RSS

Dr. Victoria S. Brown dreams of a day when childbearing will be anticipated, welcomed and expected, and incorporated into our culture of medicine.

Comments

Jane Lowe Meisel, MD

Nov, 15 2018 1:10 PM

Dr. Brown, thank you so much for sharing this brave and important story.  I gave birth to my now six-year-old first child during my first year of oncology fellowship, and your story resonated with me on so many levels.  I think even our best institutions struggle with how to support new mothers, and you are so right that validation from leadership is a critical piece if we are to move forward.

I am the leader of ASCO's Women in Oncology Work Group this year, and I will share your thoughtful list with our group so that we can start to brainstorm about how ASCO might be in a position to help address this issue on behalf of all of our female members.  Thank you again for your honesty, and know that you have probably helped many of your colleagues already, who will feel less alone in similar struggles just from having read this beautiful piece.

Victoria Brown,

Nov, 16 2018 3:42 PM

Thank you sincerely for your heartfelt response.  It is encouraging beyond anything to think there might be a route to action. 

If even one woman feels less alone reading this, then admitting my vulnerabilities was worth it.

Victoria Brown

Sonali M. Smith, MD

Nov, 16 2018 2:39 PM

Dear Dr. Brown--thank you so much for sharing your story. Your sheer willpower and strength to "get through it" is inspirational, but your point that it shouldn't take superhuman powers to be a nursing mother is sobering because we are so far from the conscious and unconsious bias against all aspects related to childbearing. Your patients, and we as an oncology community, are lucky that you did not leave our field despite some of the hurtful sentiments and statements. Many talented female oncologists do not survive the pressures related in your story, and our field suffers as a result. This is truly a wakeup call--we need a culture that accepts childbearing as a natural and valuable part of a woman's life that should not make her less worthy in her career. In particular, we need practical options for women to temporarily modify their jobs (WITH FULL EMOTIONAL AND COLLEGIAL SUPPORT) and then also help them re-enter the field when they are ready. Please keep your voice strong--we hear you! 

Victoria Brown,

Nov, 16 2018 3:51 PM

Thank you for your very kind words and your vision for the future.  Support and validation like this helps tremendously during a difficult time.

-Victoria Brown

Surbhi Sidana, MD

Nov, 16 2018 10:38 PM

Dr. Brown, thank you for sharing your story so candidly. Your grit and perseverence are admirable, but I agree with prior comments that we need to take steps so that new mothers, especially trainees who are at a very vulnerable stage, are supported at work. This includes both practial steps like the suggestions you mention and addressing any underlying bias. 

Time is precious to all of us and seems to pass so quickly. How much more quickly does it pass for someone who knows that they have a life-threatening illness?

Comments

Jess Franklin Armor, MD

Nov, 09 2018 9:03 PM

Having been in practice for 15 years, I have a fairly large number of patients who had early stage disease (breast cancer, for example) who still are coming back for annual visits well past 5 years out, despite literature showing that such visits to a specialist are unnecessary, as long as their primary care physician does a breast exam, asks a few pertinent questions, does a physical, and gets annual breast imaging as indicated.  Similar for stage II or III colon cancer patients that are 10+ years out now.  There are a few patients that are happy to "graduate" from the oncologist office, but many see us as their "life preserver."  It is hard to convince someone that coming back to see us once a year will not keep their cancer from recurring.  I've tried the survivorship thing in our office, but patients don't seem to absorb the information--and that just wasted more time for me, and for the patients and staff in the office.  The enlarging panel of survivors makes it very difficult to schedule newly diagnosed patients, and keeps me up late each night plugging away on the EMR.  Is there any good way to (nicely) convince people that it is OK to not have to see me any longer?  Sure, I'm honored, but as you say, it's a waste of everyone's time (and the patient/insurance company/Medicare/tax-payers' money) for many of cancer survivors to keep returning unnecessarily.  Sure, some of my older partners will point out that people develop 2nd or 3rd malignancies, but how does seeing us every revolution around the Sun prevent such?  It doesn't.

