[00:00:00] Dr. Jessica Singh: Welcome to the Holistic Physician Coaching Podcast. I'm your host, Dr. Jessica Singh. This podcast explores physician health, wellbeing, and fulfillment, embracing all aspects of the human experience. Just as in medicine where a single interaction can transform a life, this podcast is grounded on the belief that each coaching conversation has the power to inspire, heal, and bring about meaningful change. 

[00:00:34] Dr. Shanda McManus is a family medicine physician, speaker, and author. She is an emerging voice on grief, race, and what medicine costs the people who practice it. Dr. McManus was born and raised in Philadelphia. She received her BA in English literature from the University of Pennsylvania and her Doctor of Medicine from Thomas Jefferson Medical [00:01:00] College. Dr. McManus was a 2021 PEN America Emerging Voices Fellow in Creative Nonfiction and a 2023 Baldwin for the Arts Fellow. Her writing has appeared in Bellevue Literary Review and other literary journals. She is an assistant professor of clinical medicine at Hackensack Meridian School of Medicine, where she teaches narrative medicine and humanism. She publishes Weatherproof, a Substack newsletter on Black women's health and healing. Her debut memoir, Brother Epistles: A Sister's Memoir, published with Split/Lip Press June 2026, began not as a book, but as an act of reconnection with her brother Monir, who was murdered in 1992 when she was a first-year medical student. Dr. McManus believes storytelling is its own kind of medicine. Welcome so much, Dr. Shonda McManus. It's so wonderful to have you here.

[00:01:59] Shanda McManus, MD: Thanks [00:02:00] for inviting me into this beautiful space and giving me a chance to share.

[00:02:06] Jessica Singh, MD: Sometimes I wonder when you read physicians' bios especially such as yourself, there's so much that gets embodied into these tiny little paragraphs, and you know that's only the highlights of what your life journey.

[00:02:16] Shanda McManus, MD: You know that's only- Yeah. Mm-hmm

[00:02:17] Jessica Singh, MD: So just to start, if you'd like to share just key experiences or turning points in your life that led you to the work you do today.

[00:02:25] Shanda McManus, MD: Yeah, I'd be happy to share. I think the most pivotal thing is I lost my mother to ovarian cancer when I was 14. And between the ages of 10 and 14, I was like her main source of support. I learned how to do the colostomy bag, the IV feedings. I went to the electric company. I learned to sign checks. And just things in my family it ended up me having a lot of that experiences. So I think, that really somehow created the desire in me to [00:03:00] be a physician because I saw how much impact they had for my mom. There are no doctors in my family. There were no college graduates in my family.

[00:03:10] So, my mom had one oncologist, and he just gave her so much hope. His name was Dr. Idicula. And I really saw that, like, when she talked to him or had a visit, she was just lit up from within. And tragically he died in a car accident midway through her care. And she got another physician, and I think he wasn't that.

[00:03:33] He wasn't empathetic or compassionate. This was in the '80s where we still didn't treat cancer pain adequately, and it was just such a contrast. And I think that really became my philosophy as a physician to give care, to make space for people. Because even if you don't cure someone, you can heal, and I think that was really very pivotal to bring [00:04:00] me to this point today.

[00:04:01] And like I said, I grew up in the inner city, North Philadelphia. My grandmother was also a very fundamental, foundational piece that unconditional love and someone who's just like, "You're valuable just because you exist," and I carry that with me today. And I think having received that love, I know how important it is for other people to have that support in their lives. Yeah, so that is just a little taste of kind of what shaped me and who shaped me. My mother, my grandmother really were foundational in that.

[00:04:41] Jessica Singh, MD: It's incredible to have such. I think one of the things that often gets overlooked in medicine is the life experiences that we bring and carry. And not even just our lives, but our heritage, our culture, all of this perspective that gets brought into. Then our educational degrees and everything...

[00:04:56] Shanda McManus, MD: mm-hmm.

[00:04:57] Jessica Singh, MD: that makes us into medicine. And so I know [00:05:00] I'm curious as to see how this ended up shaping your work today too as well with the grief and all the work that you do. And it's interesting 'cause when you have experiences like that so young.

