Latest / The David Rubenstein Show / Dr. Selwyn Vickers

Transcript

Dr. Selwyn Vickers · The David Rubenstein Show

0:03
Speaker 1: One of everyone's greatest fears that he or she might
0:05
Speaker 1: be diagnosed at some point in their life with cancer.
0:08
Speaker 1: I recently had a chance of talk to doctor Selwyn Vickers,
0:11
Speaker 1: who runs a Royal song Kettering Cancer Center, one of
0:14
Speaker 1: the leading cancer centers in the United States, and I
0:16
Speaker 1: had a chance to talk with him about the progress
0:18
Speaker 1: being made in treating cancer. So today we are about
0:22
Speaker 1: I guess, more than fifty years after President Nixon declared
0:25
Speaker 1: war on cancer? Have we really made that much progress
0:29
Speaker 1: in the fifty years or so since he first declared
0:31
Speaker 1: war on cancer?
0:32
Speaker 2: Yeah, I think we have the.
0:36
Speaker 3: Ability for someone who has a diagnosis of cancer broadly
0:41
Speaker 3: thinking about having a chance for cure has significantly improved.
0:45
Speaker 3: We've gone from all cancer diagnoses probably around the time
0:49
Speaker 3: of that announcement that was around thirty to forty percent
0:52
Speaker 3: chance of cure that we're approaching sixty eight to seventy
0:56
Speaker 3: percent of patients across the board who get the diagnosis
1:00
Speaker 3: of cancer have a chance at five years to being
1:03
Speaker 3: told they don't have a tumor.
1:04
Speaker 1: So what is the best way to avoid getting cancer?
1:06
Speaker 1: I guess that's the question everybody asked, Well, what is
1:09
Speaker 1: the answer to that?
1:10
Speaker 3: Yeah, I think the best way to avoid it is
1:13
Speaker 3: obviously healthy lifestyles, avoid smoking, certainly limit red meat to
1:19
Speaker 3: the amount that you eat. Now, all of these statements
1:22
Speaker 3: are no guarantee you won't get cancer, but we do
1:24
Speaker 3: know to some degree that they probably have a role
1:27
Speaker 3: in accelerating or increasing risk. In general, there is no
1:31
Speaker 3: actual way to prevent it. There are certainly things we
1:34
Speaker 3: do can screen early, and if we catch cancers early,
1:37
Speaker 3: we have a really good chance of curing them.
1:40
Speaker 1: What extent is environmental factors, What extent is it behavioral factors,
1:44
Speaker 1: And what extent is the genetic factors that causes cancer?
1:47
Speaker 3: Yeah, so it's a combination. There's a small percentage of
1:52
Speaker 3: inherited genes that put you at risk. The most common
1:56
Speaker 3: is BRCA one and two for women with breast cancer,
1:58
Speaker 3: increasing risk of a varian cancer as well, and one
2:01
Speaker 3: or two others those we know and we can detect.
2:04
Speaker 3: There's certain other select genes that are passed on that
2:07
Speaker 3: significantly increase.
2:08
Speaker 2: Your risk, but that's a small number.
2:10
Speaker 3: The other genetic aspect are genetic mutations that occur over
2:15
Speaker 3: time because of the environment and age. Those somatic mutations
2:19
Speaker 3: sometimes caused by viruses, caused by cells that are not
2:22
Speaker 3: correcting themselves certainly have a role and actually producing malignant
2:28
Speaker 3: cells that grow on control. And then I think there
2:31
Speaker 3: are certainly environmental exposures, and we are learning more. We
2:35
Speaker 3: know that there are classically ones from multiple chemicals that
2:39
Speaker 3: do it, but it's the broad combination. But I would
2:41
Speaker 3: say the biggest contributor is our aging. That has a
2:44
Speaker 3: big factor in it.
2:45
Speaker 1: So what is the most common cancer that humans get?
2:48
Speaker 1: Is that lung cancer, breast cancer, pancreatic cancer, brain cancer.
2:54
Speaker 1: What is the most common?
