You could be forgiven, as you get to know Fred Schiffman, MD, P’96MD’00, for suspecting him of having a clone. 

After spending most of his childhood on Staten Island, NY, Schiffman attended nearby Wagner College, from which he graduated magna cum laude with a BS in biology. He completed his medical studies at New York University School of Medicine and did his internal medicine training at Yale-New Haven Hospital, where he was chief medical resident. Before pursuing a hematology fellowship at Yale, he spent two years as a research associate at the National Cancer Institute in Bethesda, MD, where he recalls playing two-on-two basketball with a young man named Tony Fauci. 

Today Schiffman is a hematologist and oncologist whose publications and presentations—on disorders of the blood and spleen as well as on medical education and training—number in the 300s. The list of awards he’s received for leadership, teaching, and service occupies four pages of his curriculum vitae; the list of advising and mentoring activities is even longer. His quiver of titles includes inaugural Sigal Family Professor of Humanistic Medicine at The Warren Alpert Medical School, vice chair of the Department of Medicine, associate director of the Categorical Internal Medicine Residency Program, and associate physician-in-chief at The Miriam Hospital. In addition, he heads the grants committee of The Warren Alpert Foundation, which supports medical research and education. 

As the Sigal professor, and as faculty adviser of the Gold Humanism Honor Society for the past 16 years, Schiffman has helped create and lead myriad initiatives that weave the principles of humanism (see sidebar, p. 23) into the teaching and practice of medicine. These include programs for students, trainees, and faculty on humanistic physical diagnosis, narrative medicine, palliative care, poetry at morning report, meditation and mindfulness, improvisational acting, delivering bad news, using art to hone observational and storytelling skills, medical illustration, and, most recently, an artist-inresidence program at the Medical School. 

No surprise, then, that the American College of Physicians—the largest medical specialty organization in the country—recently honored him with the prestigious Nicholas E. Davies Memorial Scholar Award, which recognizes outstanding scholarly activities in history, literature, philosophy, and ethics, as well as contributions to humanism in medicine. 

What’s more, Schiffman was recently named president of the American Clinical and Climatological Association (ACCA, also referred to as “The Climatological”), a highly selective professional group whose membership is limited to 250 physicians and scientists focused on improving medical education, research, and practice. And he serves as editor-in-chief of the 11th edition of Cecil Essentials of Internal Medicine, a comprehensive textbook for residents containing the core principles of medicine. 

According to Mukesh K. Jain, MD, senior vice president for health affairs and dean of medicine and biological sciences, “Fred Schiffman’s life and career embodies the best of Brown: a tireless devotion to humanistic medicine, blending clinical excellence with compassionate teaching, mentorship, and leadership. He serves as an exemplary role model for our trainees and faculty.” 

If Schiffman’s professional achievements weren’t enough, he is also a highly skilled painter, poet, and guitarist. Alongside his colleague and friend Louis B. Rice, MD, the Joukowsky Family Professor and chair of medicine, he plays in a band called Rice and Beans. Still boyish at 77, Schiffman is a devoted husband, father, and grandfather. He admires lavishly, praises generously, and quotes his idols liberally. He recently spoke with Medicine@Brown about what makes him tick as a physician and a person.

M@B: This is a busy year for you. What are your responsibilities as president of the ACCA? 

The job of the president is to invite a member and a nonmember to give very special endowed lectures, organize another evening lecture of general interest to members and spouses, take the research presentations of new members and put them in a coherent program, and generally run the meeting. This year the meeting is in October in Williamsburg, VA. The president also gives an address. I’m obsessing over what I’m going to talk about, but I have some ideas. 

I’ve been a member for over 30 years. I was nominated by one of my mentors, Charles Carpenter [emeritus professor of medicine at Brown, physician-in-chief emeritus at The Miriam Hospital, and director of the Lifespan/Tufts/Brown Center for AIDS Research, who died in 2020]. Chuck was the most brilliant, dignified, majestic, humble caregiver I’ve ever met. 

M@B: You’re also in charge of the next edition of Cecil Essentials. 

Yes, I co-edited it with [Professor Emeritus of Medicine] Ed Wing last year, and Elsevier asked me if I would be editor this time around. I decided that if I could have co-editors, I would do it. So I asked three people: [Professor of Medicine] Kelly McGarry, MD, who’s head of the General Internal Medicine Residency at Brown University Health, an extraordinary person; [former chief of infectious diseases at Brown and now chief of medicine at Houston Methodist Hospital] Eleftherios Mylonakis, MD, who is astonishing; and Mark Siegel, MD, a professor of medicine at Yale and a wonderful internal medicine program director. 

M@B: How did you become interested in the spleen and blood disorders? 

The spleen is an organ of mystery. It’s a beautiful organ visually, but nobody knows what it does and why it’s important. I thought I had something to contribute. 

