Vital Signs: A higher price for cigarettes and a poem for doctors
Dr. Jon Hallberg weighs in on the impacts of the new $15 cigarette price minimum in Minneapolis.
MPR News
Each month, Dr. Jon Hallberg joins MPR News host Cathy Wurzer to talk about topics that are important to your health and take a deep dive into medical news.
Hallberg is a family medicine physician at Mill City Clinic and a professor at the University of Minnesota Medical School.
In this installment of Vital Signs, he weighed in on whether higher cigarette prices in Minneapolis will reduce smoking. He also explained the role art and storytelling have to play in the medical field — and in honor of National Poetry Month, he shared a poem.
The Center for the Art of Medicine is hosting an evening of storytelling on Saturday, May 4 at the Parkway Theater in Minneapolis.
Use the audio player above to listen to the full conversation.
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Audio transcript
[THEME MUSIC] EMILY BRIGHT: It's time for our segment Vital Signs. Each month, we talk about topics that are important to your health. We take a deep dive into medical news or what's top of mind at the doctor's office with Dr. Jon Hallberg. He's a family medicine physician at Mill City Clinic and a professor at the University of Minnesota Medical School. MPR News host Cathy Wurzer recently caught up with him in studio.
CATHY WURZER: So let's start with some top health news. Minneapolis City Council just passed one of the highest prices for cigarettes in the country at $15 a pack. It's even ahead of New York City, which is at $13. And the hope is that it will deter people from smoking.
But I want to know, what do we know, doctor, about the success of such a move? Does it make it tougher for people to smoke?
JON HALLBERG: Well, that is certainly the hope. I mean, boy, is this ever a stick approach rather than a carrot approach. And the hope is that it's so expensive that people have no choice but to abandon their habit.
And I admire the public health intent of this, but I also have really deep, great compassion for people with addictions. And this is one. And it affects certain populations disproportionately. And I'm concerned about that, but I guess the hope would be that I'll be having more conversations, and so will my colleagues in clinic to try and help people get off the cigarettes.
And I will point out that of all the things we human beings can do to ourselves, smoking is just pretty much hands-down the thing that is the most detrimental to our health. And conversely, quitting can be probably the single greatest thing someone can do to improve their health and improve their health rather quickly.
CATHY WURZER: I'm wondering, are you seeing fewer people smoking in your practice?
JON HALLBERG: Oh yeah.
CATHY WURZER: There's so much in the way of anti-tobacco messaging out there.
JON HALLBERG: Yeah-- I mean, I started practicing in 1995. I started my residency in 1992. And over the past 30-plus years, I've seen quite a drop. But just yesterday, I had someone in for a physical exam, and there in his shirt pocket was a pack of Marlboros. And we talked briefly about if he's ready to quit smoking yet. And he's not, but I always believe in keeping the door open.
And not only are we able to help people-- and truly, it's one of the great joys of my practice is to help people, see them successfully quit smoking. And we should point out that there is free help available through the state, through the quit plan that's available. And even some products like patches and lozenges and sprays are available for free. So there's lots of ways to help people quit when they're ready.
CATHY WURZER: I note that e-cigarettes are not part of this Minneapolis ordinance, and they're a really big problem among teenagers. Are you seeing teens vaping using e-cigs?
JON HALLBERG: Oh, sure-- I mean, personally, in my population, I'm seeing a little bit of a decrease in that. I think that the-- I don't know if it's the cool factor or what it is, it seems to be maybe waning a bit. But I was in France back in December and having dinner at a host family's house and-- let me try that again-- at a host family's table. And one of the family members was sneaking a vape in between bites, and I see it everywhere. But I would love to think that that's also kind of losing a little bit of its cachet.
CATHY WURZER: Let's switch gears. You are the founder of the Center for the Art of Medicine at the University of Minnesota, which I love that because I think when people think of medicine, they don't really think of art. But there is an intersection.
JON HALLBERG: Oh--
CATHY WURZER: And it's beautiful.
JON HALLBERG: --thank you. Yeah, I mean, we often talk about this expression or this phrase, "the art and science of medicine." In medical school, certainly the first year and often the second year are heavily, heavily on the science. That's really the focus.
And I often say to people that when you start medical school, we're learning a foreign language. It's this language of medicine and science and the underpinnings of everything that goes on in the human body-- everything from the anatomy, obviously, but also the physiology, so what we're made of and how that stuff works.