2:55
Speaker 3: So the most common cancers in America are breast and prostate.
3:00
Speaker 3: Three hundred thousand cases of breast, somewhere around two hundred
3:04
Speaker 3: and eighty thousand cases of prostate. Lung is arguably one
3:09
Speaker 3: of the most if not the number one killer.
3:12
Speaker 2: It's about one hundred and.
3:13
Speaker 3: Fifty thousand cases, but it is the most lethal large
3:16
Speaker 3: number pancre's cancer. The incidence has increased. When I began
3:21
Speaker 3: my practice, there was about thirty thousand cases a year
3:24
Speaker 3: on average.
3:25
Speaker 2: Now there are over sixty.
3:26
Speaker 3: Five thousand new cases of pancredit cancer a year, and
3:30
Speaker 3: so it's approaching a level where it's going to be
3:33
Speaker 3: the second killer, comeless common killer of patients with cancer,
3:38
Speaker 3: even though it doesn't have the numbers. Like breast cancer,
3:41
Speaker 3: we can cure well over ninety percent of breast cancers
3:45
Speaker 3: and well over ninety five percent of prostate cancers are cured.
3:48
Speaker 1: And now with prospective prostate cancer there's a PSA which
3:52
Speaker 1: is a kind of a blood marker. But we don't
3:54
Speaker 1: have those kind of things for brain cancer or or
3:57
Speaker 1: for pancreatic cancer, right we don't have a market.
4:00
Speaker 2: We don't.
4:02
Speaker 3: They are clearly tests that are being evolved based on
4:06
Speaker 3: being able to detect circulating tumor, DNA and other markers,
4:10
Speaker 3: and our ability to have broader ability to manage the
4:13
Speaker 3: data through competition oncology that are giving us gradual insight
4:18
Speaker 3: for early detection. It's not as specific as we want
4:22
Speaker 3: and it's not completely as accurate. So sometimes if I
4:24
Speaker 3: get a positive test, I really don't know which tumor
4:27
Speaker 3: to look for. Sometimes it does give directions, but that's evolving.
4:31
Speaker 2: But you're right.
4:32
Speaker 3: We have PSA, we have mammograms, we have colonoscopy, we
4:36
Speaker 3: have cervical screening for certain cancers, and we have CT
4:40
Speaker 3: scans for lung but we don't have broad availability of
4:44
Speaker 3: screening for the large number of cancers that are still killers.
4:47
Speaker 1: Now, the type of cancers that are killers are ones
4:50
Speaker 1: where you don't know about them until maybe stage four globlastoma,
4:53
Speaker 1: brain cancers, that type, pancreatic cancers, another type, maybe liver cancer.
4:58
Speaker 2: That's right.
4:59
Speaker 1: How do you know if you have one of those
5:01
Speaker 1: kind of cancers? What is the best way to go
5:03
Speaker 1: in for an annual cancer checkup or.
5:05
Speaker 2: What do you do?
5:06
Speaker 3: Yeah, so it's hard, and that's a question that's perplexed me.
5:11
Speaker 2: I would love to say, go out and get a
5:12
Speaker 2: cat scan for everybody. We can't do that. We don't
5:15
Speaker 2: have enough cat scanners to screen.
5:18
Speaker 3: We need a better ability to enrich who's truly at risk.
5:22
Speaker 3: And recent studies now with AI have been able to
5:25
Speaker 3: begin to predict who in the population by virtue of
5:30
Speaker 3: a number of things that they pulled together their medical history,
5:32
Speaker 3: some blood tests, who's at risk for a pank ratic cancer.
