Dr. Gary Hammer, an M.D. and Ph.D., is one of those rare doctors and scientists for whom professional achievement is incomplete without genuine human connection. His message is simple: being a doctor is not just about correct diagnosis and treatment; it’s also about compassion. It requires courage, honesty, a willingness to be emotionally vulnerable, and a sincere connection with the patient.
We spoke about these values and his personal and professional choices with the Millie Schembechler Professor of Adrenal Tumors and Director of the Endocrine Oncology Program at the University of Michigan’s Rogel Cancer Center, Dr. Hammer. He is the former President of the Endocrine Society, and an internationally recognized endocrinologist and scientist. His research focuses on adrenal homeostasis, stem cells, and rare adrenal tumors. He is also the co-founder of two biotechnology companies, “Millendo” and “VasAragen,” which are working on developing biological treatments for endocrine diseases.
Before we move on to the medical aspects of your career, I must highlight your efforts to encourage doctors to find their authentic selves. You urge them to always be honest, sincere, and empathetic with patients. In a TED talk you gave about ten years ago, you spoke about the importance of a personal connection with the patient. Why do you consider this connection so important? Why do you think it’s so essential?
Because, in the end, we are all patients. None of us gets out of this alive.
That is the first answer: there is no reason why the relationship between a doctor and a patient should not be considered an honest conversation between two people. One has knowledge in a specific field of medicine that helps the other, but ultimately, it is still a conversation between two people. From a practical point of view, and this is the essence of your question, a genuine connection between two people, especially a doctor and a patient, promotes healing. I oppose the outdated approach where the doctor talks and the patient listens.
The paternalistic doctor model is now a thing of the past. What I have found is that when a doctor is sincere and doesn’t hide behind a white coat, it inspires trust in the patient. When one person talks to another, it brings them closer on a human level. When you put yourself in the patient’s place, you share their feelings, you realize that this human empathy is essential. The patient sees and feels this, and their trust in you grows. This has become a fundamental approach for me in my interactions with patients.
Modern medicine often contradicts this concept. In the past, healers and shamans were respected not only for their healing skills but also because they were an integral part of the emotional, mental, and physical health of the community. They were part of the community from the very beginning. In modern medicine, when we sit behind computers, we often don’t even look at the patient; we just type or search for treatment algorithms, and in doing so, we lose what is most important.
Typically, before I see a patient with a complex endocrine tumor, I always prepare in advance. It takes me 2 to 4 hours to review records and learn everything about them. So that when I meet with them, I know everything about them. This practice is being lost in modern medicine. Electronic medical records are, of course, valuable, but they also carry the risk of losing the human connection, which I believe is the essence of healthcare.
Perhaps this is the shortest explanation of why it is so important for me to allow myself to open up emotionally, to fully feel and completely grasp the patient’s condition. Of course, you can’t break down and cry with every patient, but I have cried at times. Such a relationship can be considered a sacredly honest relationship, just like with a psychotherapist. A good psychotherapist knows how to “hold” someone else’s pain while remaining stable themselves. They get deeply involved and empathize, but they often need therapy themselves to maintain that depth.
Medscriptum: Just like many other doctors…
Dr. Hammer: Yes, many do, and they probably should. I think we all really need to open up; we need to have the courage to reveal our own feelings. To show our human side, our emotions. While it’s very exhausting to do this in every meeting, this experience always teaches you something. Sharing the patient’s feelings helps you grow. An immeasurable space opens up between you where the sincere sharing of human emotions begins. And for me, this is the essence of medicine.
Medscriptum: You are a doctor, a scientist, a writer, and, as I recently learned, an active mountaineer. You also find time for painting. For example, you won the 2023 painting prize for a painting of the adrenal gland. How do you manage to balance so many different pursuits?
