Essential Wisdom: Inspiring Future Female Physicians

Ann LaCasce, MD, MMSc - Hematology and Oncology

January 30, 2020 Carrie Dubeau Season 1 Episode 12
Essential Wisdom: Inspiring Future Female Physicians
Ann LaCasce, MD, MMSc - Hematology and Oncology
Show Notes Transcript

Help me welcome Dr. Ann LaCasce! Dr. LaCasce practices medical oncology at Dana Farber Cancer Institute in Boston, MA. She is the Director of Dana-Farber/Partners CancerCare Hematology-Medical Oncology Fellowship, an Associate Professor of Medicine at Harvard Medical School, and an Instructor of Medical Oncology at Dana-Farber Cancer Institute. Dr. LaCasce received her MD from Tufts University and went on to complete residency in Internal Medicine at Brigham and Women’s Hospital. She earned her fellowship in Hematology & Oncology Dana-Farber/Partners CancerCare. Her academic interests include Hodgkin/Non-Hodgkin lymphoma and the study of novel treatment agents. She is also active on the Alliance Lymphoma Core Committee.

spk_0:   0:05
welcome to essential wisdom. Inspiring future female physicians. A podcast for engaging and informing the next generation of women in medicine. My name is carried a bow. I'm 1/4 year medical student at the Frank H. Netter, MD. School of Medicine at Quinnipiac University. Essential Wisdom is a podcast for discussing the joys and the challenges off being a woman in medicine through the sharing of stories and advice by women who mentor us. Take a seat with me at the desk of the mentors, come along, tow, walk the holes of the hospitals to experience residency and life as a physician personally, as we get to know these phenomenal physicians and scientists. Hello, everyone. And welcome back to essential wisdom, inspiring future female physicians. My name is Carrie, and I am very excited to welcome you back to essential with some this week. Help me Welcome Dr Anne the case. Dr. Lee Case practices medical oncology at Dana Farber Cancer Institute in Boston, Massachusetts. She's the director of Dana Farber Partners, Cancer Care Hematology Medical Oncology Fellowship. She's an associate professor of medicine at Harvard Medical School and an instructor of medical oncology at Dana Farber Cancer Institute. Dr Lee Case received her MD from Tufts University and went on to complete residency in internal medicine at Brigham and Women's Hospital. She earned her fellowship and hematology and oncology at Dana Farber Partners Cancer Care. Her academic interests include Hodgkin's and non Hodgkin's lymphoma and the study of novel treatment agents. She's also active on the Alliance Lymphoma Core Committee. Dr Lee Case Thank you so much for being here to join us. Welcome to essential wisdom. We'll start this episode by asking you to tell us a bit about your path to becoming a female physician.

spk_1:   2:06
I am originally from Downey's Maine. My dad was an internist who, um, had trained in Boston, and I started off in oncology, went before it really was a specific sub specialty, and he worked at the V A in Jamaica Plain here in Boston. Ah, and they had very few options for patients with cancers, and most people died miserable deaths because we didn't have good supportive care, either. And I think that he got early burnout and decided he really wanted to have a more community based internal medicine practice. So he moved up to Maine, um, and was Ah, physician there for many years, and I worked for him over the summers and really admired his How much he got out of his work in those relationships he had with patients. And, um, early on, I was drawn to science and decided I want to go to medical school. So I sort of followed in his footsteps all the way along and went to Boden, where everyone in my family went and was pre med, um, and enjoyed the coursework. But also, um, sort of fell in love with art history. I needed to fulfill my requirements. Aren't that Sounds interesting. I'll try that and really enjoyed it. And around that time in the pre meds in my class were so intense. And there was a guy who stole my organic chemistry notebook. And I thought, God, do I really want to work with this kind of intense person my whole career And maybe maybe the arts would be something I should really look at a little bit more. So I got an internship at ah Gallery in Boston, just completely randomly and contemporary. Already knew nothing about contemporary art in the gallery. Um, was on the upswing uh, and moved to New York. And so I moved to New York and work their managing the gallery, which I loved. It's a lot of fun, but it's sort of after a couple of years, I realized that, um, you know, these competitive political work environment existed everywhere. And, you know, this young artists that you would think purely based on talent would, um, you know, become very successful. It was much more complicated than that. And I decided I was ready to go back to medical school. So I Look, um, I had no idea what I was doing. I was no longer because I didn't go through pre med at Boden. I didn't have a committee. And I, um, just sort of actually hadn't taken English in college because one of my high school teacher sort of ruined me on English forever. And so I look at what? What programs don't have an English requirement. So that's what I applied to, and it was sort of willy nilly, and I, you know, needed to get letters of recommendation. And one of my letter writers was on sabbatical, so it took a while for that. Thio come through So I sort of started lates and thank God I got into tough. Um, that was a really good fit for me. They were really interested in my having had an unusual path on, and I just totally loved it there on and got interested in. He mocked very early this'll woman. There was a hematology course run by a really amazing ah, woman who was ah, lymphoma specialist. And I just thought I want to be like her. And between that and looking at slides of, um, pathologic specimens and blood smears, it was very much like arch pattern recognition. And I really am very visual, so All right, this is what I want to do. And I got lucky. I worked in a lab, and then I ended up at the Brigham, where there's a lot of oncology. So, um, and lymphoma just kept rising to the top. Is the area want to focus on? So I got really lucky.

