Dr. Jack Braha is a Brooklyn-based gastroenterologist who serves as the Director of Hospital Gastroenterology of Brooklyn Gastroenterology and Endoscopy Associates while also serving as the Chief of Gastroenterology at Mount Sinai Brooklyn Hospital. A specialist in screening for colon cancer, irritable bowel syndrome (IBS), pancreaticobiliary disorders and emergency gastroenterology care, Dr. Jack Braha understands the importance of early detection in preventing illness.
In addition to his medical duties and extensive medical research, Dr. Jack Braha is the skilled host of “Medcast Plus,” which is a BRIC TV television show that is dedicated to educating the community about important Health issues.
Dr. Jack Braha recently discussed his career, practice, and his experiences hosting “Medcast Plus” via an exclusive interview.
Medicine, TV hosting, and rewarding experiences
Meagan Meehan (MM): What got you interested in medicine and why did you decide to focus on gastrointestinal issues?
Jack Braha (JB): For as long as I can remember, medicine has always been an interest of mine. From a young age, I always wanted to be a physician, and my friends from kindergarten still remind me of this. Medicine is a calling. There is [hopefully] something inside of every physician that sparks their interest every day to take care of another human being. There is a significant barrier to entry into becoming a physician.
I spent four years in college studying the pre-medical courses, four years in medical school and another six years as a resident and fellow to become board-certified in my field. Then we spend the rest of our lives continuously learning and practicing our craft.
I chose gastroenterology after changing my mind a few times about what field I would spend my career focusing on.
I still somehow think that one day I could be in another specialty because medicine is so interesting and I always want to know everything – not possible! There was always an interest in gastroenterology in my mind. I had battled with IBS during my teens and twenties, a few friends were suffering from crohns, and ulcerative colitis and my grandfather had died of colon cancer.
Yet when I started my first day of medical school, I wanted to be a trauma surgeon or an emergency medicine specialist. This was largely rooted in my past as an emergency medical technician (EMT). Then, towards the end of medical school, I came full circle back to gastroenterology. I had a few great mentors that were gastroenterologists, and they inspired me. I decided that I wanted to fight the diseases that I had learned all too much about in real life.
MM: How did you find your niche specialties and what is most rewarding about working in this field?
JB: As physicians, we all seem to find that specific part of our field that we tend to focus on. For me, it has been preventing colon cancer and treating patients that suffer from irritable bowel syndrome (IBS).
There really is not much more gratifying than preventing cancer by removing a big polyp during a colonoscopy and saying, “gotcha!” On the social side of things, there are syndromes and disease that impact someone’s lifestyle and being able to help IBS patients return to their daily lives without pain or fear is very rewarding. Recently, a patient with IBS came back to thank me for helping him get back to school after a hiatus due to severe IBS symptoms, that felt really good.
MM: How do you handle breaking bad--sometimes awful--news to patients and would you say that your job takes an emotional toll on you?
JB: This is the worst part of being a physician. No many how times you do it or practice to be better at it, it still sucks.
There is no standard way of doing it; each patient is unique and will react differently. Anyone that says that they are good at it is lying, or too stone cold to be practicing anymore. I have had to tell someone that their loved one is gone, that they have cancer and most importantly, I have had to tell someone “I don’t know.” Being able, to be honest with someone during a difficult time is important. I tell younger students that it is important to know what you don’t know and admit when you are in over your head. Medicine is a collegial field, and we rely on our colleagues for advice and second opinions.
Tough moments like this take a toll on your emotions and mental state. It is likely that they always will.
I don’t think it is possible to get used to telling someone bad news. I always try to start with acting as if I was telling myself the bad news and how would I want to hear it. The problem is that it is hard to act and I find myself feeling the same emotions. We try to stay strong and put on a confident face during these encounters, but I have found myself in the hospital bathroom crying my eyes out more than a few times. Thankfully we have plenty more good than bad days, and you learn to cope during the rough times. Family time, good physical fitness and frequent vacations help keep the mind focused and avoid the increasing amount of burnout experienced by physicians.
MM: During your career in medicine, what have you learned most about people?
JB: People can present many different ways but with the same disease. We have to learn to adapt (almost in an instant) to their personalities and expectations. I have experienced both thankfulness and indifference from people – thankfully it has been a lot more thankfulness from our wonderful patients. Being a people person will get you through your “doctor day.”
MM: How did you get involved with “MedCast Plus” and what do you enjoy most about hosting the show?
JB: I started with Medcast Plus when Gregory asked me to come on as a guest to talk about IBS. I had such a good time that he asked me to host the show. Together we have worked to bring on medical experts to help educate the community about their health.
If just one person watching gets screened for cancer or gets their blood pressure under control because of us, then it is all worth it. That is my favorite thing about hosting the show.
Show information and medical breakthroughs
MM: How important do you think the information on this show is and how much do you promote the merits of early detection and the need to get tested for various illnesses?
JB: We try to bring on health professionals that will teach our viewers about things that affect most of us or someone we know. Educating the community about ways to screen or find diseases before they become an issue is huge. We know that by findings most cancers in their earliest stage, like breast cancer or colon cancer, we can achieve a cure.
The problem is that many people out there either don’t know about these tests or are afraid of them, we try to keep it simple and easy to understand. When I talk to our guests, I try to keep it real and relative to our viewers. I focus on the questions that a patient would ask a physician not what a physician would ask a physician. This is important in an era of five-minute office visits and urgent care, where patients don’t always get to have a meaningful conversation with their provider.
MM: What would you say are a few of the most exciting recent medical breakthroughs that are specific to your field?
JB: In gastroenterology, we continue to see the results of increased adherence to colon cancer screening.
The most recent data shows a significant decline in the incidence of colon cancer in those over 50 years old. This is likely due to the good work of gastroenterologists removing polyps during colonoscopy. The training, technology, and techniques continue to improve allowing gastroenterologists to do more with colonoscopes and endoscopes and more patients are avoiding surgery because of this. Another breakthrough has been the study of the microbiome. While most of the over the counter “probiotics” have yet to be proven to do anything, there have been some quality studies highlighting the role of the bacteria in our gut. The most exciting has been the treatment of C. difficile infections. Here, scientists have found that fecal transplant can treat and prevent future disease in over 90% of patients.
MM: How do you hope your medical career (and hosting career) evolves over the next ten years and what else is happening for you in 2019?
JB: 2019 is off to a good start. Gregory and I have filmed a few episodes for “Medcast Plus” that will air soon and we have a great lineup for the coming year. I just participated in an article about colon cancer prevention and did a “live” colonoscopy to promote colon cancer prevention month for the “Ask Men” website. In May, along with a few students that we mentor, I will be presenting research on collagenous gastritis, a rare disease, at Digestive Disease Week in San Diego.
As for the future, medicine is rapidly changing. We continue to ride the wave where it takes us and adjust our sails to the changing winds.
As physicians, we are taught early in our career how to adapt and survive (30 hours on-call in the ICU will do it quickly). This will likely include an increasing number of visits done through telemedicine, challenges with insurance payments and the Affordable Care Act along with increased costs of providing good medical care. Personally, I hope that in ten years I am still hunting for polyps and preventing colon cancer, taking care of gastrointestinal emergencies in the ER and hosting a show that promotes good health and conversation – basically what I am doing right now!