[00:05:11] I couldn't imagine what that was like for you while you were caring for your mother to have a doctor that you loved, especially an oncologist caring for her, and then to have the doctor pass away so tragically.

[00:05:21] So many different elements and I'm wondering what about those experience stayed with you and as you got older and made the decision to go to medical school or

[00:05:30] Shanda McManus, MD: Yeah 

[00:05:31] Jessica Singh, MD: And how you viewed grief as a physician?

[00:05:33] Shanda McManus, MD: Yeah, I think it, it's very interesting because I think initially, I lost my mom when I was 14, then my grandmom when I was 17. She was killed in a car accident after we went to live with her, my brother and I. And then I was carrying that, and then my first semester in medical school I lose my brother to homicide, right?

[00:05:54] And it happened, it was Christmas Eve, and by [00:06:00] January 3rd I was back in school. And so I had this heavy backpack of grief that I didn't reflect on, I didn't integrate. I just pushed it down and away because I had this feeling like I didn't have space to grieve or I couldn't take time for that, and if I got off the train of medical school or took a breath, I might never get back on.

[00:06:28] And also as a Black woman, I already felt like, "hey, maybe I don't belong here." And any show of weakness was not welcomed when I was training, and I still think that's the case today. Allowing for doctors to be human, right? The experience of grief is very human and loss and processing loss. But I felt like at the time there was no space for that.

[00:06:57] So I say this in my book, but [00:07:00] I put like a tourniquet on all of that. And so you know how tourniquets work. They're not supposed to be long-term, right? They're just supposed to buy you some time. And it wasn't until like decades later that I was even able to turn and look at that grief. And I think that for me it was coming to a place in my life where I had security emotionally, psychologically, the necessities of life that I felt like, "okay, it might be safe now to turn and look." And I'm so glad I did because what I realized is that I hadn't been all that I could be because I had those essential parts of self, that grief experience that I didn't integrate. So yes I was a wife, I was a mother, I was a practicing doctor. Seemed like everything was okay. But I wasn't [00:08:00] everything. I hadn't brought my whole self, right? And I think after I was able to go in and claim my grief, I became more in every facet of my life. 

[00:08:13] Jessica Singh, MD: What would you like to acknowledge for yourself about how you carried that backpack of grief or how you wore that tourniquet for all those years?

[00:08:23] Shanda McManus, MD: Yeah. I really have, like, a compassion and empathy for that young woman, that girl that I was that didn't have that space. And I really, really-- I'm sharing now because I don't want anybody else to feel like they can't claim their grief while they're training to be a doctor, while they're a resident, while they're an attending, or really any sort of professional.

[00:08:50] Please do it. Please take that space for yourself because the medicine, the school, the work, all of that will be there. [00:09:00] And when you come back to it, you'll be more. You will be more in touch with your own humanity. So when you encounter patients, you encounter family members, you're enlarged with that pain and with that hurt, right?

[00:09:15] So that's why I'm sharing because I think that sometimes doctors are seen as superhuman, meaning above the human experiences of loss and grief, and we are not. I'm sure you've heard the statistics that doctors have some of the highest suicide rates, highest divorce rates of any professional.

[00:09:38] And why is that, right? And I think it's things like this where we sometimes don't have the space to claim all of our human emotions and experiences.

[00:09:50] Jessica Singh, MD: That's so well said. And even as you're speaking, I think just anyone listening who's gone through it, you feel the somatic constriction in your body and then a [00:10:00] relief... when you talk about space.

[00:10:03] Thank you for giving that advice or what you would say to yourself, to that young woman at that time. For those who may be in medical school or residency going through grief, I guess, does anything come to mind as to how, if you had your time again, you would have done things differently?

[00:10:19] Shanda McManus, MD: What I think is when that happened over the Christmas holiday, I wish I had sought out support within the medical school, like directly, instead of hiding the whole thing, and not really speaking about it. I had a classmate who lived next door to me in my apartment building, and he saw me one day on the elevator and he said, "You seem just like really depressed and sad."

[00:10:47] And I shrugged him off and went into my apartment. So I wish I had taken that extension of someone seeing me and leaning into that a little bit. I could have sought out, [00:11:00] been more proactive, but I just didn't have any initiative to do that. I needed someone above me to see it and pull me towards it. So I wish that at the time there had been more resources that were really underscored for me. I'm not saying my medical school didn't have it, but it wasn't really promoted and/or there weren't built-in wellness checks, right?