spk_0:   6:02
Would you be able to talk on your interest? I I'd be curious as a person who's interested in art in visual learning and design. How does research kind of fulfill that tree? You? So, um, I don't know

spk_1:   6:18
that my research unnecessarily, um okay. Applies directly to the visual. I think being an oncologist definitely does, cause we look at a lot of image and love imaging and looking at, um, specimens, you know, for what is the lymphoma look like under the microscope. And that's so much part of how it categorized disease and diagnose disease. So that part I really like visually. But my work in trials, clinical trials is more about treating patients when you new therapies or combinations. So it doesn't directly apply there. But I've job every day, is very visually oriented. And, um, in looking at scans and looking at those diseases responding,

spk_0:   7:09
Yeah, that's very cool. I wouldn't have thought of that. And I think that that's a really unique aspect to your story. I left that you shared it. Thank you. Sure. Did you have any specific female mentors in the process?

spk_1:   7:24
You know, I really don't feel like I had much in the way of, um, direct mentorship. Um, until I was junior faculty. I had I had a mentor when I was a fellow, and we had to do you know, we did research, and I did not really have a full understanding of where I was going and what I needed to be doing. Um, and the woman that I worked with his grade, but she's a laboratory based researcher has been very successful, but she didn't do that kind of work that I wanted to do, so I sort of feel like I, um never really had someone say Okay, here, here's where you want to go. Here are the things that you need to do to get there. I just sort of peace mailed it and, um, I had some very good mentorship along the way, but it was very sort of the whole notion of the mosaic mentorship. And eventually it was really more, um uh, peer mentors who were really helpful to me on not necessarily here. But I met a lot of the women who do particularly women who do lymphoma nationally through different organizations and meetings and things. And we sort of band together. And it's been there, you know, bouncing ideas about, you know, applying for things, or career sort of goals. That has been most helpful to me. So I sort of kind of bumbled my way along and got lucky a number of times. And then, you know, this, um, Toe be the program director for this fellowship program than opening came up. The guy ran the program 35 years and was my program director whose amazing but pretty intimidating and I thought there's no way anyone would ever choose me for this job. I had been a chief resident at the Brigham and then had done some, um, had been an assistant program director at the Brigham, which basically meant I met with some some of the residents and wrote letters of recommendation. But it wasn't a very intensive sort of role, but this woman actually was a chief of hematology, really encouraged me to apply. So okay, apply. And you know, I got again. You know, I think thes education jobs are, you know, this is a small subset of people who really want to pursue those, and I wasn't exactly sure what it even entailed. But I ended up in the role, and it's been really fun and great, and I think I see one of my most important roles as's program directors to make sure that people understand career development and mentorship because I think that's critical to getting anywhere in academics.

spk_0:   10:06
With that being sad, would you spend a couple of minutes talking on what you're job looks like? How does your time be? Become partitioned between patient care, academics and research.

spk_1:   10:18
So I see patients two days a week, two full days a week in the clinic. Um and then my fellowship roll is supposed to be 40% of my time on, we have about 50 fellows. We have the largest human fellowship program in the country because we're enjoying program with MASS. General. So that takes up a lot of my time. And then I also d'oh clinical research, and that fills in the rest. Um, so I I work a lot. I work, you know, any of my academic work, like writing papers or reviewing things or reading I mostly have to do at home or on the weekend because, um, my week's often are so busy with meetings once you are in an administrative role, you get tapped in to be in meetings. Um, and I think as women, you know, there's, ah, all committees need women. So you end up getting asked to do a fair bit. Uh, it's important to figure out what things you can say no to, but I kind of like being part of the institutional infrastructure and really knowing what's going on within the department of, ah, medical oncology. So I probably don't say no enough. Um, so I work a lot. Uh, but I I love the balance of the different things I do.

