Archive for November, 2021

 

Nov 21 2021

Cura Personalis

by at 12:42 pm

I have a surprisingly unexamined interior life. As an oncologist, a busy day in clinic or a visit to see an inpatient has long been part of my routine. I come home from work, and when asked how my day was, I respond with some variation of, “It was OK.” Sometimes I might mention that I had to make a difficult decision, or deliver bad news. My busier colleagues might see 25 patients each day. It’s a lot of work. You might think the patients whiz by the oncologists as if they are on an assembly line, each representing a set of problems to be addressed.

It’s not as simple as that. Whenever I see a new patient, it represents one of the most important moments of that person’s life. They are literally placing their life in my hands. It is a most awesome privilege and responsibility. I can help almost all of them. Some can be cured, and those victories are indeed sweet. Many have incurable cancers, but I have the opportunity to offer appropriate hope, consolation, a gentler glide path and a softer landing. I am inspired by these thoughts, but each encounter represents a potential attack on my core being, since my job is more than just work. It is a calling. It is a sacred responsibility, and failure always looms. Like many oncologists, I usually deal with these feelings by walling them off — my recipe for sanity. But my wall is not built of bricks or barbed wire. It is made of stronger stuff.

Over the course of my career I have developed coping mechanisms, mostly by being open and more fully engaged with my patients. I learned this from my best friend, an oncologist who developed a devastating cancer that took his life. He made me take care of him. I was with him every step of his tragically short journey, and it changed me forever. The walls came tumbling down, and were replaced by my true self. By reaching out and really trying to know my patients, and to let them know me, I actually derive more comfort and continued satisfaction in patient care. I know this is paradoxical — how can I hurt less by reaching out more, by caring more? But, it works for me.

I was moved to share these reflections after participating in Friday afternoon’s second Edward M. Kovach Cura Personalis Endowed Lecture. It was recorded in front of a small audience and will be broadcast in early January for everyone to enjoy. (Be on the lookout for that date.) The lecture followed an exciting and informative Ruesch Center Symposium on GI cancers, a hybrid event that took place both in-person at the Georgetown Marriott and online.

The Kovach event was not a lecture, but rather a panel consisting of John and Liza Marshall and Nora McInerny, an author and blogger who lost her young husband to glioblastoma multiforme. They were discussing John and Liza’s remarkable book, “Off Our Chests.”

John is, quite simply, one of the finest oncologists and humans I have been privileged to know. In their book and at the event, he and Liza chronicled their journey through her breast cancer diagnosis, treatment and survivorship, and what it means to be an “oncology family” that suddenly gets smacked in the face by a cancer diagnosis. I’ll note that John certainly married “up” (though Liza did well for herself too). It was inspiring to see how they reacted as their worlds crashed around them, and how they worked through their challenges. I think the experience made John a better doctor, in part because he truly examined his life. He is a man of deep faith, and I was moved when he mentioned that whenever he loses one of his patients, he closes his eyes, looks up, thanks them, and wishes them well in the next phase of their journey. I lack that capacity, but I can do worse than emulate his commitment to cura personalis.

I am grateful to John, Liza, Nora and the Kovach family for making this event possible. Cura personalis is not only about the patient; it is about the family, the community, and the caregivers. I am proud to be at a cancer center that transforms this slogan into attitudes and actions.

I will take a week off from my blog this coming weekend. Have a wonderful Thanksgiving holiday, and as always, stay safe and be well.

Lou

 


The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

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Nov 14 2021

Normal(ish)

by at 5:12 pm

I don’t know that the data fully warrant it, but life is beginning to feel “normal(ish).” Interestingly, new cases have plateaued and perhaps have increased slightly across the U.S. and in DC, though deaths continue to drop, presumably because breakthrough infections in fully vaccinated people rarely lead to hospitalization and death. I had a full work week, mostly in the office, with Cheryl and/or Alexus there as well. There is some increasing presence of people in the New Research Building, though it feels like we have a long way to go to get to our pre-pandemic hubbub. Unlike some sectors of our economy, I simply don’t see how we can develop alternate work patterns when it comes to doing wet lab experimental research. By the way, if you are working on campus, you might want to schedule your required post-Thanksgiving COVID-19 test now. Here’s the announcement from this past week in case you missed it. There’s also information about two booster clinics being held on campus Dec. 3 and 4.

John Marshall led an “all hands” masked in-person meeting for the Hematology/Oncology Division on Friday afternoon, where we were able to discuss the positive trajectory of the cancer center, the division’s clinical operations and supports, and clinical research. Plus, John’s team handed out a boxed Georgetown Cupcake to each participant in a late-pandemic version of a happy hour reception.

Quick reminder: On Tuesday at 3 p.m. at the inaugural ASCO Virtual Plenary Series, Mike Atkins presents findings from a national melanoma clinical trial he led that was ended early because a better course of treatment became evident before the study concluded. I’m not permitted to say more than that, as the information is embargoed until Mike presents. Be sure to tune in.

Some exciting news… the 2022 BellRinger date was announced this past week — Oct. 22, 2022. Planning for the ride is already underway, and we’re looking forward to an amazing weekend of camaraderie and cycling.

We saw an Arena Stage production of “Celia and Fidel” on Wednesday evening, though we decided to go with the livestream instead of attending in person. I had a work dinner on Thursday, and then we had dinner with dear friends from Philadelphia at another wonderful DC restaurant, Annabelle.

Then, it was off to the beach to celebrate Harriet’s birthday with our kids and their families. I love being here after the season. It is quiet, but the ocean is still beautiful. I look forward to what remains of the dying light of a mid-November Sunday afternoon.

Have a wonderful week, and remember to stay safe and be well.

Lou

 

 


The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

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Nov 07 2021

Cancer Center Advisory Board Week

by at 10:06 pm

I hope you enjoyed the only 49-hour weekend of the year. I needed every minute after a Zoom festival of EAB meetings. It started on Monday when we had our own External Advisory Committee meeting to review our progress and make recommendations for our upcoming CCSG submission. The run up to that meeting was truly an all-hands-on-deck effort, and Georgetown Lombardi did its job well. We received a lot of useful feedback that will be helpful as we move forward.

Well, by now you know that we had a most encouraging curveball in the run up to the meeting, when NCI recommended that we delay our competitive CCSG renewal submission from May 2022 by one year to give time for the consortium to further mature. This would not have happened if we were not making progress and if the value of our consortium was not recognized by NCI. We have been given a great opportunity. It will be a lot of work, but we welcome the challenge.

I spent Tuesday catching up on other work that had piled up prior to the EAC meeting. Then, the onslaught. On Wednesday, I chaired the EAB meeting for an aspiring NCI designated cancer center, and on Thursday split my day between my clinic and another cancer center advisory meeting. Finally, on Friday, I participated in an essentially all-day mock site visit for an NCI-designated cancer center. Needless to say, I was cross-eyed and brain-fogged by the end of the week. On Friday evening, we went out with friends for a socially distanced and absolutely delicious meal at a new DC restaurant called L’Ardente. Then I slept.

The coming week will be busy, but we are looking forward to a cold-weather weekend at the beach to celebrate a family birthday.

I hope you have a great week. Stay safe and be well.

Lou

 


The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.

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