[00:11:31] Where you have some sort of advisor that's really just supposed to check in with you personally. Like, how are you doing? So that would really be my wish for students and trainees to have access to that " how are you advisor" and having that built in to the training.

[00:11:52] Jessica Singh, MD: I'm so glad you mentioned that for medical education especially, 'cause at all medical schools we have advisors who do the check, like [00:12:00] they, "Are you completing your exams? Are you passing your rotations?"

[00:12:04] And then you miss this elephant in the room. And so now as faculty, how do you do things differently?

[00:12:11] Shanda McManus, MD: Well, it's interesting. At my medical school, I teach in a course called Human Dimension, and it's really a great course that goes through all three years because we have an accelerated schedule for our students. And I am with a group of eight students through their whole time at the medical school.

[00:12:30] So we have small groups. The topics are everything related to medicine outside of the biological sciences. So palliative care, substance use, environmental impact, narrative medicine. And so I really get a chance to meet with these students about twice a month and talk about those things, but also get to know them as people and make myself available.

[00:12:59] "Hey, if [00:13:00] there's something, anything, you can come to me, and I will be checking in on you." And I think it's just really a great opportunity to, one, connect with these bright young students, but also acknowledge that medical school is hard. It is really hard personally, physically, intellectually.

[00:13:22] And having someone who's been through it, who can say, "I know it's hard, and you can acknowledge that it's hard, and you can also acknowledge when you need support. Or, maybe you need a break because of a situation that's happening in your life, and you can come back from that break and get back on your train and not lose anything."

[00:13:43] So yeah, that's what I try to bring into med ed.

[00:13:47] Jessica Singh, MD: What a gift it is to have that space.

[00:13:50] Shanda McManus, MD: Yeah

[00:13:51] Jessica Singh, MD: Um, And I know you were talking about how things were when you were in training and how they're still probably like that at many institutions in the United [00:14:00] States, let alone the world. Yeah.

[00:14:02] And so I'm curious as to know what gaps you've experienced or in seeing commonly in medical education with respect to grief and what needs to be filled.

[00:14:12] Shanda McManus, MD: Yeah, I think that a gap I see is I think when students come to medical school, there should be some sort of grief inventory. There should be a system of saying, "What are our students bringing in with them? And maybe they haven't processed or they haven't had the tools, and how can we match them with the tools that they need from day one?"

[00:14:37] You know, When I started medical school, I had lost my mother and my grandmother. What if there was built-in intake and support so there was someone aware of that? Maybe I could have already been in some sort of grief counseling or how to manage when then I encountered another loss, right?

[00:14:57] So I think that, that grief inventory [00:15:00] and also teaching our students in the curriculum how to deal with grief; their own and the grief of their patients and loss and really, like, do some more than the five stages of grief. Like, I got that lecture in medical school, but there's so much more to grief than that, and I think it's been very abbreviated and kinda, "Okay, people have five stages just so you know." But it's so much more than that. I think grief when you've experienced it, it threads through your whole life. It spirals, it comes back, it loops. And I can say honestly, it's never over. It's not over, and I think that there needs to be more teaching on that so students and trainees can tend to themselves and then tend to their patients in a much more holistic, informed, empathetic, and compassionate way.

[00:15:57] And then on the floors, the first [00:16:00] time a patient dies or God forbid... I remember being an intern, my first rotation was the ICU, and the first day a woman passes away and the nurse is like, "Okay, you have to go pronounce her." And I was like, "What's that mean? What do you do? Don't unplug anything 'cause..."

[00:16:20] And there was someone to walk me through those steps, but not someone to walk me to, "Now you gotta go down the hall and tell her children," and how to do that. And also after you do that, maybe you have someone to talk to. "How was that? How do you feel? What might you do differently next time?"

[00:16:40] To give you some space before you go to the next case and the next patient and the next... because you get callous if you don't integrate that grief you encounter so often as a physician. And I'm sure a lot of patients have had that experience with, "The doctor didn't even seem to care [00:17:00] when they told me my loved one passed away."

