The Lost Aura with John Lantos, MD
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What question does Dr. John Lantos raise about AI’s impact on the doctor‑patient relationship?
At the Nocturneist, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality. All views expressed are those of the person speaking and not their employer.
This is the Nocturness. I'm Emily Silverman. Today's episode features Dr. John Lantos, pediatrician, bioethicist, and physician writer, whose latest essay, The Lost Aura of the Physician in the Age of Artificial Intelligence, asks a deceptively simple question. What happens to the role of the doctor when artificial intelligence becomes remarkably good at practicing medicine? John argues that AI didn't create the challenges facing modern medicine. It simply accelerated trends that have already been unfolding for centuries. As medicine has become increasingly data-driven, standardized, and technological, the relationship between doctor and patient has gradually shifted. Now, with large language models offering medical advice, empathy, and even shared decision making, we're forced to ask what remains uniquely human about the work of healing.
In our conversation, we explore the history of the doctor-patient relationship, the concept of the physician aura, and the surprising possibility that AI won't replace physicians so much as redefine what they're for. But before we dive in, take a listen to John reading from his essay, The Lost Aura of the Physician in the Age of Artificial Intelligence.
French philosopher Michel Foucault analyzed a shift in the way doctors interacted with their patients in late eighteenth century France. He showed how, in the minds of these scientific pioneers, individual physicians and patients were increasingly framed as what he called disturbances that can hardly be avoided. But that ideally should be neutralized in the pursuit of objective medical truth. Foucault called this abstraction the clinical gaze, the patient's story, and the physician's interpretive presence became secondary to precise measurements and visualized pathology, quantification, and standardization. Physicians were encouraged to spend less time talking to patients and more time gathering the data that would lead to an evidence based diagnosis and treatment plan.
AI is the logical outgrowth of this philosophy of medicine. It can perform many of the non technical tasks that were once thought beyond the reach of technology and machine learning. It now obtains informed consent, counsels patients about end of life decisions, and provides psychotherapy, and it does so with language that expresses attentiveness and concern. Perceived compassion and patient explanation no longer depend solely on the capacity of clinicians, but These capacities of AI might allow it to fulfill the dreams of both biotechnological medicine and humanistic medicine.
I am sitting here with Doctor John Lantos. John, thank you so much for coming on the show.
It's great to be here. Thanks for having me.
So I wanna get into your piece, uh, The Lost Aura of the Physician in the Age of Artificial Intelligence, because I think it's a really interesting topic. But before we get there, I would love to learn a little bit more about you. Uh you have a long and storied career in pediatrics and in bioethics. So I was wondering if you could maybe paint for us a sweeping arc of how you came to be a pediatrician and also how you got involved in bioethics.
Sure, I was always interested in humanistic aspects of medicine. I uh was an English major at Brown before going to med school and when I got to med school became fascinated with the ways that medicine was changing. One of the experiences I had uh that shaped my view was uh after my second year of med school got to go to Nigeria for three months and Spend some time in one of the teaching hospitals in Benin City, Nigeria. And came to realize how quirky Western medicine is and how extravagant it is. I saw patients with neonatal tetanus, measles, patients who are dying of dehydration and compared those with the patients I was seeing as a medical student in Pittsburgh.
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Chapters
8 chapters
1
What question does Dr. John Lantos raise about AI’s impact on the doctor‑patient relationship?
0:00–6:30
2
How did Michel Foucault’s concept of the clinical gaze shape modern medicine?
6:30–18:55
3
What experiences in Nigeria and West Virginia shaped Dr. Lantos’s view of health disparities?
18:55–28:29
4
When did AI reach a “quantum leap” and how did it start changing clinical encounters?
28:29–37:44
5
What does Walter Benjamin’s idea of an “aura” mean for the physician’s role today?
37:44–46:44
6
How did Dr. Lantos use a large language model to help decide his own cardiac treatment?
46:44–55:45
7
What challenges do trust and empathy present for doctors and AI systems?
55:45–57:29
8
What does the future hold for medical education and the role of doctors in an AI‑driven world?
57:29–58:24