5:37
Speaker 3: We do know now if you're a smoker, and if
5:39
Speaker 3: you're a certain age or exposed to smoke, you should
5:42
Speaker 3: in you over fifty, you clearly should get a low
5:45
Speaker 3: dough CT scan, which is proven to have a significant
5:48
Speaker 3: difference in outcome and detect early cancers, and yet only
5:52
Speaker 3: about six to eight percent of the eligible candidates take
5:55
Speaker 3: advantage of that CAT scan. So one, I think it's
5:59
Speaker 3: coming day that AI programs looking at our broad array
6:02
Speaker 3: of data can enrich the population who we know maybe
6:06
Speaker 3: at risk, and then once doing that, probably getting a
6:10
Speaker 3: scan MRI, a CT scan is going to be the
6:13
Speaker 3: tool which we can't do for everybody, but we can
6:15
Speaker 3: do for a select population.
6:17
Speaker 1: Now, pancreatic cancer, that's a disease that Ruth Bader Ginsburg
6:21
Speaker 1: died from and increasingly many people have it. You don't
6:24
Speaker 1: typically know you have until stage four. You are a
6:27
Speaker 1: pancredic cancer surgeon. Why didn't you decide to specialize in
6:30
Speaker 1: that area?
6:32
Speaker 2: You know? One a couple of things.
6:34
Speaker 3: Number One, at the time that I trained at Johns Hopkins,
6:38
Speaker 3: we were the leading center for treating patients or pancreatic cancer.
6:43
Speaker 3: And as you talked about, at that time, the leading
6:47
Speaker 3: opportunity to make a difference in somebody's life was surgery.
6:51
Speaker 3: So Number one, I felt, I felt I had great
6:55
Speaker 3: training and had capacity to make a difference by virtue
6:58
Speaker 3: of that skill set. So it was the environment, the
7:00
Speaker 3: leaders there who encouraged us to look at difficult problems
7:05
Speaker 3: and make a difference. So one it was a skill
7:07
Speaker 3: set of training. Two I was at a center where
7:10
Speaker 3: we focused on it, and three it was a problem
7:12
Speaker 3: that really needed the attention to make a difference.
7:15
Speaker 2: I soon learned as a surgeon.
7:17
Speaker 3: After I did my first hundred patients for pancredic cancer,
7:21
Speaker 3: successfully operating on them, I could count on one hand
7:24
Speaker 3: how many were alive at five years, and so I
7:27
Speaker 3: knew that was a bigger problem than just my surgical
7:30
Speaker 3: skills could resolve.
7:31
Speaker 1: Okay, so I'm always worried about pancredic cancer too. What's
7:34
Speaker 1: the best sign that I might be having pan credic cancer?
7:38
Speaker 3: You know, the signs of cancer are often due to
7:42
Speaker 3: something simple. But if you were to think about the
7:45
Speaker 3: things that you might worry about, particularly as you get older.
7:50
Speaker 3: We don't naturally just lose weight when we get older.
7:53
Speaker 3: So one notice that.
7:55
Speaker 2: Yes, a sudden Yes, a sudden weight loss.
7:58
Speaker 3: So you want to ask the quest question, why am
8:00
Speaker 3: I dropping weight even though I've been trying for the
8:02
Speaker 3: last five years and nothing's happened. New onset diabetes that
8:07
Speaker 3: for some reason now I don't have a history of it.
8:10
Speaker 3: I'm over sixty five and I'm developing diabetes that and
8:14
Speaker 3: then subtly, although not early on, it's the case where
8:19
Speaker 3: either somehow my urine turns dark or I begin to
8:24
Speaker 3: have some shades of change and my eyes or my
8:27
Speaker 3: thumbnails that begin to look a bit of a yellow
8:30
Speaker 3: what we call jarndice.
8:31
Speaker 1: Now you've said weight loss is a sign sometimes something
8:34
Speaker 1: isn't good, but I know it's not directly in your area.
8:37
Speaker 1: But ozempic, which is now a very popular drug to
8:41
Speaker 1: produce weight, some people say that it might cause some
8:44
Speaker 1: type of tumors. Are you an advocate of ozempic for
8:48
Speaker 1: everybody or for some people?
8:49
Speaker 2: Yeah.