[00:17:03] And so I think that's a disconnect and where we can do better in medicine, equipping trainees, residents, and ourselves.

[00:17:13] Jessica Singh, MD: It's so, so important and so tricky, like you mentioned, because I'm curious to know, you said you had, in hindsight, waited until certain elements of your life were safe and stable before you even allowed yourself to go there. And you accomplished this extraordinary thing along the way before even tapping into that. And as you're talking about doing this for physicians in training, so many attendings, right? The ones of us who didn't get this when 

[00:17:40] Shanda McManus, MD: yep.

[00:17:40] Jessica Singh, MD: we were training it's, It's that callous almost. It's like it's so hard 'cause one of the things that we understand more and more as we get through the system is that it's the system that brings these characteristics.

[00:17:52] We have to survive. We have to function in such a way to be able to treat the next 

[00:17:56] Shanda McManus, MD: Yep.

[00:17:57] Jessica Singh, MD: How do you do that if you let yourself really [00:18:00] process the emotions for each one?

[00:18:02] I don't know if I've figured out the answer yet..

[00:18:04] Shanda McManus, MD: No..

[00:18:05] Jessica Singh, MD: Or seen anyone has to be with you, because how do you see death and not have it change you at that level?

[00:18:13] Shanda McManus, MD: Yeah. I think it's really, like, that's something that think about what I think is a underutilized way in is the creative pursuits. Like, for me, it was writing and taking that space to write, to go in, allowed for all those ill-defined feelings. I felt some type of way, and through writing I was able to acknowledge it and think about it and look at the shape of that thing.

[00:18:44] And I think music is a way to do that for some people. A lot of people play instruments. I have another physician friend, she does watercolor. And I think the arts really allow space [00:19:00] for processing all the stuff that we take on in medicine. I think we need more of that.

[00:19:07] we need physicians to tap into whatever that side of them that gives space to expression to kinda cope with all those feelings. 

[00:19:21] Jessica Singh, MD: It's such an amazing point to bring out about the arts because there's an element of psychological safety in the way these spaces are created about being able to express without editing or without judgement. And it seems so simple, but it's something that we don't often have in medicine unless we're aware of it and create it.

[00:19:41] Shanda McManus, MD: Yeah. And I think that, like, we all in medicine can do more in the line of making those spaces available. What if in the hospital there was like a creative room for the docs to go in where you could draw, where you could write, where you could sit [00:20:00] in a cozy chair bundled with the lights low just to space created within these spaces where we work. 

[00:20:09] Jessica Singh, MD: Absolutely. I'm curious how did you find narrative medicine, and what was that process like for you? For those who haven't yet had the pleasure of reading your book, would you like to share a little bit more about it?

[00:20:22] Shanda McManus, MD: Yeah. In college I was an English major, but I wasn't a creative writing major. It was literature, 'cause I've always loved to read. That was like a sanctuary for me. Later in my life I saw an advertisement for a community writing class, and then that was the beginning of it for me. I just started writing and reflecting, and it was just a great fit for me. And then I heard about narrative medicine. And I would have never thought that these two interests, medicine and writing, could come together in any meaningful way. Dr. Rita Charon out of Columbia, she pioneered this discipline of [00:21:00] narrative medicine, which really is, I think if you boil it down to its essence, is the use of story in healthcare, right?

[00:21:08] So you can use it to take care of patients. You can use it to take care of yourself, right? I was just blown away when I saw that, "hey, this discipline, these are two things that I love, right? I can put them together." Because really when you think about it, medicine is about stories, right?

[00:21:26] Patients come in and they tell you a story. And making space for that story is what good doctors do. And then we help build a new story together with our patients. And I think that really seeing that link was really inspiring and something that I just felt like, wow, if I had known this when I was in medical school, that you could knit these things together, I would've just been so excited, like I'm excited now about it. 

[00:21:55] Jessica Singh, MD: feel I can warmth and joy. Thank you for sharing about it. 'Cause even though it's growing in [00:22:00] popularity, who knows who you may reach just by talking about it, so thank 

[00:22:03] you. 

