at being kind to myself, but I do feel like it was so meaningful, so deep, meaningful, deeply meaningful, even though it was difficult, um, that it was a kindness for myself to be able to share my story and, and, um, you know, impact people broadly. So, um, yeah, I didn’t view it as a task. Um, you know, even though it was difficult, it was challenging, you know, I viewed it as something that I found even if, you know, one person benefited or maybe zero, I found, hey, at least the experience was very deeply meaningful to me.

Jonathan Fields: [00:34:01] Yeah. And we’ll be right back after a word from our sponsors. I know as we head into 2025 and then further into 2025, the cancer progresses to a certain point where you make the decision to close your, your practice, um, which had to have been hard.

Bryant Lin: [00:34:22] I really do miss it. I developed relationships some for, you know, 15 plus almost. I mean, I probably had some patients almost the full 20 years of my practice. Who, who stuck with me? You know, honestly, right. It’s a two way street. Your patients got to stick with you and you’ve got to stick with them. Right? I was really grateful that so many people reached out and, you know, dropped off thank you notes and gifts and so forth. Uh, you know, for that, that relationship that we’ve developed over the years, I think that was incredible. And I was sad to lose that. You know, I still do see patients just with the residents. So they’re not my patients. They’re, they’re the residents. Patients. Uh, but once in a while, one of my old patients will sneak in and, uh, to see me with the resident. And yeah, I miss it. I do miss it almost every day, you know, to be able to talk to people that I’ve known and, you know, I’ve hopefully helped a little bit through thick and thin, you know. And, you know, medicine is a privileged profession. I think medicine, to me, it’s like medical profession and then maybe clergy.

Bryant Lin: [00:35:30] There’s probably a few others where, you know, you’re with people, you’re trying to help people at the best and worst times of their life, right? And people from all backgrounds, right. In one day, especially in the Bay area, I can see somebody who doesn’t have any housing in the morning and in the afternoon, somebody who’s worth billions of dollars, right. And they could have the same problems. You know, so that that was an amazing thing to experience and to be part of. So yeah, I definitely miss it. It was difficult to do that, but I felt it was a fairness to the patients because if I’m sick and not sick, sick and not sick, it’s difficult for patients to get in, to be seen to have continuity. So I thought it was much more fair to the patients to be able to, you know, have a new doctor. And so they can they can make sure they get in to see as opposed to waiting to see me, which, you know, if I’m not doing well, then it may take some time to get in. So I did it for me, but also for the patients so that they would have better care.

Jonathan Fields: [00:36:33] Yeah. It seems again, like there’s this default to thinking of others in nearly every decision that you make at a time where, you know, there’s also a lot of import to thinking about yourself. I mean, as we have this, so we’re sitting here having this conversation, you know, as we wrap the summer in 2026, you’re two plus years into the diagnosis. And as we’re chatting, you know, like somebody might join us, they might listen to us, they might see you like he’s he’s radiant, he’s energetic, he’s funny, he’s enjoying life. He’s like, like fully alive. Um, and like, the brain is probably saying, how can he also have stage four for metastatic cancer.

Bryant Lin: [00:37:17] Yeah, I mean, I love the name of your podcast. I mean, that to me, that resonates with me. You know, I feel like, you know, I say a bunch of things. I’m like 99.999% of my life has been awesome. I’ve lived a great, not just a good life, a great life, right? And this has been 0.0001% of that, you know. And, you know, I’m, I’m, I’m grateful that I’ve been able to live this life like not everybody is able to. But I do think part of it is, you know, perspective and attitude. But to me, you know, part of that’s under your control. You know, if you have circumstances, if you’re, of course, able to put food on the table and have a roof over your head, um, you know, I’ve been lucky that I have all these things and I’ve been able to live a great life. And every day I examine, I’m like, I look at my I did it this morning. I’m like, oh, great, I have this podcast. It’ll be fun. It’ll be fun to do. Talk to Jonathan today. And you know. But I look and sometimes I’m like, ah, I don’t. That’s not something that’s going to it’s not going to be fun. I’m going to cut that out. You know, uh, I try not to do it the last minute, but I do do look at life more immediately. I think in the past, probably I would cut things out in the long term. But today I day to day, I’m like, geez, what should I do this morning? Um, you know, I was like, oh, I woke up and was feeling good.