8:50
Speaker 3: I think as the new golp one inhibitors, which are
8:55
Speaker 3: these drugs that really affect how we feel about being full,
9:00
Speaker 3: become further advanced, I think it's going to be an
9:03
Speaker 3: overall sea change for American health care, including cancer, because
9:08
Speaker 3: we know obesity over time has a significant impact increasing
9:12
Speaker 3: cancer rate and risk. I don't have a strong opinion
9:16
Speaker 3: about at this stage whether an ozembic or a manjuro
9:19
Speaker 3: would cause a cancer, but I think the global impact
9:22
Speaker 3: is one to actually reduce our overall health burden, including cancer.
9:26
Speaker 1: Talk about your background. Where were you born?
9:29
Speaker 3: So? I was born in Demopolis, Alabama. It's in the
9:31
Speaker 3: small town in the black belt of Alabama, a rural
9:35
Speaker 3: farming area where my parents were educators.
9:39
Speaker 1: Now, your parents were extremely well educated for blacks in
9:43
Speaker 1: the South at that time. How did they get so
9:45
Speaker 1: well educated?
9:46
Speaker 3: Yeah, So on my father's side, it was really a
9:51
Speaker 3: parents who themselves had limited education. My grandfather with a
9:55
Speaker 3: fourth grade education, who didn't learn how to write and
9:57
Speaker 3: read until he was in his forties, who really felt
10:01
Speaker 3: his children needed.
10:02
Speaker 2: A college education.
10:04
Speaker 3: And on my mother's side, her mother in the nineteen
10:08
Speaker 3: twenties at the travel two hundred miles to an academy
10:12
Speaker 3: to start it by Presbyterians in the southern part of
10:15
Speaker 3: Alabama to get her high school degree, and then went
10:18
Speaker 3: to summers to get her bachelor's degree. So they had
10:23
Speaker 3: foundations of understanding the value of education and the ability,
10:27
Speaker 3: particularly for a Nigro in the South, to have a
10:30
Speaker 3: chance to advance their lives and careers.
10:33
Speaker 1: When you grew up in a segregated environment, isume So
10:36
Speaker 1: you were the only child of your parents. Yes, so
10:39
Speaker 1: did they say we're putting all our hope in you,
10:41
Speaker 1: and we want you to be a pancreatic cancer surgeon.
10:43
Speaker 2: No, they had no clue what I might be.
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Speaker 3: I think they simply wanted me to do the best
10:49
Speaker 3: I could in anything I took my interest in. Clearly,
10:53
Speaker 3: achievement in high school and undergrad was really sort of
10:58
Speaker 3: the first thing that they looked for and expected of me,
11:02
Speaker 3: and I tried to do that because I realized the
11:05
Speaker 3: legacy of both grandparents and even great grandparents who studied
11:10
Speaker 3: with book A. T. Washington, that I had a significant responsibility.
11:13
Speaker 1: So were you a superstar in high school?
11:16
Speaker 2: You know, I was a good student. I would say this.
11:20
Speaker 2: I grew up in a town called Huntsville.
11:22
Speaker 3: It really offered the best education that I could get
11:26
Speaker 3: in Alabama at the time. But when I arrived at
11:29
Speaker 3: Johns Hopkins, I was probably behind ninety five percent of
11:33
Speaker 3: my classmates.
11:34
Speaker 1: And what I've been exposed, you must have done okay
11:36
Speaker 1: at Johns Hopkins undergrad because you got on the Johns
11:38
Speaker 1: Hopkins medical school.
11:39
Speaker 2: Yeah, I had to catch up. It took me about
11:41
Speaker 2: a year to catch up.
11:42
Speaker 3: And you know, there were classes my classmates had who
11:46
Speaker 3: went to prep schools I was taking for the first time.
11:49
Speaker 3: I hadn't had calculus when I arrived, and they'd all
11:52
Speaker 3: had calculus, and so the level loved thing of the
11:54
Speaker 3: playing ground took me about a year for that to occur.
11:57
Speaker 2: Once the playing.
11:58
Speaker 3: Ground became level, I found that I compete just as
12:01
Speaker 3: well as they could.
