The Second Pass at Healing with Rana Awdish, MD
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What is the background and purpose of this episode’s sponsorship and introduction?
This episode of The Nocturnists is sponsored by the Buxbaum-Siegler Institute for Clinical Excellence at the University of Chicago. The Institute is dedicated to fostering compassionate doctor-patient relationships and advancing clinical care. Each year, the Buxbaum-Siegler Institute recognizes extraordinary healthcare professionals through the National Clinical Excellence Award. To learn more about the award and to nominate a deserving clinician, visit buxbauminstitute.uchicago.edu. Support for The Nocturnist comes from the California Medical Association.
At The Nocturnist, 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.
You're listening to The Nocturnist Conversations. I'm Emily Silverman. Today our guest is the wonderful and wise Dr. Rana Adish. Rana's book, In Shock, was published seven years ago and is basically canon at this point in the medical memoir world. The book tells the story about how when Rana was pregnant, a hepatic adenoma ruptured and caused her to bleed into her abdomen and very nearly die of hemorrhagic shock. It's a harrowing story, not just because of the disease state itself, but also because of the delays, missteps, and other difficult aspects of the ordeal. Triageing her to L&D instead of the regular ER because of her status as pregnant. Not responding to her with nearly the urgency as was necessary, as demonstrated by sending in the intern and resident to take her history as she bled into her liver.
focusing on her baby pretty much exclusively and not really moving on to address Rana's health until the baby sadly dies. Speaking about Rana in the operating room as if she couldn't hear and saying things like she's circling the drain. A nurse lying her flat and then stepping away, leaving Rana to struggle with shortness of breath from pulmonary edema until she hit the code blue button. The hypervigilance that came with knowing that any little mistake in the ICU could harm her and the exhaustion of that hypervigilance. Her eventual stabilization and discharge and beginning the process of putting herself back together again, concretely and abstractly. Also returning to work in the ICU where, inexplicably, she seemed to attract critically ill pregnant patients.
But in addition to these terrifying accounts were so many moments of trust, healing, and connection. Her steadfast husband, Randy, who embraced her with unconditional love and support. The surgeon who exuded trustworthiness and resolve. The colleague who ultrasounded her liver in private when she noticed a new pain in her side. The nurses and doctors who said just the right thing at just the right time. Like the anesthesia resident who looked her in the eyes and said, "'I'm not leaving until you can breathe again. You're safe.'" Rana recounts this story with beautiful, clear prose and with such emotional precision and even dark humor that it's a pleasure to ride alongside her.
Who is Dr. Rana Awdish and what prompted her to write *In Shock*?
She brings us as close as she can to her experience, internal and external, so we can glean as much insight as possible without actually having to go through the experience ourselves, which is the hallmark of powerful storytelling. And because of Rana's tremendous story, skill, and insight, she has made an indelible impact on the medical community, giving numerous grand rounds and seminars about her story and lessons learned, and always nudging the profession towards something more compassionate. Now, as I mentioned, it's almost exactly seven years later, and Rana is here to talk about what she's been up to since. How does she look back at her book, In Shock? How have her ideas about healing and storytelling evolved?
What is she working on now? There's a lot to dive into, but before we do, take a listen to Rana reading from her memoir, In Shock.
When the pain began, it came in a breathtaking wave that receded just as swiftly as it approached. My first thought was, okay, so there really is something wrong.
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Chapters
8 chapters
1
What is the background and purpose of this episode’s sponsorship and introduction?
0:00–3:14
2
Who is Dr. Rana Awdish and what prompted her to write *In Shock*?
3:14–7:21
3
How did Dr. Awdish experience her near‑death event and what were the key moments in the ICU?
7:21–16:56
4
What early signs of healing, trust, and connection emerged after her hospitalization?
16:56–27:41
5
How does Dr. Awdish describe the first “pass” at recovery versus the second, more recursive healing process?
27:41–37:16
6
What role does intuition, body awareness, and the concept of ‘subtext’ play in her ongoing health journey?
37:16–46:22
7
How is creativity—painting, movement, and yoga—used by Dr. Awdish to process trauma and support healing?
46:22–55:41
8
What can listeners expect from Dr. Awdish’s upcoming book and final reflections on medicine and compassion?
55:41–1:00:50