Bryant Lin: [00:38:44] And unfortunately, I recently had actually progression again. Um, so I had to go through a month of chemo of radiation, chemotherapy, radiation, and I was feeling pretty lousy. Um, this past weekend, I just finished my radiation on Friday and I have esophagitis because the radiation was in the chest and it can, so I can’t eat things. But last night we went to, we had a dinner set up for the residents. So we have a little small group groups of residents that are assigned to us. And I’m like, I’m not going to miss that. That’s so much fun. I. Enjoy that every time, you know, we try to eat dinner with them like two. Or 2 or 3 times a year. Um, it’s so much fun, even though I so we went to this nice restaurant. I really couldn’t eat much because, you know, it feels like food gets stuck. And I was tired. Honestly, I was running a little low, but you know, I enjoyed it. I didn’t cancel, I didn’t bail out. So, um, you know, I think about what’s worthwhile. I think about that. But also I look for the joy in life. I think, you know, too often it is easy to forget to look for that happiness. It’s easy to wait for that happiness, right? But, you know, I try to look for happiness in everything I do. Yeah. I don’t want to wait for it.

Jonathan Fields: [00:39:57] Yeah. I mean, I’m inclined to say, you know, like, I, I wonder if what you’ve been through has has changed that for you. But what the bigger story that I’m hearing you saying is, it seems like this has been a part of your wiring for your entire life, but maybe it’s just, there’s a, there’s an urgency behind it now that wasn’t as strong before.

Bryant Lin: [00:40:15] Yeah, I think so. I think urgency is, is, is the right word for it. Yeah. I think the urgency to, to, you know, to really experience every minute to live in the moment, you know, all these kind of hackneyed things you hear about all the time. It’s true. But I love sitting in the backyard, put my feet in the grass, read a book, you know, just reflect on life, to listen to the birds, to listen to the hummingbirds, the, the bumblebees, you know. So it doesn’t necessarily mean I have to do something right. Sometimes doing nothing is also just, you know, where I find my happiness. So I’ve been trying to do that. And luckily I haven’t had to cut out too many negative things. It’s my I guess my life has not had too much negative negativity.

Jonathan Fields: [00:41:00] Yeah.

Bryant Lin: [00:41:00] So far.

Jonathan Fields: [00:41:01] Which is a powerful reflection of the choices that you had made before this moment in time. I’m curious, you know, clearly like you have two sons. Um, and when you think about them. Yeah. And I’m sure when you’re talking with, with, um, your wife and you’re trying to figure out how do we have this conversation with them? What do we share? What do we not share? How transparent are not transparent? Are we? Are you open to sharing some of how you’ve processed that?

Bryant Lin: [00:41:30] Yeah, absolutely. I think with my kids, I guess number one, you know, they’re now 14 and 18. Um, so, you know, they were 12 and, you know, 16 at the time of my diagnosis roughly. Um, and so they’re, you know, not super young. So that’s one thing, you know, I was lucky in a way. They’re not super young. I think if they were very young, you know, it would be a different story. I think as teenagers and, you know, we were completely transparent with them through this whole process. Hey, daddy’s not doing well. He’s had a cough. He’s going to get an X-ray. He’s going to get a CT scan. So we kept them filled in all the time. I think it’s been very good for them. We you know, it wasn’t like a conscious decision. I think we we thought it would be just something very difficult to hide from them. Um, but also we wanted them to know what was going on. We wanted them to know and, you know, to understand and, you know, it’s part of life. People in your family get sick. You know, they can get ill, they can die. Um, you know, that’s part of life. Of course, if they’re five years old, it’s different again, if they’re 14 years old or 18 years old. Um, I think also it helped us kind of, you know, be conscious about spending time together.

Bryant Lin: [00:42:48] I think we, you know, we all get busy and, and they’ve got to live their lives, you know, I don’t want them to spend 100% of their time with me, you know, like during the day, my, you know, my, my oldest is in college. He’s starting his sophomore year. So, you know, we won’t see him probably till maybe Thanksgiving. Um, and, uh, you know, my youngest, you know, he goes to high school and he comes back and luckily he walking distance. And you know, he does what he does plays with computers. And you know he’s got a I just I still, you know, I still got to yell at him every day to do his homework. Um, but, you know, enjoying those moments, I think, uh, has been a good thing to, to point out to say, hey, you know, we got to enjoy this time together. Not, not so explicitly, but, you know, really making this effort, uh, to spend time together and not necessarily quality time. I always find that an interesting term. You know, sometimes it’s doing nothing, right. I mean, just living your life, right. Sitting around watching TV or, you know, um, you know, sitting around and, you know, uh, not doing anything, honestly, just just vegging out. Um, you know, that’s important.