12:02
Speaker 1: When you went to Johns Hopkins Medical School, which is
12:04
Speaker 1: one of the most famous medical schools in the country,
12:06
Speaker 1: up in the world, was it very integrated at the time,
12:09
Speaker 1: were mostly white.
12:10
Speaker 3: So there was a surgeon there who was from Alabama,
12:13
Speaker 3: a guy named Levi Watkins, who became a mentor and friend,
12:17
Speaker 3: and he grew up in Alabama where my grandmother and
12:23
Speaker 3: my mother went to the college where his father was president,
12:27
Speaker 3: and Levi went to Tennessee State, Vanderbilt and then Johns Hopkins.
12:32
Speaker 3: Stayed on faculty, but challenged Johns Hopkins that it clearly
12:36
Speaker 3: needed to be more diverse. So he wrote all the
12:39
Speaker 3: African American medical applicants in the country and encouraged them
12:43
Speaker 3: to apply to Johns Hopkins, and he provided a platform
12:46
Speaker 3: for people like me to have an interest in going there.
12:49
Speaker 1: After you graduated, what did you do?
12:50
Speaker 3: So after I graduated, I made the transition to realize
12:54
Speaker 3: I wanted to be a surgeon, looked around the country,
12:57
Speaker 3: and decided to stay in Baltimore because I thought Hopkins
13:00
Speaker 3: had the best surgical training of that time.
13:02
Speaker 1: But ultimately you went back to Alabama.
13:05
Speaker 3: That was a hard decision. I had an offer to
13:07
Speaker 3: stay on faculty at Hopkins. I'd been there for in
13:11
Speaker 3: Baltimore for sixteen years, and briefly accepted a job to stay,
13:15
Speaker 3: but then change my mind to go to Alabama, in
13:19
Speaker 3: part because I felt I wanted to go back home
13:22
Speaker 3: into a new environment.
13:24
Speaker 1: Now as a great surgeon, sometimes you might say I
13:27
Speaker 1: don't need to go be into administrative parts of hospitals.
13:31
Speaker 1: I just want to be a doctor, just do surgery.
13:33
Speaker 1: What prompted you to want to get out of just
13:35
Speaker 1: doing surgery to be an administrator and a hospital leader.
13:38
Speaker 3: Yeah, I think it was again watching others who did
13:42
Speaker 3: it well.
13:43
Speaker 2: I had a.
13:44
Speaker 3: Dean who recruited me from Birmingham, Alabama, to Minneapolis, Minnesota,
13:49
Speaker 3: which is a big jump to convince me to move
13:51
Speaker 3: my family, but she did several things that showed me
13:56
Speaker 3: the power of a leader at a significant level to
13:59
Speaker 3: affect the.
14:00
Speaker 2: Career of other leaders.
14:02
Speaker 3: And after I'd helped build a growing Department of Surgery
14:05
Speaker 3: at the University of Minnesota. I thought I could serve
14:08
Speaker 3: in that role. In particular, I realized over time that
14:13
Speaker 3: my training as a surgeon brought a set of credible
14:16
Speaker 3: things to the table. One, if surgeons have a measure
14:20
Speaker 3: of emotional intelligence, not much of our training reinforces that.
14:24
Speaker 3: It reinforces skill, not necessarily emotional intelligence. But if a
14:28
Speaker 3: surgeon has some self awareness and emotional intelligence, what they
14:32
Speaker 3: bring to the table of leadership are three fundamental things.
14:36
Speaker 3: Number One, they do everything in teams, their operations. Their
14:41
Speaker 3: patience they see is all team focused. Number Two, they
14:46
Speaker 3: value process, but they hold themselves very much accountable to execution.
14:51
Speaker 3: They understand that it's good to explore a patient, but
14:54
Speaker 3: what really matters is did you take the tumor out?
14:57
Speaker 3: And then number three, they make difficult decisions on incomplete information.
15:02
Speaker 3: Those things I realized that I could bring to the
15:05
Speaker 3: table as a leader if I had a sort of
15:08
Speaker 3: a passion for working with people and had some sense
15:11
Speaker 3: of self awareness.
