From ballet to medicine, a love of stories has driven this bioethicist

Tyler Tate, MD, Stanford Medicine's newest pediatric bioethicist, has no shortage of stories to tell about his unusual upbringing.

Like how he ate a mostly vegan diet until age 10 -- memorably hosting a birthday party where his mother baked a regular cake for his friends and a sweet potato cake for him.

Like how he was homeschooled through high school in St. Louis, Missouri, while spending up to six hours a day on extracurricular pursuits.

Like how he remained unvaccinated into young adulthood after a bad reaction to an early shot frightened his parents.

Tate's interests were vast and furious. He found success as an athlete -- in both fencing and tennis -- and as a performer, excelling as an actor, mime and even a professional ballet dancer. Later, he devoured books on philosophy.

On the meandering road toward a career in pediatrics, one that has him focused on deep ethical issues that often affect very sick kids and their families, Tate discovered what it is that makes him feel most whole: the stories that connect us as humans.

From ballet to medicine

As a kid, Tate would become so engrossed in fantasy novels that his parents and grandparents had to scream to get his attention. Performing biblical stories in church plays, he discovered a love for bringing narratives to life on stage.

After stints in miming and ballet, Tate would eventually become a successful collegiate tennis player. (Photos courtesy Tyler Tate)

When he was 11, Tate's family enrolled him part time in a performing arts school. There he threw himself into courses on miming, drama, piano and musical theater. Though he had been a serious fencer, even qualifying for the Junior Olympics, he eventually quit to focus on the performing arts. He starred in school musicals and, for two years, performed with a semi-professional mime troupe.

Eventually, an instructor suggested Tate try ballet to gain better control of his body. He grew so enamored with the art form that he wore out the tape on video cassettes of the American Ballet Theatre. At 16, he started taking classes with the St. Louis Ballet.

"I've never loved anything like I loved ballet," Tate said. "It brought the flow state and embodiment I'd experienced with sports, but it's also performance, acting, stories."

By the summer after his junior year of high school, Tate was training at the American Ballet Theatre in New York. After graduating, he headed to the Boston Ballet for another summer intensive program. It was there that he recognized dance might not be his ultimate career path.

"That's when I realized that I was good but not great," he said. Tate didn't relish the thought of fading into the background on stage. By the end of the summer, he was telling everyone he planned to become a doctor.

Marrying science and the humanities

The idea to go into medicine sprouted from two seeds: Tate's father, a veterinarian, told him that becoming a doctor would be more lucrative than following in his footsteps. And Tate witnessed the power of health care firsthand during annual church service trips to Acuña, a Mexican border town.

One summer, a doctor he was volunteering with treated a tooth abscess in a child wracked with pain. "I remember realizing the world was so unjust, and I wanted to help people like this poor kid," he said.

Tate decided to pursue a career in global health, but he wasn't done with dancing just yet. Instead, he became a professional dancer with the St. Louis Ballet while taking classes at Maryville University of St. Louis. After one year, he enrolled at the university full time, majoring in molecular biology and leaving dreams of a dance career behind for good.

At Maryville, Tate channeled his energy into becoming a serious collegiate tennis player, taking multiple all-conference and all-academic honors as one of the Division II Saints' top performers. "It's probably clear that I go real hard when I go toward something," he said.

'It's probably clear that I go real hard when I go toward something.' (Courtesy Tyler Tate)

Academically, he poured himself into a newfound passion for philosophy after a logic course shifted his understanding of the world around him, including his conservative evangelical Christian upbringing.

"Reading (Immanuel) Kant made me realize that 'I believe in tables' and 'I believe in God' were not the same, even though, growing up, we acted as if they were," he said. "I realized that religion requires faith. Philosophy sent me on a quest to try to understand what human beings can know and what it means to believe in something you cannot taste, touch or smell."

Tate decided to minor in philosophy, but he viewed it as a hobby. When he started at the University of Alabama at Birmingham's Marnix E. Heersink School of Medicine, he was still planning on a career in global health. He spent a summer researching risk factors for patients with HIV, with support from federal grants, and six months in Zambia conducting research on the rotavirus vaccine.

I didn't realize until years later that, to be successful, you have to be in love with the methods, not just the topic.

Tyler Tate

"I was finally doing what I wanted as a doctor, but I wasn't happy. The bulk of the work was designing control trials and statistics, detached from human emotions," Tate said. "I didn't realize until years later that, to be successful, you have to be in love with the methods, not just the topic."

During a pediatric residency at Seattle Children's Hospital, Tate thought about leaving medicine entirely to pursue a PhD in philosophy. But colleagues convinced him to apply to the hospital's two-year fellowship in clinical ethics. During that time, Tate shadowed doctors in pediatric palliative care, a subspecialty he knew little about. That team sometimes started the day by reading and discussing a poem. "I was like, 'Oh my goodness, these are my people,'" Tate said. "Poetry is not something accidental -- this is part of the practice."

Finally, Tate had found a way to marry medicine with the humanities. "The thing I love is sitting with a patient and hearing their story and working out with them how we're going to steer their life back onto a course of health that involves not just biology, but spirituality, storytelling, psychology and structural aspects," he said.

Seeing shades of gray

Tate decided to dedicate his career to palliative care, where his love for philosophical deliberation and appreciation for people's stories are invaluable. After earning a master's degree in bioethics and medical ethics at the University of Washington, he moved to Duke University for a fellowship in hospice and palliative medicine. In 2018, Tate became an assistant professor at Oregon Health and Science University in Portland, where he later helped direct the school's Center for Ethics in Health Care.

This summer, Tate moved to Stanford Medicine, where, as an associate professor, he focuses on applying philosophical, historical and cultural analysis to medicine's thorniest ethical questions. As part of the Division of Quality of Life and Pediatric Palliative Care, founded in 2023, and the Stanford Center for Biomedical Ethics, Tate will see pediatric patients facing conditions such as cancer and congenital heart disease and offer consultations to other providers when ethical quandaries arise.

For the next three years, Tate will also spend half his time as a Greenwall Faculty Scholar, researching a question that has dogged him for years: What do we mean when we talk about childhood suffering, and how can we respond to it ethically? Doctors and parents often use the term as a basis for medical decisions, but its definition is murky, and children often can't make their wishes known.

He's developing a cohesive theory to guide practitioners in complex situations, such as when a child is on life support.

"Who gets to decide whether a child is suffering?" he said. "Is that even the right question to be asking? Are there times that we have a moral obligation not to intervene?"

Hughes Evans, MD, PhD, one of Tate's medical school professors, said that his background in the arts has helped him embrace the ambiguity inherent in bioethics and palliative care. "A lot of doctors are scared off by questions that don't have clear-cut answers, but he's comfortable living in that uncomfortable space," she said.

Palliative care is all about navigating emotions and stories.

Tyler tate

Tate believes his experience as a dancer helps him read patients' subtle signals. "Palliative care is all about navigating emotions and stories," he said. "My training has made me very perceptive about what the meaning of the body is -- a certain gesture or how someone moves in a space."

Tate also finds that his distinct history allows him to see situations from multiple perspectives. "Every epoch fails to see that the things it takes as given truths are actually assumptions and cultural products," he said. "Approaching it all with humility is one of the gifts from my past."

Image: Emily Moskal/Stanford Medicine (Ballet photo courtesy Tyler Tate)