Bryant Lin: [00:43:55] So yeah, we, we were lucky that they, you know, were old enough. They understood. And we were worried, you know, early we even told my wife told my kids, um, teachers, hey, if you see anything, if there, you know, if they’re behaving differently, let us know. And luckily, you know, they’ve, they’ve taken it in stride and you know, been helpful to my, my son would, you know, drive me to when he’s when he, when he’s available and my wife wasn’t available to drive me to chemotherapy and drive me to my older son to, to, to radiation. Um, you know, so, so it’s been, it’s been just a blessing to, to have them around and available. Um, and, uh, yeah, no, they’ve, I don’t know. Also, I think there is one side though, I don’t know if they think daddy’s indestructible. You know, I do think there’s a little bit of that because you know, I’m a doctor. I’m at Stanford. I, you know, I tend to solve a lot of problems, right? So maybe, maybe in the back of their mind, daddy’s going to figure it out. Um, so I don’t know if that’s part of it as well, but no, they’ve, they’ve, they’ve, um, adapted to this news and this, this reality very well, surprisingly, which was again reassuring for us as parents.

Jonathan Fields: [00:45:08] Yeah. I mean, I understand also that you’ve been writing letters to them. I’m curious, are those more letters for now, or are those more letters for when you feel you won’t be there to say what’s in the letters?

Bryant Lin: [00:45:20] Yeah. I think one there was one kind of big letter that I did with my friend Frish Brandt, and I sponsor her class. She calls herself a letter midwife. Um, and, uh, you know, that’s they could read it now. I think one of them has read it. Um, but, you know, it’s really for later. Honestly, um, I was thinking about, you know, I’ve written small things, but, you know, I was thinking about, hey, should I record videos? You know, people always like, oh, record videos for later. And I haven’t done that actually given advice and things like that. I think it’s so tough to do that. And because you don’t know what’s going on in the future, I think, I think to me, just living the living life with them moment to moment is more important than anything like that. But but at least they’ll have that letter that was, you know, uh, Frisch has this great ability to interview people and extract different things that, you know, you weren’t really thinking about. And, um, you know, she was fantastic at doing that. So, you know, I learned stuff about myself. I learned that serendipity was really something I wanted to share with my kids, like the importance of serendipity, of seeing something that’s maybe random or lucky or unlucky and, you know, doing something with it, right. You know, so like, like my patient who had this severe reaction, right? That was kind of unlucky for him. But, you know, I did something with it. So it’s serendipity has two parts. Something has to happen and there’s a somewhat of a randomness to it. But you have to recognize what happened and have some action that resulted from it. So I didn’t realize that was so important to my life until we talked about it. So writing that letter was really important to, uh, coalesce that idea. And I included a chapter about it in my book. It was so important to me. Yeah.

Jonathan Fields: [00:47:07] I’m curious. You know, the other thing that that, um, I just feel from you is this baseline of happiness that is extraordinarily high. But I would imagine also there are days where that’s not there. Uh, when you’re, especially when you’re going through really tough treatment or thinking about like, okay, so maybe, you know, maybe I can try and be positive about like the nature of where I am right now, but there are going to be moments or days where it’s probably a lot harder to access that. How do you, how do you navigate that?

Bryant Lin: [00:47:41] Yeah, it’s, you know, I have this distinct memory, especially early on. My wife was out of town on a business trip. I’d just gotten a CT scan, and the CT scan was good news actually. And it showed that the cancer was still there, but it had shrunk. But, you know, in the back of my mind, you know, there was that dream, especially early on. Oh, it’s going to disappear. Right. You’ll get a scan and it’ll be gone. And I had a tough time because my wife wasn’t there. You know, I didn’t have somebody to talk to about it. And, you know, that was that was tough. I still remember that I was in the shower and kind of choked up just thinking about this. Um, but I think to me, it’s really that support system, those connections, the people around you. That’s what buoys me when I’m not feeling well. Just like this past two weeks, I’ve been feeling pretty lousy. Today I feel awesome. So thank you, Jonathan. Today I feel great. It’s great. Um, I think it’s talking.