15:12
Speaker 1: So he rose up in Minnesota. Why did you go
15:14
Speaker 1: back to Alabama? Which had racial issues?
15:17
Speaker 2: UAB is a unique place.
15:19
Speaker 3: It's a bit of an oasis of academic excellence, broad diversity.
15:24
Speaker 3: It's the most diverse Carnegie Tier one research university in
15:28
Speaker 3: the country. It's done more transplants in African American than
15:32
Speaker 3: any hospital in the world.
15:34
Speaker 2: So I felt the.
15:34
Speaker 3: Compelling opportunity to continually drive the mission of that institution
15:41
Speaker 3: in spite of the landscape socially and politically that I
15:45
Speaker 3: thought it could have a significant impact on that part
15:47
Speaker 3: of the world.
15:48
Speaker 1: And how long did you run? UAB So I was
15:51
Speaker 1: there for nine and a half years, almost ten years.
15:53
Speaker 1: So when Memorial Sloan Kettering approached you, did you say, Look,
15:57
Speaker 1: I'm a great surgeon. I got what I want right here.
16:00
Speaker 1: This is my native state. I don't need to leave.
16:02
Speaker 3: Were you intrigued, No, it was more of the former,
16:06
Speaker 3: Like you said, it was I have a good place,
16:09
Speaker 3: have a good job, I've built a level of trust
16:12
Speaker 3: in the community, i have a compelling mission, and I
16:18
Speaker 3: think I need to really think.
16:19
Speaker 2: Very hard about leaving it.
16:21
Speaker 3: And I would say there are very few places that
16:24
Speaker 3: would intrigue you to consider it leaving, and Memorrison Cattering
16:28
Speaker 3: is one of them.
16:29
Speaker 1: So as you rose from a small town only child
16:32
Speaker 1: in Alabama to where you are now, you must have
16:35
Speaker 1: encountered a fair amount of racial prejudice.
16:37
Speaker 2: Yeah, I had my share of it.
16:39
Speaker 3: I learned early on from one of my mentors at
16:45
Speaker 3: john Hopkins. He was one of the faculty there, and
16:48
Speaker 3: he reminded me that people will often have difficulties with you,
16:54
Speaker 3: but don't make their problem your problem. And so one
16:59
Speaker 3: of my early experiences of taking care of a patient
17:04
Speaker 3: who had a liver cancer or in this case of
17:07
Speaker 3: bioduct cancer, they struggled that there was a black surgeon
17:12
Speaker 3: saying that they needed half of their liver out. I
17:15
Speaker 3: respected that because it was unusual. Even my grandmother had
17:19
Speaker 3: not ever seen a black doctor, so that was a
17:22
Speaker 3: foreign thing to her. So I respected the understanding that
17:25
Speaker 3: what they were going through was not the norm. They
17:29
Speaker 3: called back to Johns Hopkins to see if I actually trained,
17:33
Speaker 3: and I said, do what you need to do to
17:35
Speaker 3: be comfortable with this situation.
17:36
Speaker 1: So when you join Memorial Sloan Kettering, what you want
17:39
Speaker 1: to do is expand the coverage of moreel Sloan Kettering
17:42
Speaker 1: and make sure more people were able to get the services.
17:44
Speaker 1: What progress have you made so far in that.
17:46
Speaker 3: I have wanted Memorial Sloan Kettering and be a cancer
17:49
Speaker 3: center to the world, both culturally, ethnically.
17:51
Speaker 2: And geographically.
17:53
Speaker 3: And there have been great efforts that have occurred, some
17:55
Speaker 3: of them before I got here. One of the efforts
17:58
Speaker 3: by our legislative team was to get our state to
18:01
Speaker 3: really drive manage Medicaid, manage care in New York, to
18:07
Speaker 3: actually negotiate with Morrisloan Kettering so patients with Medicaid broadly
18:11
Speaker 3: could access us. We've had that law enacted and patients
18:15
Speaker 3: now broadly are able to come to us. Our Medicaid
18:18
Speaker 3: service of patients is up by sixty three percent. So
18:22
Speaker 3: Number One, we now are getting a broader access to patients.