spk_0:   11:37
That's that's great. Thank you for sharing that. Looking at that through the lens of being a woman, what are some of the challenges that you have faced along the way? So, uh, you know, I'm pretty

spk_1:   11:53
fortunate in that, Um uh, my husband is has a much more flexible now than I do. So, um, he can and he loves to cook. So he does Basically all the cooking. I don't like to cook, and,

spk_0:   12:08
uh, pretty easy. Um, we have a nanny.

spk_1:   12:12
My son is just going into eighth grade, and I only have 11 son.

spk_0:   12:16
So, you know, we have

spk_1:   12:18
Ah, nice small family, which I got a late start on having kids of my son when I was 40. Um, so you know, I think it's all about how being ableto support your work and figure out howto, you know, be in a family and, um, you know, spread the work around and, you know, I I got lucky. I think the challenges are, you know, trying to feel like you're doing a good job as a parent when you're really busy and, you know, working at home frequently. But I think we've, um and we tend to spend a lot of time as a family skiing in the winter. So we'll go away on the weekend. I can work in a car, which is agree thing to be able to do so I can get a ton of work done driving to the mountain or in the summer. We have this little place in Maine, so we go up to Maine a lot. I could get a ton of work done in the car, which is really helpful.

spk_0:   13:15
So I have a pretty

spk_1:   13:17
unique situation. I think in that, um, I have a lot of support, but, um, you know, I don't have family in the area, so it's mostly just are

spk_0:   13:27
you know, I think you

spk_1:   13:27
have to figure out what things are important to you to do. and outsource other things. And when you're starting out as junior faculty, sometimes that financially could be a little bit difficult. But, you know, having someone clean your house or, you know, if you don't like cooking figuring out ways Thio have food prepared for you. You know, these are really important to keep you saying so that when you're home, you could spend the time the way you want.

spk_0:   13:53
Yeah, and that That brings me exactly into the next question. It's really has to do with how. Then you set your priorities and decide what you want. At each period, I think of your life, and so I tend to just ask like, how do you set your priorities? And if if you wanted them to be different, how do you wish you said, um,

spk_1:   14:11
you know, I think I'm probably not as deliberate about setting priorities. I think probably the women I know it's it's similar. I think it's a matter of balancing the things you want to do, and you don't necessarily say, Well, this is my I mean, of course, my son and my family is my number one priority, but I don't I don't think of it in that way. It's really about how can I juggle these things and figure out how to come up with a a way of getting all the things done I need to do and want to dio within the time that wake, you know, So it's not as deliberate as you would think. I you know, I like doing all the different things I do. And sometimes it becomes clear that I need to say no to something because I won't be able to prioritize the things I want to do. But I probably should be more deliberate, but I'm sort of more about, you know, Okay, I confined the niche to get that done, and I'll do that. And then I don't know. It's probably not as, um, distinct are thoughtful and answers.

spk_0:   15:18
What are your thoughts on the capability to achieve balance and what is balance? I think balance is

spk_1:   15:28
different for every person, and you sort of have to figure out for yourself what you know what's tolerable and what makes you happy. And, um, you know, I think I don't know. It's, um it's a hard question. Um, and it's very individual, you know, I think when people come in who are interviewing for fellowship and that's the first question they ask, it's It's always a little bit weird because I think, you know, I'm pretty driven to do the work. I do, and I get a lot of satisfaction out of that. And I think you just have to I don't know howto you have to figure out what's important to you as an individual, and if that is all right, I know I want to be home with my kids when they're young. Then you pick a career and you structure that career around that priority. And I think that that is definitely feasible for everybody wants to do it. I think when you are, it all depends on what you want to do. I think in my career tracks, you know, I got the advice. Don't work part time. When I was coming back after I had my son, I had so much fun on maternity leave, you know, I just hanging out. Do you know, I just It was so much fun being at home. Um I thought, Well, maybe I wanna work for days a week, and then somebody a very senior woman here said, Ah, at this women in medicine thing don't do that because what will happen is you will work full time and you will get paid part time. And, you know, in this environment where everybody works really hard um, you know, you just do your saying you keep your head down. I think when you need Thio leave work to go do something that's family related to just do it and you don't make a big deal about it. You know, I noticed my male colleagues leaving all the time to do family related or kid related things, and they don't make excuses. They don't make a big deal about it. They just do it. I think women tend to feel guilty. I know. I d'oh. You know, I feel like if I leave it 5 30 I have to make a comment about why I'm leaving early, you know? And that's just my own mind set, which is ridiculous. Um, so I think it's really you know, you have to figure out for yourself what's gonna work, and you know, there's some and I think we need Thio ask. You know, if you're an academic medicine, and you wanna work part time? I think you have to think about it and, um, ask the question. Is there a way to do this? Can I share a job? You know, I think we need to be more open minded as we move forward about how to structure jobs. Um, and there's some career paths that it may just not be the right career past, if you know, you know you want to work part time. They're certain types of jobs where that may be very difficult, though you may be able to do it part time and then sort of re integrate. I have friends who are, you know, superstar Lymphoma Docks, who took a slower path to academic promotion early to spend time with their kids and then once their kids were older than they really ramped it up. So I think it's feasible. But you really have to, you know, not be afraid to ask. Um, you know, once you're in a position where you can negotiate,

