Exhausted but rejuvenated

We all need to recharge our batteries now and then, although we don’t all like to do it the same way. My wife’s preferred method is to put her feet up on lounge chair and read a good book. For me, something a bit more physical is a preferred choice.   There is nothing quite like going for a jog after a stressful day at work in the cancer center to help me clear my head.

My preference for unwinding on vacation includes being physically active. Indeed, I am doing so this week. For the past eight years I have spent the end of July with a group of friends riding on RAGBRAI. For those of you who are not familiar with this Iowa standard, RAGBRAI is the “Register’s Annual Great Bicycle Ride Across Iowa.”   It is one of the largest recreational bicycle rides in the world. On RAGBRAI, more than 10,000 bicyclists spend a week riding from the west edge of Iowa to the east, with each year taking a different route. RAGBRAI is a rolling folk festival with riders in costumes and the small towns bringing out the town band and selling sports drinks and other high energy foods to bicyclists as they take a break during the ride. You may have heard there is also a beer garden here and there along the way (and no, I am not among the “wilder” RAGBRAI crowd frequenting the beer gardens while riding a bicycle). What I love about a day on RAGBRAI is that it is incredibly different from a day in the cancer center. No discussion of cancer; no deadlines or meetings; everyone is carefree and relaxed. The biggest decision I have to make in the morning is whether I should stop for a breakfast of pancakes or ride two more miles for the French toast. The afternoon dilemma – apple versus cherry pie.

Now, as usual, I thought about turning my time on RAGBRAI into cancer metaphor. How we can help the immune system recover and rejuvenate in order to fight cancer? The relationship between mental and physical well being? Nah … They are both good ideas for future blogs, but not today. After all, I am on vacation …

So, back to the ride. Tuesday’s was the longest ride of the week and included a RAGBRAI tradition called the “century loop” which, for those of us who took this detour, resulted in a ride of about 105 miles.   It was fantastic. I was physically exhausted but mentally rejuvenated.

More specifically, after the long ride, I spent time sitting under a tree with my feet up.   Maybe my wife was on to something after all.



Isn’t that nice!

We have all heard about “Iowa nice.” Iowans tend to work hard and do an outstanding job, but are modest and do not seek recognition or brag. Well … I will try to retain my “Iowa nice” but will cross the line slightly when it comes to modesty.

An annual rite of passage for academic medical centers is the release of national rankings such as the US News and World Report listing of “Best Hospitals.” Leaders of medical centers acknowledge that the formulas used to calculate these ratings are quite arbitrary and don’t directly measure the quality of the care we deliver.   For example, reputation score plays a major role in the rankings, changes slowly over time and can be influenced by creative approaches to marketing.

Nevertheless, despite these limitations, we look carefully to see how our ratings change from year to year, and think about how we can improve them.

This year, the University of Iowa Holden Comprehensive Cancer Center was ranked No. 27 nationally among cancer hospitals. We had the highest possible scores in survival, number of high-risk Medicare patients, advanced technologies and patient services as well as recognition for being an NCI-designated cancer center and a Nurse Magnet hospital.   This ranking is particularly notable given that the majority of top-ranked cancer hospitals are in major metropolitan areas.   Indeed, we are the only cancer center ranked in the top 50 in a town as small as Iowa City.

It is gratifying to see the hard work, excellence, team spirit and dedication of our faculty, nurses, and staff get recognized at the national level even if by an imperfect mechanism such as the US News rankings.

Not bad for a hospital in the middle of the corn fields!

As we say in Iowa – “Isn’t that nice!”

So it goes …

In Slaughterhouse-Five, the masterpiece by Kurt Vonnegut (from our own Iowa Writer’s Workshop), the protagonist Billy Pilgrim used the phrase, “So it goes,” repeatedly when considering various traumas including the incredible horrors of war.  Much has been written about what Billy, and hence Mr. Vonnegut, really meant by this phrase.   I will not weigh in on this debate, but instead reflect on what this phrase means to me. Continue reading

Standard protocol—individualized

I will always remember this spring as a time of weddings.  First (and foremost!), my daughter’s wedding in Iowa City in late May followed by weddings in June of a cousin in Florida and a nephew in Maryland. I also came upon a number of weddings during my recent visit to Romania, including a wedding procession marching down the main street in a tiny Transylvania town and weddings taking place in the Orthodox and Catholic churches of the beautifully preserved and restored fortress town of Alba Iulia. Continue reading

Yogi Berra and Molecular Oncology

I can think of nothing better than Yogi Berra quotes to organize a brief discussion of how molecular oncology is impacting cancer medicine.