[00:22:04] Shanda McManus, MD: Yeah. Yeah

[00:22:05] Jessica Singh, MD: And, you had mentioned something earlier which was so important. The point about grief not being like a one-time thing, and how it keeps coming. And when you allowed yourself to go there, especially with respect to your brother, what did you experience, I guess, about how grief shows up?

[00:22:25] Shanda McManus, MD: Yeah, I think it's really interesting because I think before I consciously turned towards the grief, it showed up in these bouts of depression and just a feeling sometimes of being a little disconnected or removed from people that I really love. But there was something, a withholding that happened that I can see in retrospect was unprocessed feelings about grief and loss. And I think for me, in writing this book, it's a series of letters that I write [00:23:00] to my brother, right? And so the shape of the book is a spiral, and I go through the point of the murder, but I go in the past and in my future now without my brother. And that's really how grief manifests, right?

[00:23:16] Because we have this person, and we have these experiences with them, right? But then that person dies, and we go forward, but there's a empty space in our forward life where that person was, right? And so that's also a part of the experience and part of the relationship that I think you still can have beyond.

[00:23:40] You're still connected to those you love even when they pass on. And I think that the writing allowed me to resurrect that connection and to feel like once again my brother's a part of my life and a part of me. Even though in body [00:24:00] he's not here, there's still some sharing that gets done and revisiting and remembering and thoughts in and around that.

[00:24:09] Jessica Singh, MD: It's so inspiring to read a book with that heart, to know that's his way of honoring his life, his legacy, and to carry him with you in your heart. It's, it's incredible It's also interesting too because as a physician, paramedics, police officers, there are a handful of people in this world that get to witness death the way physicians do I mean, at the frequency that doctors do. And yet, like you mentioned, there's this catch 22 about how we often don't take the space or aren't given the space to process.

[00:24:40] process 

[00:24:41] Shanda McManus, MD: Yeah. 

[00:24:42] Jessica Singh, MD: And so I'm curious 'cause it's also, in terms of culture, like the time it took in write the book, yes, it took time to make that space for yourself, to be given that space for yourself. So many different cultures, so many different funeral rituals. You know, uh, my parents grew up in India, if someone passes away, it's [00:25:00] like, okay, if

[00:25:00] If someone

[00:25:01] if I went back to where I was in residency and be like, " "Hey, I'm taking 14 days off."

[00:25:06] I, 

[00:25:07] Shanda McManus, MD: Yeah 

[00:25:08] Jessica Singh, MD: I still, like, feel a little constriction talking about but what I'd like tell myself back then is just take the FMLA, take the time you need for the grief.

[00:25:18] And it's also, 

[00:25:19] Shanda McManus, MD: Yep 

[00:25:20] Jessica Singh, MD: I can't imagine how difficult it was for you because there's anticipated grief and the grief that comes before death, and from trauma, just to process what happened when you don't expect it at all, like for your brother.

[00:25:33] Shanda McManus, MD: Yeah, and I think that's so important. If I had one message, take the space. The work will be there. How different would it have been if I could have even had a month to just be? And I was really depressed. When I went back to school it was gray, it was cold. I felt so alone. The circumstances of the death [00:26:00] were one where, no one likes to talk about death anyway, but death related to murder, you really don't wanna talk about that. And it was really isolating and, it was hard. So I would encourage, you know... and ritual is important, right?

[00:26:16] And I think here in the West, "Hey, time to move on. You did this and this." You know? And in some cultures there's ritual for a year or there's a way that you dress so everyone knows you're in this tender space of grief, and there's space given to it within the culture and the support.

[00:26:40] So I think here in the US we could take a note from some of those places because the thing is grief is gonna show up. So how about we give it space to show up in a way that can be a balm, could be a healing thing instead [00:27:00] of something that kinda eats you up and pulls you down from within. 

[00:27:04] Jessica Singh, MD: Absolutely. And as you talk about the rituals and grief, the thing that's coming, especially as I'm hearing you now talk so calmly and so confidently about everything, is spirituality. What drove you? What inner beliefs carried you through? This was so much to carry by yourself. 

[00:27:22] Shanda McManus, MD: It's interesting because I talk a little bit about this in the book. Like, I had a little bit of anger. I'm raised in the Christian tradition, and it felt really unfair. I felt like I had my, I don't know, cup of bad luck, and then for this to happen, and my brother and I were really close. We're only 18 months apart. And the griefs I had before I lost him, my mother and grandmother, he shared that completely with me, right? Because it's also his mother, his grandmother. But now when I lose him, I'm by myself, right? I don't have [00:28:00] that.