When I was a hematology fellow at Yale, I attended a lecture by Leon Weiss, MD [chair of the Department of Animal Biology at the University of Pennsylvania School of Veterinary Medicine]. I went to Penn some weekends to work with Leon and learned how to do electron microscopy on the spleen. Years later I wrote and edited a hematology textbook, and some of the authors were my former students. And my hematology book was cool. Because I was the editor, I got to do what I wanted: It’s the only hematology textbook I know of that includes a poem in the chapter on the spleen.

M@B: How do you teach humanism in medicine? 

Here’s what we tell students and residents: When someone is ill, a person’s presence is powerful. Be there with the patient. Hear them. I encourage every group of medical students, before they go home at the end of the day, to go to the patient’s room, put their backpack down, turn off their phone, and sit with the patient. Hold their hand. Talk about the day. Have them ask questions. If a patient has had that direct contact and you ask how long the doctor or medical student spent with them, they’ll say “20 minutes,” when in fact it was only three. 

Primarily during Medical Humanism Rounds, which I do with third-year medical students Friday afternoons at The Miriam and monthly in the evenings with first- and second-year students, I’ll say to a patient, “You’ve seen good doctors and bad doctors, Mrs. Smith. What do the good ones do?” And Mrs. Smith will say, “Dr. Schiffman, they listen. When I see their facial expressions, I know that they’re hearing me.” You can only do that if you’re present. 

Dr. Daniel Wolpaw, who is a great caregiver, wrote an essay in the New England Journal of Medicine called “Seeing Eye to Eye.” In it, he describes a portable stool that he carries on rounds so that he can sit by the patient’s bedside and communicate with them at eye level, instead of standing over them. It’s shared decision-making. It’s taking into account what that patient feels. 

You can cure a disease—if there’s altered physiology, you can give medicine, do a procedure. But when you heal somebody, it’s because you’re present. 

M@B: Some might say never mind the hand-holding, expertise is everything. How do you respond? 

I’ll tell you exactly what I believe. You’re flying in a plane and the lights go out. The plane begins to rumble. There’s a terrible snowstorm at the airport where you’re landing. If you have the choice, you want a pilot who’s landed a thousand times at that airport—with instruments, without instruments. That pilot might come on the PA system and say, “Folks, we’re in a lot of trouble. I hope we make it.” But that highly skilled pilot you hope for could also be calm and reassuring and say, “Folks, we’ve lost our electronics, but I’ve landed at this airport a thousand times. It’s going to be a little bumpy, but we’re going to be just fine.”

 You can be the physician who’s competent and expert and understands the devious puzzles that nature throws at you. You can also be kind and reassuring. Hold the patient’s hand, talk to them, tell them that as far as you can tell, things are going to be OK. It’s not either-or. It’s got to be both. 

As I said in my address to the MD Class of 2009, “you must show up and you must touch”—but there must also be a disciplined intellect at the bedside. 

M@B:What about when a patient doesn’t get better? 

It is difficult to experience the soul erosion that occurs when you lose a patient. I followed a patient for 20 years who had breast cancer and then breast cancer bilaterally. She then developed a biliary tract cancer. I had the honor and privilege of being at her bedside with her husband and sister when she passed away. That was very important to me—to see her not suffer, to be present as she took her last breaths. It helped me cope with her loss. 

Another family asked me to give a talk at the wake of one of my patients. That meant a lot to me, and it meant a lot to the family. There was a sense of closure. Articles have been written about the importance of a doctor at a wake or a funeral.

Here at The Miriam we do what’s called Grief Rounds. When a house staff team loses a patient, we ask that they inform us. Before they start their medical rounds, we ask them to talk about the patient, who they were to the team, who they were to the family. And we encourage them, after a couple of days, to give the family a call and say, “How are you doing?” 

M@B: You’ve said that humanistic medicine is at risk. What did you mean? 

Electronic medical records. Don’t get me wrong—some aspects are very good, like accuracy and consistency. That said, EMRs abandon narrative, and that’s dehumanizing. I’m no Luddite, but this is what we want [points to a photo of a doctor and patient looking at each other], not this [points to photo of a woman seated on an exam table looking at a doctor, who is turned away from her and typing at a computer keyboard]. 

When you walk into the room, first say: “How are you, Mr. Jones? It’s been a couple of weeks. How are you feeling? Have you had any bleeding?” Then sit down at the computer and say, “I’ve got to turn this thing on.” You’ve already prepared the computer, so you’re not focused on it the whole time. All you have to do is make some notes and check marks. 

Also, there simply aren’t enough primary care physicians to go around. Sometimes I’ll discover something on the physical examination and ask, “So what does your primary care doc say about this?” And the patient will answer, “Oh, he hasn’t examined me in a long time, he’s so busy on the computer.” 

M@B: Would you argue that humanistic medicine is good for both the patient and the physician? 

If it’s done the correct way, yes. In the book Healers: Extraordinary Clinicians at Work, David Schenck and Larry Churchill refer to the “gift of the patient.” They write, “The fundamental gift the patient brings for the clinician is the chance to be a healer.” They quote a doctor as saying, “[My patients] give me the gift of healing, and I give them back my presence.” 

M@B: You’ve been a role model to generations of medical students and residents. Who were your early role models? 

