I am frequently asked about my choice of career. Even today, some cannot understand why I chose to be an oncologist. At the time, it was driven by a desire to do more, and to do better. Back in the ‘90s (there I go dating myself again!), cancer was a very different disease. Patients did not have much in the way of options and many died of their disease even as they were being treated with chemotherapy. Back then, we didn’t talk about palliative care or quality of life, really. As a resident, it was common to have patients die of sepsis from chemotherapy-related complications. More often than not, patients came in and never left, but not before one final “hurrah,” one final chance for a miracle. I wanted better for my patients and I wanted to be a part of trying to aim for better. I was driven by the science and the lack of clarity and the lack of options, and I was driven by the patients and their families who suffered from cancer, whether it be leukemia, lymphoma, colon cancer, or any others.
My fellowship interviews mostly concentrated on what I had done while in residency, sharing cases that I found interesting, and talks about my future plans after training. Yet, one interview stood out, and still does today. It was with George Bosl at Memorial Sloan Kettering Cancer Center. I might not be remembering it with full clarity, but George spoke to me about, well, about me. He wanted to know what it was like to grow up on Guam, my family, what my dad did. He asked me about patients, and what about them stuck with me. I felt he wanted to get to know me, as a person. One more thing—he clearly loved what he was doing. He was proud of MSKCC and his faculty and he opened me up to the possibilities should I train there. I walked away thinking, if I get a chance, I’m going to MSKCC.
Understanding the person beyond their diagnosis became a hallmark of my training. I remember going in to rooms with my attendings and so many of them would open their arms to greet their patient, ask about their last vacation, or their new grandson, or some other facet of life. The interactions were warm, and I saw how the power of communication helped ease the interaction, even when the news was not good. It was about connection.
There is an adage in medicine: see one, do one, teach one. It always seemed to speak towards the myriad procedures I had to learn during medical residency, but I’ve discovered that it applies to communication. I am a product of my mentors, who showed me that it’s important for me to take a social history, to listen to patient cues when they speak about events in their lives, and it’s important to use that information to really see who is in front of me.
So, as an attending, I greet many patients with a hug, ask about their kids and that vacation they just took. Sometimes they will ask about my family and recent trips I’ve taken (thanks to Dr. Google) or tell me they read something I wrote. That sense of familiarity makes medicine worthwhile to me and I’ve realized something even more important—by doing so, I’ve made things better, one person at a time.
Looking back, I would say my interview with George was a seminal event in my career. I still think of our exchange whenever I meet someone new—whether it be a colleague, fellow, or resident—and I would aim to know them, as a person. For a new patient, understanding who they are became as important as understanding cancer and learning the landscapes of standard and experimental therapy.
So, thank you to my mentors at MSKCC and since. A good doctor is more than the grants we write and the trials we run, more than what’s found in our biographies or hospital directories. For anyone learning the field of medicine, and especially oncology, here is my advice. A good doctor is the one who listens, reacts, and remembers.