UP FRONT
As you would expect, there
was a lot of kindness and nurturing in our household. If I’ve been
a success, it’s because of my early
coaches, mentors, and guides – my
mom and dad.
If you hadn’t gone into
medicine, what career could
you see yourself in?
I would have happily been a
teacher, probably in a high school. I
did some theater in high school and
there is an element of performance
in teaching – or wizardry, really
– that appeals to me. However,
someone much smarter than I am
said that there are many elements
that make up a good teacher, but
the one absolutely essential item
is caring and ensuring that their
learners “get it” – everything else is
just technique.
Who have been some key
role models and mentors in
your career?
When I was at Yale, Samuel Thier,
MD, was one of my most important
teachers. He is a brilliant clinician
who showed me the importance
of kindness and blending art with
science. Charles Carpenter, MD,
at Brown University, is a majestic
individual and a caregiver extraordinaire. He was always present with
his patients, showing us how there
is no substitute for actually being
there. He was my teacher and also
taught my son, Josh, when he was
a medical student! It was great to
see him in action at several levels.
Robert Gifford, MD, Edwin Cadman, MD, and Tom Duffy, MD,
at Yale were very influential. And,
at Brown, Edward Wing, MD, and
Louis Rice, MD, have been leaders
and friends who have encouraged
me to evolve and develop interest in
humanistic medicine. All of these
people are continuing inspirations
for me.
As a mentor, what advice do
you give to medical students
or fellows early in their
career?
As beautifully articulated by
John Romano, MD, an insightful
physician-leader, our mission as
physicians and mentors is “to keep
paramount one’s concern for the
patient and the patient’s family,
to prevent distress when possible,
and to do what one can to return
the patient to his or her role in
society before illness occurred; by
example, as well as by precept, to
demonstrate to one’s students the
therapeutic intent of medicine – the
basic wish to comfort, relieve pain,
and, when possible, prevent distress
in those entrusted to one’s care.”
I tell young trainees to do what
you love, but recognize that certain
parts of the day aren’t going to be
fulfilling. As you’re starting out,
political and economic battles will
always pop up, but try to avoid
them and concentrate your efforts
on your patients and their families.
Establish your reputation as a superb
caregiver first and everything else
will fall into place.
As the saying goes, “Choose
a job you love and you will never
have to work a day in your life.” So,
make your work your play. People
who love what they do are truly
blessed. It may take a little bit lon-
INTRODUCING
PROVEN PROPHYLAXIS +
SIMPLE,* TWICE-WEEKLY
LY D
LY
DOSING
OSING SCHEDULE =
moments THEIR WAY
*ADYNOVATE allows patients to infuse on the same 2 days every week.
ADYNOVATE [Antihemophilic Factor (Recombinant), PEGylated] Important Information
Indication
ADYNOVATE, Antihemophilic Factor (Recombinant), PEGylated, is
a human antihemophilic factor indicated in adolescent and adult
patients (12 years and older) with hemophilia A (congenital factor
VIII deficiency) for:
• On-demand treatment and control of bleeding episodes
• Routine prophylaxis to reduce the frequency of bleeding episodes
ADYNOVATE is not indicated for the treatment of
von Willebrand disease.
DETAILED IMPORTANT RISK INFORMATION
CONTRAINDICATIONS
ADYNOVATE is contraindicated in patients who have had prior
anaphylactic reaction to ADYNOVATE, to the parent molecule
(ADVATE [Antihemophilic Factor (Recombinant)]), mouse or
hamster protein, or excipients of ADYNOVATE (e.g. Tris, mannitol,
trehalose, glutathione, and/or polysorbate 80).
WARNINGS & PRECAUTIONS
Hypersensitivity Reactions
Hypersensitivity reactions are possible with ADYNOVATE. Allergictype hypersensitivity reactions, including anaphylaxis, have
been reported with other recombinant antihemophilic factor VIII
products, including the parent molecule, ADVATE. Early signs of
Baxalta, Advate, and Adynovate are trademarks of Baxalta Incorporated. USBS/MG159/15-0140
ASHClinicalNews.org
ger to get on the pathway to what
fulfills you, but that’s okay. Don’t
hurry to your destination – enjoy
the journey. In academic medicine today, the old model of the
“triple threat” is still sought after,
but, to borrow a football analogy
and the words of another author,
most academic triple threats are
really double fakes. If you try to
hypersensitivity reactions that can progress to anaphylaxis may
include angioedema, chest tightness, dyspnea, wheezing, urticaria,
and pruritus. Immediately discontinue administration and initiate
appropriate treatment if hypersensitivity reactions occur.
Neutralizing Antibodies
Formation of neutralizing antibodies (inhibitors) to factor VIII can
occur following administration of ADYNOVATE. Monitor patients
regularly for the development of factor VIII inhibitors by appropriate
clinical observations and laboratory tests. Perform an assay that
measures factor VIII inhibitor concentration if the plasma factor VIII
level fails to increase as expected, or if bleeding is not controlled
with expected dose.
ADVERSE REACTIONS
Common adverse reactions (≥1% of subjects) reported in the
clinical studies were headache and nausea.
Please see the following page for the Brief Summary
of ADYNOVATE.
For full Prescribing Information visit www.ADYN