But so much of clinical practice, the day-to-day interaction with patients, is-- I get paid to listen to stories, essentially. And then, of course, these are often mystery stories. I'm trying to figure out things or kind of get to yes or have some positive influence in someone's lifestyle and how they're taking care of themselves, or they're not taking care of themselves. And our center was created to really focus on this other part, the art of medicine.
CATHY WURZER: To that point, doctor, there's this event at the Parkway Theater in Minneapolis next week, which is an evening of medical storytelling. That sounds intriguing.
JON HALLBERG: Yeah, so our center, when we created it-- and I'm the creative director, but I have a team of-- there's six of us total that run it. And I have a couple of colleagues who are the co-directors of it. And their focus, their specialty is storytelling-- again, kind of getting at that idea that so much of medicine is about hearing stories, but also processing stories.
And so much of what we do is we hear these stories. We have to think about them, process them. It's heavy stuff. And so storytelling and storytelling events has been one of our marquee features of the center. And yeah, we have our second show at the Parkway Theater.
We had one a year ago in April, and this will be on Saturday, May 4, and featuring incredible health clinicians-- so not just physicians-- who have been coached. And they've really got some great, great stories. This is very much of that kind of The Moth radio show quality.
CATHY WURZER: Of course, storytelling is this distinctly human gift, right?
JON HALLBERG: Oh, yeah.
CATHY WURZER: And I think you can learn. It's a great educational tool. But to that end, I'm wondering-- the use of storytelling in the medical field, does it help physicians listen better? Because often, I think sometimes patients feel like they're not being listened to. So if you use storytelling as a tool, might that help?
JON HALLBERG: Yeah, I mean, we do it in a couple of different ways. One is tuning our ears to listen to the stories, to listen to the subtle clues that patients are trying to tell us. And that's kind of been an adage in medicine, that if you just listen, you're going to figure out what's going on with somebody.
And then on the other hand, it's like, you've got this-- the heaviness of it. And so telling stories, writing stories helps us process that. And I think it's good for well-being. It's good for burnout prevention. It deepens empathy.
And stories can be told, of course, through film, through theater, through so many different avenues, so many different venues. I believe it makes us all-- all humans better humans through listening to and appreciating story.
CATHY WURZER: So getting back to the Center for the Art of Medicine, there are other forms of art, obviously. How do you think art can be healing?
JON HALLBERG: Oh, gosh, I mean, there's just so many ways. I think that the way that it engages our senses, the way that it activates different parts of our brain, takes us places that we couldn't otherwise go, either through pure imagination or through the visual appreciation, the auditory appreciation-- just so many ways.
And I think that this is a big movement. There are some recent books that have come out looking at the scientific underpinning of listening to and telling stories, the importance of creativity in our lives. So it's not just this gestalt or a feeling, but I think that science and evidence is pointing to how important the arts are to our health.
CATHY WURZER: So speaking of an art form that can transport people, I think poetry fits that bill. And of course, April is National Poetry Month. I think we should share a poem--
JON HALLBERG: Oh, gosh.
CATHY WURZER: --with the audience.
JON HALLBERG: I would love that. So I have in my hand a book that was published by the University of Iowa Press, and it's called Blood and Bone-- Poems by Physicians. And I've had this on my shelf for years. I've turned to it. I think I've read every one of these poems at least once, if not more than once. And I've used many of them in different programs I've given over the years.
And the one I have in my hand here is by Vernon Rowe, who is a neurologist. And the reason-- I mean, this is hands-down one of my all-time favorite poems. And the reason I love it so much is that we're in an age of-- I mean, it's a great time to be alive from a medical standpoint. We can cure so many things, treat so many things effectively with less pain. It's just a great time.
But there's a limit to science and what it can do. And so this poem is entitled "MRI of a Poet's Brain." And I'm going to be reading a bunch of words here that are just anatomical markers within the brain. But I can't think of a poem that better kind of explains this idea of, like, though we know so much, there's still a little mystery. So here it is, "MRI of a Poet's Brain."
"In this image
of your brain,
I see each curve
in the corpus callosum,
curlicues of gyri,
folding of fissures,
sinuous sulci,
mammillary bodies,
arcuate fasciculus,
angular gyrus,
tracts and nuclei,
eyes and ears,
tongue and pharynx--
but not even a single
syllable of
one
tiny
poem."
CATHY WURZER: Wow, I love that.
JON HALLBERG: Yeah, it's just such a-- I think he captures it so nicely that there's a limit to technology. We will never be able to see the formation of a poem in our brain, even if our functional MRIs are so sophisticated one day that we can see where thoughts derive. We still can't figure that out.
