Dr. Shiv Rao, cardiologist and CEO of Abridge, joins hosts Raj Manrai and Andy Beam on NEJM AI Grand Rounds for an inspiring conversation at the intersection of medicine, technology, and meaning. Shiv shares the origin story of Abridge, reflecting on how a deeply human encounter in clinic sparked the idea for a company now transforming clinical documentation across more than 100 health systems. From his early days programming electronic music to navigating LLM deployment at scale, Shiv offers a rare look into the soul of a founder building not just infrastructure — but a movement. He unpacks how generative AI can be used to restore presence in the clinic, what it takes to earn clinician trust, and why he believes taste, empathy, and curiosity are the real moats in health care AI.