Dr. Hammer: The first thing I want to say is that we must be careful when we evaluate someone’s life. It’s hard to believe, but I’ve been in this profession for 25 years, and it would be wrong to say that I achieved everything at once. One way to explain this is: you can achieve many great things in life, but it’s rare to do them all at once. Later, I will explain why I avoid using the word “achievement” and prefer to talk about the pursuit of “passion” and “purpose.”
The second answer concerns balance. It’s important to understand that each person has their own individual “fulcrum” or point of equilibrium, where they feel most balanced, whether it’s their career, hobbies, or family relationships. And we must respect that. Everyone has a different perspective on career and life balance.
I remember when I was a medical student, I constantly compared myself to others. If someone was working more than me, I thought, “They must be giving something up.” If someone had an active life outside the hospital, I thought, “They probably can’t keep up academically.” But over time, I realized how pointless and harmful such comparisons are.
Each of us makes choices that align with our priorities, values, and abilities. There is no universal formula for what balance should look like. I am learning to accept and appreciate this diversity of choices, both in myself and in others.
As for my personal balance, I’ll answer your question in two parts. First, I simply appreciate the versatility within me. However, of course, I have had to make sacrifices and compromises many times. When you are a student or a resident, you have very little time. As a result, parts of your “life portfolio” temporarily take a back seat.
My youngest son, Zak, for example, competed in rock climbing at the Olympic Games in Paris last summer. A few weeks after the games, he enrolled in university and asked me, “Dad, how am I supposed to continue training for the Olympics and also study?” I remember telling him two things: “Zak, I can’t help you. Your own fulcrum, your point of balance, belongs to you and you have to find it yourself. There is no single right answer. The good thing is that you are asking the right question. This question will change over time. It will reappear again and again as your life progresses, because life moves forward.” And that’s all we can ask of ourselves.
Medscriptum: But how do you find your balance?
Dr. Hammer: You’re asking me how I find balance? Everything depends on what you spend your time on, what you prioritize. It’s easy to say but difficult to do. I love my family. I really love rock climbing, so outside of my professional life, I consider them my priorities.
In my professional life, I have only been able to lead a team and write textbooks while maintaining my composure because I am not a micromanager. I emphasize one factor: I like to delegate authority. I believe that distributing tasks and a “flat,” or non-hierarchical, structure is very important. Hierarchies have their place—for example, in the operating room, the person holding the scalpel, the surgeon, must be in charge. But in other aspects of my life, I oppose hierarchy. In my lab, college students, medical students, and young professors work, and I value everyone’s opinion.
I often mention that we are all “imposters.” We all do something for the first time. When I started my company, Sling Therapeutics, I really had no idea what I was doing. Today, people ask me, “How did you do it?” My answer? I don’t know. I think magic is always outside the comfort zone.
That’s why it is so important for me to be brave and fearless. This doesn’t mean being reckless. It means not being afraid of your own weaknesses and failures, because there will be setbacks; failure is inevitable. Rock climbing is a good analogy for this; a big part of climbing is falling. Science is the same; it’s mostly failure. In medicine, we make mistakes every day. So, when you look at your own weakness fearlessly, it helps you. We are talking about balance, but these are parts of a single system. I support flat organizational structures where you give others the opportunity to become leaders.
We have all seen doctors or leaders whose organizations crumble when they leave. For me, that is a sign of poor leadership. The best leaders create something bigger than themselves and then pass it on to others. They mentor and give people the chance to become leaders themselves. This is much more satisfying than being at the top of a hierarchy.
And we’re back to our previous conversation about delegation, which is based on empowering others. That is true leadership, “servant leadership,” as John F. Kennedy called it. Leadership is not about an individual’s legacy; it’s about the legacy of the mission and purpose to which you have dedicated your life.
I want to share something I mention to all residents and young professionals: “the ladder-climbing” syndrome. This is particularly difficult on the path of medical education. I’ve already said that we sometimes have to make sacrifices, but another trap is the belief that happiness is always just one step away.