CATHY WURZER: No-- you know what? I always love talking to you. I'm so glad you stopped by this month. Thank you.
JON HALLBERG: Thank you, Cathy.
EMILY BRIGHT: That's MPR News host Cathy Wurzer talking with Jon Hallberg, family medicine physician at Mill City Clinic and a professor at the University of Minnesota Medical School. Tickets are available for the Art of Medicine storytelling event they talked about. I remember when that happened last year. I'm so glad they're doing that again. That is happening Saturday, May 4, at the Parkway Theater in Minneapolis.
CATHY WURZER: So let's start with some top health news. Minneapolis City Council just passed one of the highest prices for cigarettes in the country at $15 a pack. It's even ahead of New York City, which is at $13. And the hope is that it will deter people from smoking.
But I want to know, what do we know, doctor, about the success of such a move? Does it make it tougher for people to smoke?
JON HALLBERG: Well, that is certainly the hope. I mean, boy, is this ever a stick approach rather than a carrot approach. And the hope is that it's so expensive that people have no choice but to abandon their habit.
And I admire the public health intent of this, but I also have really deep, great compassion for people with addictions. And this is one. And it affects certain populations disproportionately. And I'm concerned about that, but I guess the hope would be that I'll be having more conversations, and so will my colleagues in clinic to try and help people get off the cigarettes.
And I will point out that of all the things we human beings can do to ourselves, smoking is just pretty much hands-down the thing that is the most detrimental to our health. And conversely, quitting can be probably the single greatest thing someone can do to improve their health and improve their health rather quickly.
CATHY WURZER: I'm wondering, are you seeing fewer people smoking in your practice?
JON HALLBERG: Oh yeah.
CATHY WURZER: There's so much in the way of anti-tobacco messaging out there.
JON HALLBERG: Yeah-- I mean, I started practicing in 1995. I started my residency in 1992. And over the past 30-plus years, I've seen quite a drop. But just yesterday, I had someone in for a physical exam, and there in his shirt pocket was a pack of Marlboros. And we talked briefly about if he's ready to quit smoking yet. And he's not, but I always believe in keeping the door open.
And not only are we able to help people-- and truly, it's one of the great joys of my practice is to help people, see them successfully quit smoking. And we should point out that there is free help available through the state, through the quit plan that's available. And even some products like patches and lozenges and sprays are available for free. So there's lots of ways to help people quit when they're ready.
CATHY WURZER: I note that e-cigarettes are not part of this Minneapolis ordinance, and they're a really big problem among teenagers. Are you seeing teens vaping using e-cigs?
JON HALLBERG: Oh, sure-- I mean, personally, in my population, I'm seeing a little bit of a decrease in that. I think that the-- I don't know if it's the cool factor or what it is, it seems to be maybe waning a bit. But I was in France back in December and having dinner at a host family's house and-- let me try that again-- at a host family's table. And one of the family members was sneaking a vape in between bites, and I see it everywhere. But I would love to think that that's also kind of losing a little bit of its cachet.
CATHY WURZER: Let's switch gears. You are the founder of the Center for the Art of Medicine at the University of Minnesota, which I love that because I think when people think of medicine, they don't really think of art. But there is an intersection.
JON HALLBERG: Oh--
CATHY WURZER: And it's beautiful.
JON HALLBERG: --thank you. Yeah, I mean, we often talk about this expression or this phrase, "the art and science of medicine." In medical school, certainly the first year and often the second year are heavily, heavily on the science. That's really the focus.
And I often say to people that when you start medical school, we're learning a foreign language. It's this language of medicine and science and the underpinnings of everything that goes on in the human body-- everything from the anatomy, obviously, but also the physiology, so what we're made of and how that stuff works.
But so much of clinical practice, the day-to-day interaction with patients, is-- I get paid to listen to stories, essentially. And then, of course, these are often mystery stories. I'm trying to figure out things or kind of get to yes or have some positive influence in someone's lifestyle and how they're taking care of themselves, or they're not taking care of themselves. And our center was created to really focus on this other part, the art of medicine.
CATHY WURZER: To that point, doctor, there's this event at the Parkway Theater in Minneapolis next week, which is an evening of medical storytelling. That sounds intriguing.
JON HALLBERG: Yeah, so our center, when we created it-- and I'm the creative director, but I have a team of-- there's six of us total that run it. And I have a couple of colleagues who are the co-directors of it. And their focus, their specialty is storytelling-- again, kind of getting at that idea that so much of medicine is about hearing stories, but also processing stories.
