Commons Healthcare Is Inevitable

Two brutal failures, a near miss with a $40,000 lawsuit, and the 1999 film The Matrix. They all set the stage for Commons Healthcare, the podcast where a team of renowned journalists investigates what it means to succeed in an industry with 340 million lives and $6 trillion on the line.

In the official teaser, hosts Tom Castles and Jack Murtha chronicle the long road leading to the podcast’s launch and describe the journey to come. They share the belief underpinning Commons: that healthcare journalism should focus on people, not just systems. And they acquaint listeners with the trials that hardened them against healthcare’s chronic techno-centrism, anti-human ideals, and hype.

Learn why we’re betting everything on human-driven and human-focused narrative storytelling in healthcare’s age of automation.

Chapter markers

00:00 · Cease and Desist: The lockdown summer of 2020 brings a devastating legal threat.

03:32 · Commons Healthcare: A podcast dedicated to human-focused narrative storytelling.

06:03 · A History of Failure: Two failed podcast attempts and a $40,000 legal roadblock.

14:09 · The Sound of Inevitability: Technological stories as a tranquilizer of the conscience.

18:15 · What’s Coming: A preview of the hand-crafted narrative profiles in season one.

Key quotes

“We want to create a future where we remember to center human beings as work evolves and takes on new forms.”

— Tom Castles

“Technology matters, but we’re not going to pretend that it’s just something that happens to us… Both [technology and healthcare] are reflections of real, deliberate decisions that real human beings make about what we build, what we value, who benefits, and what kind of future we want to create.”

— Jack Murtha

Credits

Hosts: Tom Castles and Jack Murtha
Executive producer: Christie Chisholm
Sound engineer: George Steptoe
Editor: Mark R.
Head of growth: Wynn Hansen

Resources & links

Subscribe to Commons Healthcare
Get our newsletter, Healthcare People
Connect with Tom on LinkedIn
Connect with Jack on LinkedIn
Connect with our head of growth, Wynn, on LinkedIn

Follow Commons Healthcare on socials
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Transcript

TOM CASTLES: So it’s June 2020, and I’m locked with my wife and our cat inside our third-story apartment because there’s a pandemic raging outside. What am I going to do to break up this monotony? At this point, I’ve already released two records of original music. I’ve tried and failed to bake sourdough bread. And I’ve taken up birding. And that one stuck. I’m still doing it. Well, back in June 2020, sitting on the couch, it was about 2:30. Shouldn’t the mail be here by now?

I’m slipping down the stairs to the ground floor and I peek through the viewing holes in our little mail lockbox. Today something catches my eye. It’s a piece of first-class mail. It’s addressed to me, and it’s marked extremely urgent in big blaze orange print. Yeah, at first I’m clueless, right? Like, what the f— Oh my God! It hits me. I’m leaping steps back upstairs. All these scenes from the past year are flashing through my mind.

There’s all the chaos and excitement of starting my own business with my best friend. There’s long talks with my wife about whether it’s even sane to risk starting that business and starting a family during the collective trauma of a global pandemic.

I open the door to our apartment, and my wife is in the kitchen lighting a candle. For a microsecond, the sight of her really just eases the tension that I’m feeling. She’s newly pregnant, maybe about three months, and she’s already glowing. The summer sun is shining through the window. Her eyes lock onto this letter in my hand, and then they shoot up to measure the pale, clammy face of the man who’s holding it.

And she asks me if everything’s okay, but I walk right past her into the living room without saying a word, and I sit on the couch. And then I rip open the letter’s perforated top. What I see next confirms all foreboding that everything important to me might come crashing down. My wife sits down right next to me on the couch, and she doesn’t have to ask. She already knows what this letter is. I look into her eyes, I put my hand on her belly and I tell her, I think we might be f***ed. I’m Tom Castles.

JACK MURTHA: I’m Jack Murtha.

TOM CASTLES: And this is Commons Healthcare. Commons Healthcare is the podcast where we investigate what it means to succeed in healthcare.

JACK MURTHA: So our personal experience in and around this industry corroborates what feels like consensus. And Tom, that is this: succeeding in healthcare takes a long time. It’s a lot of hard work, and it requires the ability to stomach furious headwinds and debilitating failures.

TOM CASTLES: Yeah, so that’s what it takes, right? But succeeding means different things for everyone. For some people, it means saving lives. For other people, and we’ve seen this a lot, it means making a killing. But for us, it means telling the caliber of stories that an industry with millions of lives and $6 trillion, which is insane, on the line, really deserves, the absolute best.