18:25
Speaker 3: Number two, we're partnering with hospitals across New York City,
18:30
Speaker 3: Jamaica Queen's Hospital near JFK, which has a tremendously diverse population.
18:35
Speaker 3: The most diverse county in America is Queen's. We're partnering
18:39
Speaker 3: with them to develop a cancer program. We also work
18:42
Speaker 3: with New York Hospital Health and Services also for clinical
18:45
Speaker 3: trials and patients access at our RAF Lauren Cancer Center.
18:48
Speaker 3: And we've developed a broad strategy around health equity that
18:52
Speaker 3: I think will further impact our city and our region
18:55
Speaker 3: for making sure everyone has access to the best cancer
18:58
Speaker 3: care in the world.
18:58
Speaker 1: So, as the head of the Slung Cattering Cancer Center,
19:01
Speaker 1: your biggest problem is getting enough money to do the
19:04
Speaker 1: research and give the patients the care they want. So
19:06
Speaker 1: you're always raising money or that's not your biggest problem.
19:10
Speaker 3: You know, it's not my biggest problem, but it is
19:11
Speaker 3: a problem. There is no doubt the cost and healthcare
19:14
Speaker 3: is significant, not only for our patients, but for the
19:17
Speaker 3: science and for the drugs.
19:19
Speaker 2: So it is a significant.
19:20
Speaker 3: Part of what I do is putting resources on the
19:23
Speaker 3: table so that our scientists, our clinical trialists, and our
19:27
Speaker 3: physicians are able to do their job and make discoveries.
19:31
Speaker 1: So I'm Memorial Sloan Cattering. What it does is it
19:33
Speaker 1: does research and then also does patient care. Yes, and
19:38
Speaker 1: there's an advantage, you would say, to patient care because
19:40
Speaker 1: you have people doing the cutting edge research.
19:42
Speaker 3: Yes, cutting edge research that's connected to doctors who are
19:47
Speaker 3: looking to answer questions as well as take care of people.
19:50
Speaker 1: You also have students at Moral Sloan Cattering. You have
19:53
Speaker 1: a graduate school for students, is that right.
19:56
Speaker 3: Yeah, So the Gersonal School is really one of the
19:58
Speaker 3: outstanding biomedical grad programs in the country. That our students
20:02
Speaker 3: are focused in our labs largely on basic science and
20:05
Speaker 3: cancer research. We also have almost two thousand fellows and
20:10
Speaker 3: residents who rotate the Memorial Hospital, so we have a
20:14
Speaker 3: robust educational program, although we don't have a distinct medical school,
20:18
Speaker 3: great graduate school, great training programs, nearly one hundred different
20:22
Speaker 3: fellowships at Memorial.
20:23
Speaker 1: Suppose somebody says they have a cancer that's i'd say,
20:27
Speaker 1: not a very good kind of cancer, not that any
20:29
Speaker 1: good cancer, not that any cancer is good. But suppose
20:31
Speaker 1: you have somebody's very serious stage four gleoblastoma. The advantage
20:36
Speaker 1: of coming here is you can really make a difference
20:38
Speaker 1: at stage four for somebody.
20:40
Speaker 3: Yeah, so the advantage of coming here broadly. So Number one,
20:43
Speaker 3: the outcomes are different even at stage one. For coming
20:46
Speaker 3: to a Memorial at a stage four, we certainly have
20:50
Speaker 3: the better chance of often prolonging life and having a
20:54
Speaker 3: chance to getting access to the most novel therapeutics, with
20:58
Speaker 3: no guarantee that we're willing to cure you, but we're
21:01
Speaker 3: going to give you every chance there is in the
21:03
Speaker 3: space of cancer to make a difference in your tumor.
21:06
Speaker 1: So, how does somebody become a patient somebody walks off
21:09
Speaker 1: the street and says, I think I don't feel well,
21:11
Speaker 1: maybe I got a cancer. How do people get to
21:13
Speaker 1: be a patient here?