spk_0:   18:49
yeah, absolutely. In terms of how women learn skills to negotiate and the acts to do that in their career choices, Um, what are your thoughts on, like, courses or skills classes to in order to do that. And should that be a part of our medical education?

spk_1:   19:09
Yes, it is really important. Uh, you know, both learned leadership skills and communication and negotiation skills because I think that is something that is not innate. Um, and it's something that can be learned and understanding. You know how you approach, you know, doing some of these We have, Ah, a woman here who heads human resource is. And I've had the unfortunate to work with her on Cem, different issues that have come up. And she does the strength finders. It's sort of like a, you know, Myers Briggs kind of inventory of what? Your strengths. But it's really more towards how you work in a group on, I think, understanding that about yourself and then figuring out how how to work on promoting yourself and how to have good communication skills, how to give feedback, how to receive feedback. I think those are all things that in the past it was just sort of assumed that you just kind of figured out as you went along. But I I think that people really need formal training in order to to do it well and formal training and probably practice. You know, these interactive role playing things that we all hate to dio myself talking list. But you know, when you do them and you're forced to do them, it's very obvious that, you know it is a learn, a ble skill set and important to learn. So I do think that needs to be part of the curriculum in med school and and particularly for women.

spk_0:   20:36
Yeah, definitely. If you had a piece of advice for women who are deciding upon their career either pre med or medical school, what would it be? So I

spk_1:   20:46
think it's seek out mentorship, um, and career guidance early. And don't be afraid to ask people. You know, everyone loves to tell their story. So, you know, asking starting out like, you know, when you meet with someone who's a potential mentor, asked them their story. See how they got where they are and what were the, you know, pivots along the way. And I think that goes a long way. And then, you know, I think, formally asking for mentorship and career advice and then having regular check ins with people as you go along instead of doing it in a sort of, um, organic way. I think having particularly the further along you get and the more you know when once you start to really start planning your career and your research agenda, I think having regular meetings with you know, at least an informal agenda of the things you want to talk about and having a sort of agreement between the mentor and mentee about what you're both going to bring to the table. So if you're working on a project together, okay, I will. As the men t I will turn around this in, you know, one month and as the mentor you say OK, when I get something preview, I will get it back to you within a week. And, you know, I think really being very deliberate and, um ah, upfront about what the expectations are on both sides is really important. But I think mentorship is is critical. I think almost anyone that you've talked to in medicine is going to say that it was a person or persons along the way who really got them interested in a career and really made all that difference in there developments? Absolutely.

spk_0:   22:29
Yeah. Thank you for sharing that. The idea that being in a mentorship relationship is important is I think, not enough at this point. And what you're saying is that you have to understand how to have a productive, But I really should ship with your mental wreck. It how to be a good meant t howto follow up effectively in set goals. And I know that that's come across in a lot of, like, mentorship literature recently. And I think that really good important point. So thank you for bringing that up. Absolutely. Thank you, Dr Lee Case for Oh, my pleasure on this. Yes, this was absolutely fabulous conversation. I really appreciate you taking the time. Of course. Thank you again, Doctor. Look, case for coming and sharing your thoughts here at essential wisdom, inspiring future female physicians. What a great opportunity this was for us to talk about how we can explore the things that we love and allow those to integrate into our career and into our lives in ways that we may not have expected them. Thio, I absolutely loved the chance to talk about your interest in art history and how this continues to develop in your career and hematology and oncology. I hope that as listeners out there, you're really enjoying hearing some of these really unique and interesting stories and that this is possibly informing some of the way that you think about your career development and what your passions and interests are. I hope you'll come back and continue to listen with us for the continuation of this podcast season. We have an episode coming up with an internist, and then that's followed by cardiology, and we will end out our season with a bringing it all together episode where I'll tell a bit of my story and we will discuss some of the themes that came together throughout this podcast. If you're interested, please check us out online. We have a website essential wisdom inspiring physicians dot com. That's essential wisdom inspiring physicians dot com All one word. Please check it out. It has really great images of the quotes and of the women that we've been able to talk with throughout this podcast, and I hope that you'll find that a fruitful spot for you to find out some more information. So thank you again for joining us. We will speak with you again soon