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
We are currently recruiting to bring new faculty physicians to the Holden Comprehensive Cancer Center, faculty who will help us care for our patients, teach, and conduct research. The faculty candidates we have had visit the University of Iowa have been outstanding, and we look forward to having a number of them join us this summer.
During this process, I have been struck by the number of superb applicants who began their medical careers in many other countries around the world, completed their medical training at top-notch programs in the United States, and now want to join our faculty so they can practice medicine, teach and do research in the United States (indeed, in Iowa). Uniformly, these individuals were at the top of their class in school, had the drive to come to the United States to pursue opportunities they did not have in their native country, and have been highly successful in their new home. This represents a true “brain gain” for us. Continue reading
There is a great debate raging among cancer research leaders around the country.
- It is not about whether this is an incredible time in cancer research that is fundamentally changing our understanding of cancer – we all see advances being made in our centers every day.
- It is not about whether this enhanced understanding of cancer will change how we approach cancer medicine – we all see research advances that have resulted in dramatic improvements in how we treat many of our patients, and many more are on the way.
- It is not about whether some cancers have proven to be incredibly difficult to treat – we all know there are some types of cancer where progress has been devastatingly slow.
- It is not about whether increased funding for cancer research would speed up progress against cancer – we all agree that increased funding is needed to accelerate progress, particularly for the most refractory cancers.
Earlier this month, Dr. Raymond Hohl, the Holden Family Chair and Associate Director for Clinical and Translational Research at the Holden Comprehensive Cancer Center, announced that, starting March 1, 2014, he will be moving to Penn State to become the Director of the Penn State Hershey Cancer Institute. Ray has been at the University of Iowa since 1991, and has served multiple roles in the Cancer Center, Department of Internal Medicine, and many other units on campus. The breadth of his clinical and research knowledge and interests made Ray a valued leader and collaborator in many of the activities at Holden. As a physician, his dedication to his patients was unquestionable. Continue reading
Sometimes, progress brings uncertainty. The past few years have seen a steady increase in the number of drugs and other approaches to cancer treatment such as immunotherapy that can be used to treat cancer. Most of these new approaches do not cure cancer when given as a single therapy. Nevertheless, many of them are very effective at inducing a temporary shrinking of the cancer. For many cancers, we have a number of such treatments available. From a physician’s point of view, these new treatments create more options for patients. But they raise a question that cancer doctors have struggled with for decades. Do we … Continue reading
Several years ago, I made a “decision” that I needed to figure out a better way to make decisions.
We all struggle with decisions whether big or small. We all sometimes delay making difficult decisions, or revisit the decision once it is made again and again. For me, difficult decisions can vary from deciding what treatment to recommend for a cancer patient, to determining how best to structure a new cancer research program, to deciding whether I should attend yet another meeting. There are times when I feel overwhelmed by the sheer number, the potential consequences and the variety of decisions that need to be made, particularly if I put off the difficult ones and let them build up. Continue reading
I am not sure how to begin this blog so I will just come out and say it. Last week I shared with you Maddie’s inspirational story – she is an 8-year-old girl who has been struggling with leukemia more than half her life. Her parents had sought out a highly experimental immunotherapy. When I met her just a few weeks ago, it was clear the therapy was having a powerful effect on the leukemia and she was back to being a vibrant 8-year-old girl.
This week, I learned the sad news that Maddie’s leukemia has returned, and that she and her family are considering next steps. The cancer researcher in me is not surprised and sees this as further evidence we must proceed with research at all deliberate speed; my human side is devastated. Our thoughts and prayers go out to Maddie and her family at this difficult time.
Ironically, I learned this news on the same day that our federal government shut down. Indeed, the email telling me of Maddie’s relapse was sandwiched between two emails from colleagues at the National Cancer Institute (NCI) announcing they were being placed on furlough due to the shutdown. What does this mean? In addition to all of the issues you heard about in the news, it means the suspension of new NCI clinical cancer trials and review of new grant proposals. NCI employees are now legally forbidden from contacting cancer researcher collaborators across the country. There is no question in my mind that the progress of cancer research will be slowed.
Last week, I described how Maddie had matured beyond her years. She has a remarkable understanding of how her personal story impacts the bigger picture, yet still enjoys being a young girl. Sadly, she once again has to put those childhood pursuits aside to deal with an incredibly difficult challenge. Meanwhile, our congressional leaders continue to act like poorly-behaved children and focus on themselves, and not on the very real needs of those they serve.
There is an awful symmetry here, and it leads one to think about what would happen with respect to setting priorities if roles were reversed. If our congressional leaders were in Maddie’s shoes (or those of her parents), would that change their approach? I think it would. And how about the other way around? I am not one to quote Bible verses, but Isaiah 11:6 seems particularly poignant to me at this point in time: “and a little child shall lead them.”
If only it were so…
The doctors and nurses are the most visible contributors to the delivery of care to cancer patients at the Holden Comprehensive Cancer Center, but a huge amount of work is done behind the scenes by clerical staff, pharmacists, laboratory technicians, administrators and many other highly dedicated professionals with dozens of different job descriptions. Top quality patient care requires input, coordination and dedication of all these individuals doing jobs that are both visible and jobs that are not.
Many staff members experience the lows and highs of interacting on a daily basis with cancer patients and their families in person or by phone. Even those who do not interact directly with patients are driven to do the best job possible because they recognize the importance of the job they do – making a difference at a critical time for patients and their loved-ones who are dealing with cancer.
Dealing with people in such a time of need is an honor but also adds to the pressure of the job and takes an emotional toll. Not only the doctors and nurses, but all who work in the HCCC know how hard it is when a patient we have come to know and admire does poorly, even when we have done our best (for a fantastic, heartfelt, and wrenching perspective on how providing cancer care can impact a professional, see Dr. Mo’s blog at http://doctormoiowa.wordpress.com/ ). On the other hand, what keeps the outstanding group of people who work at the HCCC going is the satisfaction that comes from an important and difficult job done well. Continue reading