And so much of what we do is we hear these stories. We have to think about them, process them. It's heavy stuff. And so storytelling and storytelling events has been one of our marquee features of the center. And yeah, we have our second show at the Parkway Theater.
We had one a year ago in April, and this will be on Saturday, May 4, and featuring incredible health clinicians-- so not just physicians-- who have been coached. And they've really got some great, great stories. This is very much of that kind of The Moth radio show quality.
CATHY WURZER: Of course, storytelling is this distinctly human gift, right?
JON HALLBERG: Oh, yeah.
CATHY WURZER: And I think you can learn. It's a great educational tool. But to that end, I'm wondering-- the use of storytelling in the medical field, does it help physicians listen better? Because often, I think sometimes patients feel like they're not being listened to. So if you use storytelling as a tool, might that help?
JON HALLBERG: Yeah, I mean, we do it in a couple of different ways. One is tuning our ears to listen to the stories, to listen to the subtle clues that patients are trying to tell us. And that's kind of been an adage in medicine, that if you just listen, you're going to figure out what's going on with somebody.
And then on the other hand, it's like, you've got this-- the heaviness of it. And so telling stories, writing stories helps us process that. And I think it's good for well-being. It's good for burnout prevention. It deepens empathy.
And stories can be told, of course, through film, through theater, through so many different avenues, so many different venues. I believe it makes us all-- all humans better humans through listening to and appreciating story.
CATHY WURZER: So getting back to the Center for the Art of Medicine, there are other forms of art, obviously. How do you think art can be healing?
JON HALLBERG: Oh, gosh, I mean, there's just so many ways. I think that the way that it engages our senses, the way that it activates different parts of our brain, takes us places that we couldn't otherwise go, either through pure imagination or through the visual appreciation, the auditory appreciation-- just so many ways.
And I think that this is a big movement. There are some recent books that have come out looking at the scientific underpinning of listening to and telling stories, the importance of creativity in our lives. So it's not just this gestalt or a feeling, but I think that science and evidence is pointing to how important the arts are to our health.
CATHY WURZER: So speaking of an art form that can transport people, I think poetry fits that bill. And of course, April is National Poetry Month. I think we should share a poem--
JON HALLBERG: Oh, gosh.
CATHY WURZER: --with the audience.
JON HALLBERG: I would love that. So I have in my hand a book that was published by the University of Iowa Press, and it's called Blood and Bone-- Poems by Physicians. And I've had this on my shelf for years. I've turned to it. I think I've read every one of these poems at least once, if not more than once. And I've used many of them in different programs I've given over the years.
And the one I have in my hand here is by Vernon Rowe, who is a neurologist. And the reason-- I mean, this is hands-down one of my all-time favorite poems. And the reason I love it so much is that we're in an age of-- I mean, it's a great time to be alive from a medical standpoint. We can cure so many things, treat so many things effectively with less pain. It's just a great time.
But there's a limit to science and what it can do. And so this poem is entitled "MRI of a Poet's Brain." And I'm going to be reading a bunch of words here that are just anatomical markers within the brain. But I can't think of a poem that better kind of explains this idea of, like, though we know so much, there's still a little mystery. So here it is, "MRI of a Poet's Brain."
"In this image
of your brain,
I see each curve
in the corpus callosum,
curlicues of gyri,
folding of fissures,
sinuous sulci,
mammillary bodies,
arcuate fasciculus,
angular gyrus,
tracts and nuclei,
eyes and ears,
tongue and pharynx--
but not even a single
syllable of
one
tiny
poem."
CATHY WURZER: Wow, I love that.
JON HALLBERG: Yeah, it's just such a-- I think he captures it so nicely that there's a limit to technology. We will never be able to see the formation of a poem in our brain, even if our functional MRIs are so sophisticated one day that we can see where thoughts derive. We still can't figure that out.
CATHY WURZER: No-- you know what? I always love talking to you. I'm so glad you stopped by this month. Thank you.
JON HALLBERG: Thank you, Cathy.
EMILY BRIGHT: That's MPR News host Cathy Wurzer talking with Jon Hallberg, family medicine physician at Mill City Clinic and a professor at the University of Minnesota Medical School. Tickets are available for the Art of Medicine storytelling event they talked about. I remember when that happened last year. I'm so glad they're doing that again. That is happening Saturday, May 4, at the Parkway Theater in Minneapolis.
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