21:14
Speaker 3: So number one, you can refer yourself and call and
21:19
Speaker 3: we will help make that diagnosis a Number two, your
21:22
Speaker 3: physician who you've seen as a primary care doctor can
21:26
Speaker 3: refer you here.
21:26
Speaker 2: Either way.
21:27
Speaker 1: I suppose somebody says, I don't have any health insurance.
21:29
Speaker 1: What do you do?
21:30
Speaker 3: We have services to take care of people who don't
21:33
Speaker 3: have financial ability.
21:34
Speaker 1: So when you are doing pancratic cancer surgery, you're not
21:37
Speaker 1: doing surgery now, are you.
21:38
Speaker 2: I still do some ser surgery.
21:40
Speaker 3: Yeah, they let me come in the operating room by
21:42
Speaker 3: permission special occasion.
21:44
Speaker 1: But if you're only doing it occasionally, can you still
21:47
Speaker 1: do surgery and really be up to speed on everything?
21:49
Speaker 2: Yeah?
21:49
Speaker 3: So I do it regular enough to know that what
21:51
Speaker 3: I do that the outcomes are not affected. So I
21:54
Speaker 3: have to As a low volume surgeon, you have to
21:56
Speaker 3: watch closely, and I typically operate with my other surgeons
22:00
Speaker 3: so that I have other senior surgeons who are part
22:03
Speaker 3: of the picture as well.
22:04
Speaker 1: What does it take to be a great surgeon?
22:06
Speaker 2: It may sound trite.
22:08
Speaker 3: Perseverance, resilience in practical terms, being able to take a
22:13
Speaker 3: blow and not having it become a permanent deformity, and grit,
22:17
Speaker 3: the ability to really turn lemons into lemonade, and to
22:23
Speaker 3: not both let discouragement or disappointment from the prior patient
22:29
Speaker 3: prevent you from taking care of the next patient.
22:32
Speaker 1: You see, you're relatively young by my standard, so this
22:35
Speaker 1: is something you expect to do for another decade or
22:37
Speaker 1: so something like that.
22:38
Speaker 3: Yeah, I would say that would be the goal. There
22:40
Speaker 3: are some things that I want to see accomplished that memorial.
22:43
Speaker 3: It's a place of phenomenal people and talent more than ever,
22:47
Speaker 3: as we talked about people getting older and the incidents
22:50
Speaker 3: of cancer really growing, I think we have a special
22:54
Speaker 3: role for the society, not only in New York and America,
22:57
Speaker 3: in the world than the role that we play around
22:59
Speaker 3: discovery and what I think is in golden age of
23:01
Speaker 3: cancer treatment.
23:02
Speaker 1: Did your parents live to see your success? You're obviously
23:05
Speaker 1: an extremely successful person. Did your parents live to see this?
23:09
Speaker 2: You know? My mother did to a degree.
23:12
Speaker 3: She saw a large part of success as it relates
23:15
Speaker 3: to both my family. She lived to see my four
23:18
Speaker 3: kids born, which was immnt since I was an only child.
23:22
Speaker 3: I think she certainly desired a larger family, and she
23:25
Speaker 3: saw some of my success as an academic surgeon, particularly
23:29
Speaker 3: for people in her purview who I treated and operated on.
23:33
Speaker 3: I just saw a man two or three weeks ago
23:36
Speaker 3: with my father who I did a pancredic cancer procedure
23:39
Speaker 3: on twenty two years ago, who's still alive. So my
23:42
Speaker 3: father has seen that as well, and clearly, who's ninety two,
23:46
Speaker 3: has seen much of my success throughout my journey as
23:50
Speaker 3: an academic surgeon and leader.
23:53
Speaker 1: Thanks for listening to hear more of my interviews. You
23:55
Speaker 1: can subscribe and download my podcast on Spotify, Apple, or
24:00
Speaker 1: however you listen.
24:08
Speaker 3: H