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What advice would you pass on to early-career hematologists ? Pick a specialty and stick with it . Each subspecialty has become so large and truly specialized that you need to become an expert to survive these days . It ’ s important to identify what you like to work on and create your niche .
Also , you need to identify with the disease – not necessarily with the treatments , which are changing so frequently .
In my case , I became interested in myeloma almost at random , but it has become such a clear path for me . And , at the time , myeloma was a small field . It was not an area with much research interest : There was a lack of knowledge about the biology of the disease and treatment options were limited . It was a challenging field to pursue , but it suited me .
How do you think hematology and medicine have changed since you started your career ? It ’ s night and day . One of the biggest changes is the loss of the individual doctor-patient relationship . Patients used to come to see you , and then you would be their doctor ; if they went to the hospital , you would still be their doctor , taking care of them throughout their life with the disease .
Now , if patients go to the hospital , hospitalists treat them . And when they come back to your clinic , one of the other doctors on your team might see them . Caring for patients has changed from individual personal contact to more of a team effort among members of the clinical practice , nursing , and hospital teams .
The traditional doctorpatient relationship has all but evaporated , and I miss that patient contact . I still have patients I ’ ve taken care of for many years . Recently , a patient and I commemorated the 20th anniversary of her myeloma diagnosis . She reminded me that when she was diagnosed we talked about a life expectancy of three to four years . It was a sad time for her and her husband ,
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but we started her on one of the available treatments , and I told her that new treatments were being developed . And now , it ’ s amazing that treatment options have expanded to the point where we can celebrate 20-year anniversaries of diagnoses .
The whole financial structure of health care has changed , as well . Medicine used to be a lucrative business – particularly for surgeons – and a good , nottoo-stressful career . But now , you need to see at least 12 patients a day to maintain your practice , and all the money earned goes into keeping the practice running ; then , you ’ re salaried and a company comes along and buys your practice . You also have to wonder whether all the patients who come in to see you will be able to afford the treatments you prescribe .
The stresses of filling out endless forms , checking on finances , and waiting for reimbursement add up – not to mention the [ frustrations associated with the ] electronic medical record system . The shift from a hands-on , caring , personalized situation to a more stressful , complicated business has prompted a number of my colleagues to move out of practice .
This paperwork and administrative burden also tie into one of my biggest pet peeves : When people send you an email and expect you to answer it right away , or when you get the followup email saying , “ I sent you that message at 10:21 ; it ’ s 10:23 now – where ’ s my answer ?”
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What do you enjoy doing in your off hours – if you have any ? These days , I love to travel and visit new places . Traveling also gives me a chance to read .
I also love music , so I ’ ve started collecting vinyl records again . I used to have many more , but my original collection seems to have disappeared in some of my travels . I ’ m slowly building up a new one .
What type of music do you collect ? It ’ s a mixture of classical and more diverse music : I have Mozart ’ s Horn Concertos next to Joni Mitchell , the Beatles , and Supertramp . I live in a neighborhood of Los Angeles – the Hollywood Hills – that is associated with a lot of musical history . Joni Mitchell lived in a house just above ours , and many of the musicians in this era lived and worked in nearby Laurel Canyon .
Are there any hobbies you ’ d like to get back to ? What I do in the off hours has changed a bit over the years . I was practically born on a golf course , so I played golf from a young age . I used to play a lot of racquet sports – tennis , table tennis , squash , and racquetball , and I even played table tennis for the university league in Scotland . I don ’ t have much time for those now , but I will play the occasional round of golf .
I have two children , a son and a daughter who are in their early 30s now and have young families . I have two granddaughters , but I
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don ’ t get to see them often because we all work and travel so much .
Did either of your children go into medicine ? Indirectly , yes . My daughter works for the International Myeloma Foundation in the meeting planning division . My son is a lawyer , but when he was in school he had a difficult time deciding between medicine and law . However , through watching me , he witnessed some of the changes in medicine that I was dealing with – he saw me filling in forms , coming home later , and all these things that turned him off to that idea . He is in medical law , though ; he works with medical groups and hospital acquisitions .
What person from history , dead or alive , would you like to have dinner with ? And what would you ask that person ? One aspect of science has always fascinated me : the connection between physics and life . I am very interested in the work of physicist Erwin Schrödinger , who developed the thought experiment Schrödinger ’ s cat . He also wrote a book , What Is Life ?, in which he proposed that life – even the spiritual component – could be explained completely through physical and chemical principles . I think it would be cool to chat with him . ●
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