[00:28:00] So I think for me there was a little bit of like, "God, you are being unfair." And I think through writing this book and also talking to people, there's a lot of people who have stories of, quote-unquote, unfair loss and griefs that they carry. And I think I found kind of solace in hearing other people, and I'm not the only one. Even among physicians who've lost people during training and had no time or space. So I think that has given me some, I guess, peace about it in the spiritual sense. I still don't understand it but I do feel like I can accept it because there are so many other people who've had just what you would say, "This is unfair."

[00:28:55] Jessica Singh, MD: And it's hard. It's hard 'cause you see it, you see so frequently in patients, [00:29:00] when when it happens

[00:29:00] Shanda McManus, MD: Mm-hmm. 

[00:29:00] Jessica Singh, MD: to us, it's, 

[00:29:01] Shanda McManus, MD: Mm-hmm.

[00:29:02] Jessica Singh, MD: We're just as everyone. 

[00:29:04] Shanda McManus, MD: Yeah Just as everyone else Yep, yep. We're human. And I think that's so important for physicians to claim for themselves. Claim your humanness, 'cause it

[00:29:05] just will make you a better doctor, but also a better person in your own life, a better daughter, a better partner, all of those things a better parent if you're able to stay close and hold on to your humanness even when it's painful and it hurts.

[00:29:31] Jessica Singh, MD: And even when if it, you know, sometimes you have RVUs and you're expected to see a certain number of patients a day or it doesn't matter... 

[00:29:37] Shanda McManus, MD: yep 

[00:29:38] Jessica Singh, MD: cuts into... But it's easy for me to say 'cause I'm no longer in that system. But even when I was, Yeah, it's just, defining those values for yourself.

[00:29:47] Shanda McManus, MD: Yeah, and how you wanna show up in your own life and how you wanna be whole, right? And we're all striving to being more whole, and I think taking those space and those moments [00:30:00] are really critical to that.

[00:30:01] Jessica Singh, MD: Thank you. I'm just gonna ask for listeners, do you have a takeaway? I know we've covered a lot of ground today.

[00:30:08] Shanda McManus, MD: Mm-hmm. I think my takeaway is take Take space for yourself and all the emotions and pain you may be carrying or you may encounter. Take a moment and claim it. Claim it. Claim your humanness because it's what makes you different from the AI doctor, okay? So, so, so claim it and make a space for yourself even when it's not given.

[00:30:37] Jessica Singh, MD: So well said. One of my biggest takeaways from listening to you is one of the points you made also about how talking to other people helped.

[00:30:44] Just for anyone, that's one of the reasons why I love these conversations. You don't often get to have this human conversation with someone such as yourself who has such beautiful, rich, intense life experience, and I just wanna say thank you again for the courage [00:31:00] to share. It, it just helps so many people 'cause then you also see yourself and realize you're not alone.

[00:31:06] Shanda McManus, MD: Yeah. Thank you. Thank you.

[00:31:09] Jessica Singh, MD: um,

[00:31:09] Shanda McManus, MD: you

[00:31:10] Jessica Singh, MD: Dr. McManus's book will be in the show notes as well as the link to her Substack. So 

[00:31:14] Shanda McManus, MD: Yes, here's the corner. This is great. I love the cover. So yes, I'd love for people to read, to hear the story for themselves.

[00:31:24] Jessica Singh, MD: Thank you so much. 

[00:31:25] Shanda McManus, MD: Thank you. 

[00:31:27] Dr. Jessica Singh: Thank you for listening to the Holistic Physician Coaching Podcast. This podcast is dedicated to making coaching more accessible and to support both physicians and those who coach them. Subscribe to access exclusive subscriber-only episodes, including physician coaching sessions, coaching debriefs, and coach mentoring sessions that offer valuable insights for professional development for coaches.

[00:31:57] Your support helps sustain this work. [00:32:00] Subscribe and leave a thoughtful review at www [dot] holistic physician coaching podcast [dot] com. Sending you warmth and light.