Jonathan Fields: [00:48:38] I’m not taking any credit for that.

Bryant Lin: [00:48:40] No, talking to people helps, honestly. Uh, I mean, for the past two weeks, I’ve been dealing with radiation fatigue and esophagitis. And, you know, what’s helped me is, you know, talking to my brother, talking to my wife, talking to my kids, and, you know, explain to them. Yeah, you know, I kind of feel lousy and, you know, and not saying much, you know, just having their presence. You know, sometimes I’ll FaceTime my brother. I don’t even say anything. But the fact he’s there and, you know, he’s seeing me and, you know, he’s recognizing that I don’t feel well. Um, you know, it’s helpful. I mean, that to me, I could not I don’t think I could be as positive or be able to recover resilient or whatever you want to call it without that support of my family and friends. And, and that has been unbelievable, you know, and even strangers I’ve, you know, having strangers reach out to me and thank me. It’s been amazingly powerful having having strangers reach out to me and like, pray for me and chant for me or, you know, support me from their religion. It’s been amazing. So all of that adds up and really helps that this kind of unquantifiable aspect of, of humanity.

Jonathan Fields: [00:49:56] Mhm. Yeah. You, you see, I’m, I’m guessing you see parts of Humanity that’s so often on a day to day basis, we. That story isn’t told like this story that’s so often told publicly now is the story of me, me, me of, you know, like of scarcity of, um, not recognizing or dehumanizing everybody but yourself. And for you to be in this position where you say like, no, there actually is still goodness there still strangers who I have never met and probably will never meet, actually doing beautiful things that I never asked them to do on my behalf.

Bryant Lin: [00:50:32] Yeah, it’s definitely reaffirmed my faith in humanity. I, you know, I don’t know, you know, people heard about my story and I don’t know their political backgrounds, I don’t know their beliefs. But, you know, the fact that we all have this shared human experience and, and some of them have a different type of cancer. Some of them it was their parents who had cancer a long time ago. Some of them have not even have cancer. They’ve got a different challenge in their life. I still remember getting a card and you know, this this wonderful woman. She didn’t say anything about what was going on in her life. She just said, hey, thank you. Thank you for, you know, encouraging me to live my life day to day and to really enjoy my life day to day. And, and that was incredible, you know, that she would take the time out of her day to. And it was a handwritten card. Uh, I think she even designed the card, the artwork. Um, that was incredible to receive something like that because, you know, it’s an effort to write the card. You make it, you’re gonna mail it, you got to find the right address. You know, that’s, that’s amazing that people will do this for each other. And yeah, I mean, it’s incredible. I have faith in humanity. I think, you know, we’re 99% the same. Maybe 1% different is, you know, and actually, yeah, looking at our genetics, right? Our genes are, we’re mostly the same. And there’s a little bit of separation between us. But, you know, I think this is something where that lived experience is something we all share. We all have challenges in life. We’re all going through crap. Um, and yeah, sometimes, sometimes you got to figure out what to do with it. And, uh, you know, I don’t think, uh, I think, yeah, the current tenor and reflection of what’s going on doesn’t necessarily adequately represent, you know, real people about what they’re thinking and what they’re feeling. I think we’re all thinking and feeling very similar things.

Jonathan Fields: [00:52:27] Yeah.

Bryant Lin: [00:52:27] Uh, to me, they’re not so much different.

Jonathan Fields: [00:52:30] So given where you are, um, right now, and the fact that in the middle of all of this, you’ve literally spent the time to write an entire book.

Bryant Lin: [00:52:38] That was another thing. I was like, are you crazy? I can’t believe I did that. That was I mean.

Jonathan Fields: [00:52:43] The parallel here also, you know, like you mentioned that like you have the exact same diagnosis that Paul Kalanithi had when he had the same impulse to actually sit down and write a book to essentially.

Bryant Lin: [00:52:55] And he is by far a better writer than me. I mean, he is such a high quality.

Jonathan Fields: [00:53:00] He was also a literature guy for, you know, like his entire life as well. Yeah. But yeah, we’re not going to go like on the comparison route here. Um, what, what do you most want people to know right now? What do you want to tell them?