JACK MURTHA: Right on, man. So we’re here to tell those stories, and we’re determined to succeed. So to do that, we’ve got the world’s best reporters, right? Veterans whose work has graced the New York Times, the Washington Post, NPR, The Economist, National Geographic, you name it, they have been there, and what we’re doing is asking them to unearth healthcare’s best human stories, stories that have never been told before, profiles of people you know and people you should know, and we’re bringing them directly to you in this narrative podcast.

TOM CASTLES: Yeah, I think a lot of people have told us that they love what we’re doing here, and that’s wild because we haven’t even released an episode yet. But they see the need, they see our unique ability to fill it, and they’re really pumped to see it succeed, and so are we.

JACK MURTHA: And then a minority has been a little bit more. I don’t know. Let’s say, skeptical?

TOM CASTLES: Yeah. Is—

JACK MURTHA: That’s fair? Nice, fair, polished. Very trying to say that. Okay. And some of that looks like, hey, isn’t it really expensive to tell stories in this way rather than just like a one-on-one Zoom interview? Or do you really think that you can make a media business succeed in 2026, and even just like kind of this generic, “Why don’t you think smaller?” And maybe they think we’re crazy.

TOM CASTLES: Maybe we are crazy.

JACK MURTHA: I’ve got it on pretty good account that we are. Yeah, but they don’t know the craziest thing of all: This is the third time that we’ve launched a narrative podcast in healthcare, and the first two times we totally failed. Let’s head back to the summer of 2020. Tom, remember that letter you got—the one where you felt like everything was going to crash down.

TOM CASTLES: Yeah, I could never forget.

JACK MURTHA: So tell us what is inside it.

TOM CASTLES: Okay, so I’m in the room on the couch with my pregnant wife when I open it, and the first thing I see is the logo of my former employer printed on letterhead above a subject line that I hoped I’d never have to read. Cease and desist.

JACK MURTHA: So eventually I get a copy too, right? And just like Tom, the timing isn’t exactly great for me. My wife and I just put an offer on our first home, and I remember calling Tom to tell him that our offer had been accepted, and there were literal tears of joy streaming down my face, like I was crying. I was super excited. It felt like a huge moment. And this letter, well, it threatened the home that me and my wife hoped to build. It threatened the business that me and Tom hoped to build, and it threatened kind of like everything.

TOM CASTLES: So why don’t you tell us where it came from?

JACK MURTHA: All right. So here is the backstory. Two years earlier, Tom and I had built our first narrative podcast together while working for a large healthcare publishing company. The podcast was different from anything else that we’d heard in the industry, and that was really for one simple reason: because rather than relying solely on Zoom interviews, we told reported stories. We cut tape together. We tried to be like some of the really good shows that we loved on NPR.

We traced the roots of physician burnout back to this cocaine-injecting surgeon from the 1800s. We chronicled the slow, frustrating rise of the electronic health record, and we post-mortemed the failure of the high-tech hospital that the world was just not ready for back in the 1990s. People loved the show.

Six months in, we were getting over 1,000 downloads per episode. Advertisers were coming on board. Seemed like we were doing something meaningful, something cool. But without going into any of the details, it just wasn’t working at that time and place with that company. So by October of 2019, I was out, and by November, Tom was out too. And just like that, our first narrative podcast was dead.

TOM CASTLES: We learned a lot from our first podcast. Foremost, that we could build something and brand it, and run it, and sell it.

JACK MURTHA: Once we were out of our previous jobs, that’s what we decided to do. We would build, brand, run, and sell ourselves.

TOM CASTLES: This was our first venture into entrepreneurship, right? We launched an agency called Map Change.

JACK MURTHA: And at first we weren’t really more than a couple of glorified freelancers, but pretty soon we built a book of business that had us feeling confident enough to do three things.

TOM CASTLES: Yeah, I started a family.

JACK MURTHA: I bought a home.

TOM CASTLES: And together we tried our hand at another narrative podcast.

JACK MURTHA: Another one.

TOM CASTLES: Another one. A second one.

JACK MURTHA: Didn’t learn our lesson.

TOM CASTLES: Can’t keep us down.

JACK MURTHA: But this time we thought more deeply about what could make us different. What if we told stories not about the healthcare system, but about the people within that system? And what if we really leaned into what makes this system human?

TOM CASTLES: Yeah, that’s what we did, right? We told the story of a doctor who was so burned out that he was wagering suicide in the parking lot outside a gun shop. I remember another story we did about chronicling, like kind of in real time, how COVID was just destroying a nursing home, and we did that through the lens of the family, who was powerless to help their grandfather living inside.

JACK MURTHA: I remember telling the story of this doctor who was really fighting hard against stigma to treat people who were going through it with opioid addiction.

TOM CASTLES: I remember you doing that too, but that episode never aired.