One problem is that primary care does not want to take these patients back into their fold, even when I issue recommendations for followup, based on NCCN guidelines, after they're out 5+ years and off all therapies for their cancer.  Many times, they send them right back for a "history of breast cancer"....that may be over a decade ago.

Yes, many visits are social visits, some are them griping about their care elsewhere, but regardless, it is a waste of resources for everyone.

Dr. Raj Mohan reflects on the important role an oncologist plays in a patient's journey, and how every step of treatment needs love, compassion, and involvement.

We all need to take a stand on gender equality, writes Dr. Eileen Parkes.

Comments

Sonali M. Smith, MD

Oct, 27 2018 9:28 AM

A beautiful and brilliant piece!! One additional factor to consider is that women leave academics in higher numbers, cut back their clinical practice and therefore at every level have fewer opportunities for advancement. This is partly due to a greater proportion of family demands placed on women, and I would love to hear ideas on how to retain our female oncology workforce and how to best support those who need to cut back for a few years but then want to re-enter. Thank you for your wonderful and actionable ideas!

 

To be a truly good doctor, you can't just care for people - you have to care about people.

Comments

Ellen Sonet, MBA, JD

Sep, 27 2018 2:02 PM

Thank you, Dr. Dizon, for highlighting the importance of treating the patient, not just the disease.  CancerCare, through its Patient Values Inititiative, is focused on making sure that cancer treatment providers know what is important to patients and families BEFORE treatment plans are finalized.  Your advice, to listen, react and remember, is the path to understanding patients' priorities and preferences.  

I worked with Dr. Bosl for 16 years, and have certainly been influenced by his humanistic approach to caring for people with cancer.   In fact, it largetly defines the work I now do at CancerCare.

Don S. Dizon, MD, FACP, FASCO

Oct, 02 2018 12:26 PM

Dear Ellen- thanks so much for your comment. The Patient Values Initiative sounds like the important work that needs to be supported, alongside all of our efforts in Personalized and Precision Oncology. Kudos! 

Carl T. Henningson, MD, MPhil

Sep, 30 2018 4:55 PM

Thank you Don for writing such a nice synopsis of what makes a good doctor,  a topic that is often not addressed. I don't know if you rememeber me but you were part of the dream team of residents that I had when I was a medical student at Yale, including Alan Sandler and Jared Post. You had what makes a good doctor well before your training at Yale and MSK. You, Alan and Jared impressed and inspired me with your intelligence, compulsiveness and compassion and inspired me to go into oncology as well. I subsequently went to Penn for Internal Medicine and HemeOnc Residency and am now praticing HemeOnc in NJ as part of RCCA and often talk about the importance of the medical student interviews to try to determine who will become a good doctor!  Thanks for your insight and inspiration!!

Best Wishes,

Carl Henningson

 

Don S. Dizon, MD, FACP, FASCO

Oct, 02 2018 12:28 PM

Carl, so great to hear from you after all this time; I do indeed remember you from our days at Yale. I am actually really touched you remembered me! I am also really happy this blog post resonated with you. I tend to write for myself, so am always suprised (gratefully) when someone reads me, and then makes the effort to comment. I hope we run in to each other in the near future! D

As an academic physician, Dr. Krisha Howell attends conferences for professional growth and networking; as a parent, one of her gating considerations is the availability of childcare. 

Comments

Dorothy Chilambe Lombe, MD

Sep, 29 2018 9:12 AM

I agree Dr Howell. Being a 'professional' mum is overwhelming and your article brings comfort that one is not unique in this situation. Its great that all these organisations are providing childcare during conferences. Makes a good statement on inclusivity. 

I had the enormous privilege of speaking with poet Anya Silver about her experience living with metastatic breast cancer and her perspective on physician-patient communication.

Subscribe to RSS