Bryant Lin: [00:53:12] I, you know, I never, I, I didn’t because of Paul’s book was so amazing. I was like, I don’t need to write a book. You know, he’s written this amazing book about his experience. But I wrote the book, you know, sunshine, because so many people said, hey, hearing your story helped me. So I realized there’s still this huge hunger for sharing stories, and that sharing stories will still help people. There’s not enough stories out there, and there’s so many different experiences people want to hear from, from other people who are going through what they’re going or something, you know, some commonality of their experience. So that’s what I wrote the book. I hope it helps people you know who are on their own cancer journeys. I hope it helps people who are, you know, that maybe they’re not they’re not on the cancer journey, but their family members, their friends, their loved ones are on a cancer journey. But I hope it helps people who are struggling with life. A lot of the chapters, you know, ten chapters are based on material from the class expanded, but the other chapters are really reflections on my reflections on living life with limited time. So, and as you mentioned earlier, you know, we’ve all got limited time. I’ve got much more limited time than most. Um, but I think we all struggle with that. You know what, what are we, what are we going to do with our lives? What are we doing? How do we live our lives? So I hate to give advice even though I’m in the advice giving profession. So instead of giving advice, I just share my perspective and what I’m going through and what I chose to do. And I hope that helps some people, uh, if when they read it.

Jonathan Fields: [00:54:56] Feels like a great place for us to come full circle as well. So in this container of Good Life Project., if I offer up the phrase to live a good life, what comes up?

Bryant Lin: [00:55:04] You know, I think about in a way my parents, you know, they to me are the kind of examples of living a good life. They’re also happy people. And, you know, they were amazing parents. We had idyllic childhoods. And, you know, I grew up in Tennessee. So, you know, Asian, Asian American growing up in Tennessee, you wouldn’t necessarily connect that with being a, you know, a, a smooth childhood. Let’s, shall we say. Um, but yeah, I think about living a good life. I think my parents set a great example for me on how to live a good life, how to, how to really prioritize what’s important, how to, how to share your values, share what your interest is in with your kids. And because to me, it’s, it’s really about friends and family, you know, family foremost. So to me, that living a good life is really living a life with family and friends around you and helping other people, helping not just the people you know, but people you don’t know. So I think to that those are things I learned from my parents.

Jonathan Fields: [00:56:11] Mhm. Thank you. So let’s talk about some of the big takeaways from this conversation. One thing I keep coming back to is how little Bryant actually changed in his life. Most of us might assume that a diagnosis like his would end up with a lot of things being blown up in our lives. His mostly didn’t, and that says more about the life he had already built and how truly aligned and nourishing it was than it does about the diagnosis. Three other things I don’t want to lose from this conversation. First, when a friend told him not to look at his own survival curves because the, quote, average person on that chart isn’t him, it gave him permission to stop treating himself like a statistic or a verdict, to look at his life as unique to him and not another plot on a graph. And maybe we all need to give ourselves that permission, regardless of the circumstance of our lives. And second, his rule for what stays in his life now is just so simple. No open-ended commitments except the ones tied to lung cancer, because those are the ones worth however much time he has left. And third, when he closed his medical practice, I thought this was so interesting. It wasn’t actually for himself. It wasn’t a about self-preservation. It was because he thought it was fairer to the patients who needed continuity, that he just couldn’t guarantee anymore. It was an act of generosity and respect to those he has loved and served for decades. I have been spinning that around in my head a lot, so maybe here’s what I’d leave you with this week. Pick one thing on your plate right now that maybe has no clear ending. It’s just been going on and on and on. No finish line. Nothing that would ever let you call it done. And ask yourself honestly, whether it’s earned that kind of open ended space in your life, or whether it’s just been there so long, you kind of stopped questioning it. Maybe there’s something to do about that. And hey, before you leave, do me a quick favor. Share this conversation. Bryant’s beautiful insights and his story with one person who, you know, needs to hear what we talked about today and leave a review wherever you get your podcasts. It helps us get discovered and brings more people into moving conversations like this. This episode of Good Life Project was produced by executive producers Lindsey Fox and me, Jonathan Fields. Editing help by Troy Young and Alejandro Ramirez. Kris Carter crafted our theme music. And of course, if you haven’t already, go ahead and follow us wherever you get your podcasts so you never miss a conversation. Until next time. I’m Jonathan Fields, signing off for Good Life Project.

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