JACK MURTHA: It did not.

TOM CASTLES: It never even reached the cutting room floor because at this point in our story, we’ve made it all the way back to June 2020 again, and there are pieces of first-class mail marked extremely urgent in both of our mailboxes.

JACK MURTHA: And our second narrative podcast is just about to fail. So when we opened those cease and desist letters, I think we both knew we wouldn’t escape the ordeal without some kind of damage. Their cease and desist letter called out our new podcast. That it appeared to be in violation of a non-compete agreement that we signed as a condition of our employment.

TOM CASTLES: And it demanded that we just call it quits in writing within a week.

JACK MURTHA: It’s important to say that we disagreed. We were going for a different audience, different kinds of sponsors, and we were taking a different approach to what they were doing. But we talked to our lawyer, and he said that there was a decent chance we could probably win that legal battle.

TOM CASTLES: Yeah, which was interesting. But then we asked him about what that would cost, and the starting price point to have our day in court was 40 grand.

JACK MURTHA: Whew!

TOM CASTLES: Yeah. Little steep.

JACK MURTHA: Little steep. Yeah, little steep. What did we do? We mailed out our concession letters the next day. Hey, our bad. We’re not going to do this podcast. Sorry, sorry, sorry. See you later. Cease and desist.

TOM CASTLES: And rest in peace. Narrative Healthcare Podcast 2.0. It’s been six years since we shuttered our second healthcare podcast, and in that time, so much has changed.

JACK MURTHA: We both have kids now. We both have homes, and our little business, our agency, is doing so well. Honestly, better than we ever could have hoped back in the day.

TOM CASTLES: Yeah, it’s all really great stuff, but it also means that there’s a lot more at risk now than there was back in 2020.

JACK MURTHA: Now we have families and homes and daycare payments and expensive outdoor hobbies, which like, hey, that’s on us, and this agency.

TOM CASTLES: Yeah, which by the way is made up of a team of people who can only pay for their homes and their families and cars and lives and hobbies if we are making good decisions.

JACK MURTHA: Yeah. And yet still, we’re betting all those things. We’re betting everything on this podcast.

TOM CASTLES: Why the f**** are we doing this?

JACK MURTHA: Because this podcast is inevitable.

TOM CASTLES: Inevitability is such an interesting concept, and especially now when everything feels so uncertain, right?

There’s this scene from The Matrix, that’s been swirling in my head these last couple of years. Neo, or Keanu Reeves, right? The main character. He’s battling Agent Smith, who’s like the main antagonist in the movie. And Agent Smith’s job is to maintain order in the Matrix. He needs to keep humans plugged into this illusion. And Neo’s job is the opposite of that, right? Like he’s here to free humanity from this hallucinatory grip of the machines.

Obviously, Agent Smith doesn’t like that. So he beats the living s*** out of Neo and throws him off a subway platform. Down on the tracks, Smith locks Neo in a chokehold, and he forces Neo’s gaze down this dark subway tunnel, and a train’s approaching. Right, we can see the headlights, we can hear the wheels screeching, howling, just barreling down the tracks toward them, and you know what Agent Smith says?

JACK MURTHA: No, what does he say?

TOM CASTLES: He says, “That is the sound of inevitability.”

JACK MURTHA: Dude!

TOM CASTLES: Yeah, yeah. So this is like one of the most symbolic moments in this major blockbuster movie that changed the ethos back in the day, and it’s all about the human toll of technological advancement. It’s personally meaningful to me, and I’m sure it’ll just millions of others who’ve found this sort of like catharsis in the way that Neo rejected Agent Smith’s authoritarianism. And look, I hate to spoil the plot, but this movie came out in 1999, so you got to go see it if you haven’t yet, I guess.

JACK MURTHA: Yeah, too late. Yeah, it’s fair game.

TOM CASTLES: Yeah, you might guess that Neo escapes Agent Smith’s choke hold and the oncoming train. Neither of those things was inevitable, despite what the agent said.

Now, the reason that this scene has been swirling in my mind is because this exact narrative around inevitability has been just taking over the discourse around technology, around people’s relationship with technology, around work and the way we think about work, and even around healthcare today. And that’s especially true when it comes to AI. Have you noticed at all that, like in the real world not in the Matrix, people are celebrating this narrative, this inevitability, like it’s a good thing?

JACK MURTHA: Yes, absolutely. I’ve seen it a lot, and I don’t know the reason why. Maybe it’s a thing against uncertainty, but like it’s a little weird there are these corporate adapt or die mandates. There are accelerationists who kind of demonize anyone asking for checks and balances.

TOM CASTLES: Yeah, there’s arms races happening between superpowers, too.