My parents. Netflix could not do a series called “The Dysfunctional Schiffman Family.” I had a nurturing and supportive upbringing. My mother, a nursery school teacher, was very loving and present. In World War II, my father served in the Philippines as a rehab officer, helping people deal with their injuries. When I was growing up, he was a high school science teacher, a guidance counselor, and a coach. When they had troubled kids in his school, they sent them to him. He was a repairer. My brother Robert, who is a terrific physician, and I learned from our father’s experience. Both parents really enjoyed getting to know people and what they’re made of so they could make things better for them. I apply that to being a good doctor. To paraphrase William Osler: Get to know the person who has the disease, and you’ll be able to treat the disease better. 

Then there are the people you meet in medical school. In my fourth year at NYU, I worked in the lab of a hematologist named Michael Freedman, and I followed him in clinic. He was kind. He was scientifically rigorous. He was a humanist. He made me believe that I could combine the art and the science of medicine. I published my first scientific paper with him. And when my son Josh [Schiffman ’96 MD’00] was diagnosed with Hodgkin’s lymphoma at 15, every afternoon for six months I drove him up to Dana Farber Cancer Institute, where he got radiation. Boy, did I learn a lot from seeing the amazing way his doctors interacted with him. 

M@B: How would you describe your pedagogical style? 

I wrote about this back in 1985, in the Yale Journal of Biology and Medicine. I said the best teaching is thinking out loud, revealing your thought processes and illuminating for your audience, big or small, what’s on your mind and how your mind is working. Allowing them to hear what you’re saying and critique it. 

I also wrote about the exhilaration of seeing someone “get it.” The teacher must gauge each learner’s way of absorbing the information and check to see if they have learned what was intended. When you strip everything else away—theatrics as a lecturer, great slides, catchy themes—the great teachers of the world have one thing in common: They care so very much that their learners have learned what they wished to impart.

M@B: What continues to motivate you? 

The thrill I get from teaching and healing. I get a thrill from seeing students learn and understand and then go off on their own and do it. You never know where your influence stops. You pay it forward: Your students become good teachers. I believe that’s a privilege.

Everything stops when I’m taking care of patients. I love making people better. And if I can’t make them better, I find something for them to hope for. Chris Feudtner, a pediatrician, epidemiologist, and ethicist, is one of my heroes. He writes that we should never destroy hope, even at the end of life. I like making people feel better, ending their suffering, but I also like to help them accommodate to their new roles or their family’s new roles to get the best out of the time they have. 

M@B: You’ve accomplished so much.  What’s left to do? 

Before COVID, [former Senior Associate Dean of Medical Education] Allan Tunkel, [Professor of Emergency Medicine] Jay Baruch, and I were trying to establish a master’s degree in medical humanities. If it’s going to occur any place, it’s got to occur at Brown. I’ve also got three papers coming out, which I co-wrote with medical students. One is on the positive effects of music in the chemotherapy infusion room. The other two are on the importance, for cancer patients, of interpersonal support and of the importance of spirituality. 

M@B: What’s a book you enjoyed recently? 

I just re-read Cutting for Stone, by Dr. Abraham Verghese. When I read it for the f irst time, I adored it. I called him up and said, “Abe, I want to go slow because I just don’t want to finish it.” He writes so insightfully and beautifully about love and loss and forgiveness. We give a copy of it with an autographed bookplate to each Gold Humanism Honor Society member. One of the things I’ve quoted in my graduation talks is what the older Stone, Thomas, asks his son, Marion: “Tell us, please, what treatment in an emergency is administered by ear?” Marion tells him, “Words of comfort.” 

M@B: Your intimates call you Freddy.  Is there a difference between Freddy and Dr. Schiffman? 

No. I try to be authentic. Even though I love acting—I was an actor in high school and I love theater—I don’t want to play two roles. I want to be me. 

Humanism—the system of thought that centers human interests, values, dignity, and experience—has shaped human development from the Renaissance through the Enlightenment and into the 21st century. The ideal of the humanistic physician—one who combines scientific knowledge with empathy and an understanding of the human condition—has followed the same trajectory. Recent studies have shown that training in the arts improves physicians’ observational and communication skills, and that physician empathy and a good patient-physician relationship can positively affect health outcomes. The Association of American Medical Colleges has explicitly endorsed the integration of arts and humanities into medical education, and more than half of US medical schools have done so. (Schiffman says the Sigal family, who endowed his professorship in 2010, did so to “set the stage for development [of] similar programs at other institutions.”) 

To empathy, Schiffman would add several other components of humanistic medicine: integrity, excellence, compassion, altruism, respect, and service. And, he stresses, this approach is not just good for patients; it benefits health professionals themselves. Indeed, in a 2022 presentation on the topic, he defined humanistic medicine as the “attitudes and behaviors that are sensitive to the values, autonomy, [and] cultural and ethnic background of patients and colleagues.” Deeply concerned by the corporatization of medicine, the reliance on technology, the limitations of telehealth, and high rates of physician burnout and suicide, Schiffman believes that humanism extends to the entire medical team: “We’ve got to take care of each other.”