You often hear: “I’ll be happy when I pass my exams.” Then you pass them and you think, “I’ll be happy when residency is over.” Then residency ends, and the goal changes again: “Now I have to go through a fellowship or become a licensed doctor, and I’ll be happy when that’s over.” You get there and it’s the same thing: “I’ll be happy when I get my first grant.” And so on, indefinitely.
The moral of the story: the climb will never end; you will always be focused on the next step, and this path will never have an end unless you change the dialogue with yourself. And this dialogue is similar to Eckhart Tolle’s philosophy: you need to live in the present. You have to be able to live and enjoy where you are, because there is nothing else. Only the present exists.
The second thing I want to say is that in medicine and science, we are constantly being judged by superiors, colleagues, committees, and institutions. It’s important not to let others define what perfection means to you. If you are not careful, you will live by someone else’s standards.
There will always be someone who reads more than you, who does something you are involved in better than you. Someone who studies more. But, and here I may sound like Mr. Rogers, but it’s true, “There’s no one exactly like you,” and that’s the truth. I love this phrase because when you’re constantly being judged, it’s easy to get caught up in the process. It’s as if it’s never enough; you can easily become a prisoner of someone else’s expectations. Therefore, you have to find your own path.
And one more thing: we are constantly trying to achieve something. The medical and scientific fields are overly focused on achievement. I want to shift this focus. Yes, doing good work is important; it’s an ideal. But we can’t always live by ideals, can we? What you want is a life filled with purpose and passion. And if achievements come along the way, that’s wonderful! But if achievement is the only goal of your life, that’s the wrong path. Then life has no meaning.
Medscriptum: If I may continue this thought, you mentioned that you have your own definition of success. Did I understand correctly that “purpose and passion” are the two words you consider to be success?
Dr. Hammer: I think that’s a really good starting point. Yes, that is one of the best foundations for a definition of success. Find something you love and that is meaningful to you; that is success.
Medscriptum: Regarding leadership, which you’ve already mentioned in a few sentences, it’s a different conversation to have with an established professional like you versus a young person who is just starting out in this field. What would you tell young doctors and residents about how to become leaders?
Dr. Hammer: Purpose. Passion. Authenticity. Sincerity. Purpose, passion, authenticity, and sincerity—these are the most important things.
By authenticity, I mean being yourself. We are all different. We are all a little weird. And for me, my “self” is everything. Now, looking back after 25 years, it’s easy to say, but I’ll tell you: never sell your soul. You only have one. Of course, that depends on your beliefs if you don’t believe in reincarnation.
I want to share a short story with you that strengthened my belief in authenticity. I was a young student. When I had the opportunity, I presented my work for the first time at a national conference. I went on stage in my characteristic free style: my speech and my clothing were not “traditional.” I spoke with energy and enthusiasm. I was probably a very young boy at the time. After the presentation, when it was time for questions, an elderly, white-haired gentleman stood out from the audience, came to the microphone, and yelled at me in front of 500 people that:
First, I had cited his quote incorrectly, and second, that I should treat a senior audience with more respect and look professional.
I also told this story in one of my TED talks. I was very upset, and those moments bothered me for a long time. For years, I have asked myself why some people are annoyed by the authenticity or cheerfulness of others? I don’t have an answer. But something similar has happened to me at least two more times. After this, I consciously decided that I would never change to please someone else: not for a stranger, not for a colleague, and not for a superior.
This idea was further strengthened by a powerful emotional experience. I told a patient’s family that their father was dying. At that moment, I was there with them with my whole being, I was feeling the same emotions, their pain transferred to me, and tears came to my eyes. At that moment, there were only five of us there; we were grieving together… and the family themselves comforted me; I received compassion from them. These two experiences—the previous meeting when the senior yelled at me and this one when I cried with the patient’s family—were a sign to me that you must have courage. You must be who you are; you must be true to your whole being.
Therefore, when I look for young leaders, I look for those who are bold. Who are not afraid of failure. Who are obsessed with achieving their purpose, who want to make an impact, and, most importantly, who are authentic.