JACK MURTHA: And then there’s so much marketing hype that’s like disguised as destiny.

TOM CASTLES: Yeah, you can’t get away from it. So, I was looking into this and thinking about this more, and I came upon this MIT computer scientist whose name was Joseph Weizenbaum. Now, he wrote a lot about this, and he called this inevitability narrative—and this is really good—he called it a tranquilizer of the conscience.

JACK MURTHA: Whew, that’s right up there with opioid of the masses.

TOM CASTLES: Tranquilizer of the conscience. It’s amazing, right? So the reason he said that is because if you leverage this narrative, it can be a super effective way to shut down conversations about human rights or about labor rights or about safety you can shut all those conversations down before they even get enough momentum to begin. It also limits the value that we place on people, and it can make humanity kind of feel incidental to the broader progress that’s happening.

JACK MURTHA: That’s why we’re not going to buy into the inevitability narrative.

TOM CASTLES: Yeah.

JACK MURTHA: Technology matters, but we’re not going to pretend that it’s just something that happens to us, and we’re not going to pretend that the healthcare system, you know, this crazy status quo is something that just happens to us either. Both of them are reflections of real deliberate decisions that real human beings make about what we build, what we value, who benefits, and what kind of future we want to create. And at Commons Healthcare, we want to create a future where work works for everyone.

TOM CASTLES: Yeah, we want to create a future where we remember to center human beings as work evolves and takes on new forms.

JACK MURTHA: So that’s why we’re here to investigate what it means to succeed.

TOM CASTLES: We’re going to do that through in-depth, independent narrative storytelling that focuses on people and not on systems.

JACK MURTHA: So our goal there is to help create, in our small little way, more systems that work for people.

TOM CASTLES: Not the other way around.

JACK MURTHA: Exactly, and also this: a career in healthcare that works for you.

Ever since those cease and desist letters, we’ve been heads down building our lives and our life’s work, but in the background, we’ve hoped all along that another opportunity would pop up, and that that opportunity would allow us to do the kind of journalism we know this industry needs.

TOM CASTLES: Yeah, and today we’ve wised up and stopped waiting.

JACK MURTHA: Why wait when we can just do it.

TOM CASTLES: Just gotta do it, right?

JACK MURTHA: Just do it.

TOM CASTLES: So we’re taking that opportunity.

JACK MURTHA: And we’re living it today. It’s Commons Healthcare. It’s this podcast, the one you’re listening to right now.

TOM CASTLES: We’ve built a team of elite journalists, right, and they’re going to tell stories about the people who make healthcare work. Together, we’re gonna investigate what it means to succeed in healthcare, and we guarantee that these stories will elevate the standard for what you expect from healthcare-focused media, and that you’ll gain perspective on the industry and on yourself.

JACK MURTHA: Season one is going to include a bunch of leaders who have reached healthcare’s highest heights, sometimes through incredibly low lows, and they have a lot of hard-won wisdom—the kind that is typically reserved for people who have been in their careers for 40 plus years, and these people who we’re profiling, they’re going to share that wisdom here with you.

TOM CASTLES: Yeah, we’ve also got people who are building and shaping the industry right now, like folks running household name healthcare companies that have survived corporate coups and have survived recessions and a half dozen pivots, and then there’s others who’ve floated between the ivory tower and the streets where health is really determined, and others who are policing healthcare policy and spotlighting the shadowy realms of this industry, of which there are many, and holding the most powerful people and organizations to account.

JACK MURTHA: There will be a mix of names you know and names you don’t, and that’s intentional. We’re going to provide a deeper, more well-rounded, more human look at the industry’s biggest players than anyone else is offering. We’re going to platform people who haven’t broken through yet, but whose healthcare stories simply cannot be ignored.

TOM CASTLES: Our promise to you through all of this is that you will not find better human-focused healthcare stories anywhere else.

JACK MURTHA: Because humans in healthcare are inevitable.

TOM CASTLES: Commons Healthcare is inevitable. Subscribe to Commons Healthcare wherever you get your podcasts.

JACK MURTHA: Visit us online at commonshealthcare.com

TOM CASTLES: And definitely be sure to sign up for our newsletter, Healthcare People, which exists really to help you build a career that’s successful by any measure, especially yours.

JACK MURTHA: And look, we want to hear from you. So if you’ve got a story that can change the way we think about each other and the work that you do in healthcare, we want to hear it.

TOM CASTLES: The best way to get through to us is contacting us on LinkedIn or reaching out to us on CommonsHealthcare.com

JACK MURTHA: I’m Jack Murtha.

TOM CASTLES: And I’m Tom Castles.

JACK MURTHA: And this is Commons Healthcare.

Commons Healthcare Is Inevitable