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The Nocturnists

13 - Uncertainty in Medicine: Denial and Acceptance

The Nocturnists

Emily Silverman

Personal Journals, Medicine, Health & Fitness, Society & Culture

4.8614 Ratings

🗓️ 26 June 2025

⏱️ 45 minutes

🧾️ Download transcript

Summary

In the series finale, we explore a different type of uncertainty—the uncertainty that arises around the healthcare system itself. This episode follows Ed Stratton, a stage IV cancer patient who beat his cancer, only to be denied a life-saving liver transplant by his insurance provider. His daughter Erin, armed with industry knowledge and unshakable determination, teams up with a healthcare whistleblower and an AI-powered startup to wage an extraordinary battle for his life. We end with a quiet reflection on uncertainty, and what it means to keep going

Find show notes, transcripts, and more at thenocturnists.org, and subscribe to our substack.

The "Uncertainty in Medicine" series is generously funded by the ABIM Foundation, by the Josiah Macy Jr. Foundation, and the Gordon & Betty Moore Foundation.

The Nocturnists is supported by The California Medical Association and donations from listeners like you.

Host: Emily Silverman, MD

Uncertainty Correspondent: Alexa Miller

Series Illustrations by Eleni Debo

Transcript

Click on a timestamp to play from that location

0:00.0

Support for the Nocturnist comes from the California Medical Association.

0:04.2

At the Nocturnist, we are careful to ensure that all stories comply with health care privacy laws.

0:09.1

Details may have been changed to ensure patient confidentiality.

0:12.5

All views expressed are those of the person speaking and not their employer.

0:19.4

This is The Nocturness. Uncertainty in Medicine. I'm Emily Silverman. This is the final

0:26.0

episode of our series on Uncertainty. And as we wrap up, we're turning our focus to a different

0:31.9

kind of uncertainty, the kind that doesn't come from a tough diagnosis or a difficult conversation

0:37.2

in the exam room,

0:38.4

but instead comes from something bigger, the healthcare system itself.

0:43.3

Specifically, we're looking at one of the most destabilizing and opaque forces in American medicine.

0:49.3

Health insurance.

0:51.3

It shapes everything, from how clinicians interact with patients in the exam

0:55.7

room to whether a treatment is approved. Here, the uncertainty isn't about the diagnosis or

1:01.6

the treatment itself. It's about whether the insurance will cover it, and whether that coverage

1:06.8

will come in time. Today, we bring you a story about a family caught in that kind of uncertainty and how they refused to accept it.

1:15.6

Later in the episode, I'll sit down with Alexa Miller, our uncertainty correspondent, to reflect on what we've learned over the course of putting together the series.

1:24.6

And finally, we'll close the series with one final voice, a voice that

1:30.1

speaks about accepting uncertainty rather than fighting it. But first, meet Ed. Oh yeah, my name is

1:38.8

Ed Stratton. I live in Ball One, Missouri. Well, it started back in March of 2019 when out of the blue,

1:47.2

I just started passing blood. And then from there, I got admitted in the hospital where they

1:52.1

diagnosed me with stage four colon cancer. This is Ed Stratton. He's a sales rep for a medical

1:58.4

device company. He loves golf and he lives in a suburb outside of St. Louis.

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