“It’s tough to make predictions, especially about the future.”

When I was growing up in New York, if you had asked me which was more likely – for me to spend my career as a cancer center director in Iowa, or to own a flying car, I most definitely would have predicted the flying car. So much for predicting the future. Continue reading

Culture shock

I am on the road this week.

First, I took a trip to West Palm Beach for a family wedding. On arrival at the airport, and at the wedding, it was apparent there are some small stylistic differences between southern Florida and the Midwest. However, the similarities far exceeded the differences and it would be a stretch to say there is a big cultural difference between the two.

Then, yesterday, I got on a plane and flew over the Atlantic to represent the Association of American Cancer Institutes at a meeting of the Organization of European Cancer Institutes in Cluj-Napoca, Romania. In fact, I am sending this blog from Cluj where I arrived a few hours ago. I spent this afternoon walking around the town to help me deal with jet lag before the meeting starts tonight.   In less than 24 hours, I went from tanned Florida retirees to a dynamic eastern European country where I don’t know the language. Now, that is culture shock! Continue reading

Succeeding together over winning

All of us have thought at one point or another about what we would have done professionally if we had the opportunity to start over and take a path totally different from the one we actually pursued.   For many years when asked this question, I answered that I would have enjoyed being an architect. Designing buildings would have allowed me to use both the scientific and the creative aspects of my brain. I also like the tangible and long-lasting aspects of building something – attributes that also apply to my current career in academic medicine. Continue reading

Life and cancer, cancer and life

This past weekend I was so very, very happy to be alive.

My daughter got married to a wonderful young man I am now proud to call my son-in-law. My extended family and friends gathered for a fantastic celebration with eating, dancing, laughter, and deep joy in being together.   All aspects of the weekend were magical: the way the bride and groom looked at each other, the perfect weather, one fantastic gathering after another, and my ability to get through my toast to the bride and groom at the wedding reception without turning into a sobbing mess (tears came later, which was just fine). It was, no doubt, one of the highlights of my life, and one I will cherish forever.

Cancer was also there. Neither of my parents saw their oldest granddaughter get married – both died of cancer many years ago. An aunt and uncle who have dealt with cancer were able to attend. So did my little sister who is in the middle of a course of chemotherapy and has no hair.   She did not let cancer interfere with her enthusiasm and joined us in all aspects of the celebration. She looked fantastic in a wig that, dare I say, looked at least as good as her natural hair (sorry, sis …). Continue reading

Advocating for advocating

We each have the right, indeed the obligation, to speak up as private citizens for what we believe should be of high priority for our government.  An example is advocating for biomedical research grants.  It is important to point out that advocating to government should be done as a private citizen.  Any advocacy done as a governmental employee or in the name of an institution – in my case the University of Iowa – should be done in coordination with the institution as a whole.

Recently,  I had an opinion piece published in “Oncology Times” that describes my personal perspective on the importance of having researchers and clinicians advocate for biomedical research.  In other words, I was advocating for advocating.   Instead of writing a new blog this week, I am providing a link to this article entitled “Advocating for Biomedical Research – Debunking the Top 5 Excuses for Not Getting Involved” which can be found at  http://journals.lww.com/oncology-times/Fulltext/2014/05100/VOICES__Advocating_for_Biomedical.24.aspx .

Left Brain vs. Right Brain. This week: No contest

Popular psychology describes the left side of the brain as logical/analytic and the right side as emotional /creative.   This dichotomy in anatomy and function is not supported by modern neuroscience, but I can’t resist using it since I want to talk about how my left brain and right brain have been going at each other this week. Continue reading