Leadership is a verb, not a title. It has nothing to do with rank or position. I have been in many meetings where the “official leader” was not suited for the meeting’s purpose, and I saw someone else openly, fearlessly, and naturally take the initiative. This can be a young or an old person.
There is a Japanese word, ikigai, which means to find your purpose and passion. And the magical moment comes when you do this well and also bring benefit to others. I saw this with my own eyes in the Endocrine Society, where I was president. Some participated in a committee just to have the “leader” title. Others did it because they loved the work. And you can guess who the real leaders were. They were the ones who came with passion and purpose.
Medscriptum: In your TED talk, you mentioned that when a patient is faced with a fatal diagnosis, there is no point in wearing a mask anymore. Sometimes, they get their first chance to live authentically for a few years, without playing a role.
Dr. Hammer: I remember I really said that. Yes. When a person faces a fatal illness, they often develop the ability and courage to live in the present, which, as I said, is emotional authenticity. Their illness “liberates” them; there is no longer a need to wear roles and masks. Only one thing remains: to live as you wish, because death is so clearly ahead.
Of course, there are patients who, for various reasons, cannot do this, and there are patients who simply choose not to fight, not to confront their situation. We have all seen this and I am completely sympathetic. I even said in the TED talk: “The goal is to live until you die.”
Many people have said this in different ways. I am not a philosopher, but when death is constantly in front of you, it predisposes you, or pushes you, or gives you the right to live authentically. This is a state where a person fully realizes that their life is temporary, and no matter how paradoxical it sounds, it is from this moment that they begin to live authentically. This state is not always pleasant; sometimes, it is accompanied by melancholy. It can be sad, but this is the entire burden of human emotion.
Medscriptum: My last question is about so-called false beliefs. Common misconceptions in endocrinology, pseudo-scientific beliefs. For example, adrenal “burnout,” the “harmful” effects of cortisol on various conditions, and various “alternative” treatments. What is your view on these issues?
Dr. Hammer: First and foremost, when patients ask me about alternative medicine, I respond: “First, do no harm.” That is my first principle. I am not opposed to alternative, non-Western medicine. It would be absurd to think that we know how to treat everything. In reality, that’s not the case. “No one can be cured of death”—that’s impossible.
But let’s go back to the phrase “do no harm.” For me, harm means four different things: physical harm, which we can sometimes avoid; spiritual harm; emotional harm; and financial harm.
Yes, I have had patients who traveled somewhere far away, ate the bark of a rare tree, and spent a hundred thousand dollars on it with the expectation that they would be cured, but as a result, they lost their home. This is financial and psychological harm, so I tell them, “It may not harm you physically, but it can harm you spiritually, emotionally, and financially.”
Another problem is that people are often confused, and unfortunately, the scientific community has also contributed to this. People confuse belief and knowledge. Belief and scientific fact are two different things.
Of course, science develops through experiments; we learn based on experience. We often take three steps back and one step forward, but that doesn’t mean that the scientific method, which was created by Plato, Confucius, and Aristotle, is a mere belief. No! These are theories, hypotheses, that are constantly being tested and refined through observation. This is the value of rational thinking on which scientific progress is based.
Belief-based evidence that is not scientifically confirmed can be very dangerous in medicine. One of the most common errors is the demonization of the hormone cortisol. Yes, an excessively high dose of cortisol is indeed harmful, but a deficiency is also a serious problem. Endocrinologists and medical science have precisely determined what the normal levels for hormones are. When this knowledge is used for speculation, as if your problem is “low cortisol,” this is not only a mistake but a harmful and unethical act.
In the Western world, we have worked hard to overcome these harmful beliefs. It is necessary to realize that these are simply beliefs, not evidence-based medicine. And when we can, doctors and scientists should come out publicly and defend science. We should advocate for everyone who talks about the importance of science, including with governments. Medical science is based on scientific research, and we must protect the evidence-based approach from unsubstantiated beliefs.
