(upbeat music) - Hi, I'm Dr. O'Mool Gupta, and I wanna thank you for joining me on another episode of Medicine Mentors, where we interview masters in medicine, leading physicians at the top universities across the United States to learn from their experiences and derive key insights, traits, and best practices that can guide medical students and residents. - Today we're honored to host Dr. Diane Reedy Lagunes. Dr. Reedy is the vice chair of Oncology Operations, Regional Cancer Network, at Memorial Sloan Kettering Cancer Center. In the past, she served as the president of Memorial Sloan Kettering Cancer Center's medical staff. Dr. Reedy's primary focus is treating gastrointestinal cancers and developing methods to integrate molecular-based therapies into treatment of neuroendocrine tumors, as well as designing and conducting clinical trials to better treatment strategies for patients with this uncommon cancer type. She's also the creator and host of Cancer Straight Talk Podcast, which brings together national experts and patients with cancer to have straightforward, evidence-based conversations. Thank you so much, Dr. Reedy, for joining us today. - Oh, well, thank you so much. It's such an honor to be here. - You know, I feel like I'm talking to a fellow podcaster, a celebrity, it's really exciting. I wanna start early on. Talk a little bit about your childhood. Can you talk a little bit about what it was like and any key incidents that you remember that have been really pivotal in shaping your journey? - Absolutely. Well, I was born and raised on Long Island in New York. My dad was a New York City firefighter and my mom was a math teacher. So from an early age, I would say that the math part and the science part was always important, but the education was the sort of investment that my parents had. My dad was always sort of someone that taught me that being in the civil servant and his sort of line of duty while he was literally and figuratively going into the fire, I knew I wanted to help people in a similar way. But interestingly, I was raised essentially in a working middle class family. I had certain amount of money that I was gonna have to go to college and the arrest was gonna be in loans. And so when I applied to medical school, I actually didn't get in and I applied twice until I got in the second time, I got it weight listed at like nine or 10 schools. I didn't come off the weight list on any of them. And then interestingly, I decided at that point, I was so frustrated that I was like, I'm just gonna go to Spain for a year and got a job working in Madrid, Spain. And then while I was there, reapplied and got accepted to all 10 schools, which tells you how subjective medical schools and the applications can be sometimes. I was always very supported by my family, but we say half jokingly that they call me Rudy because I had to apply so many dives to get a medical school, which is a lot embarrassing, but it was also sort of a testimony, I think, to me and my interest in being a medicine. And I decided later on in life that I wanted to go into medicine, but I knew I always sort of wanted to go into something in healthcare. - You know, it's interesting. A lot of people who are listening on are pre-meds medical students and failures is a part of our journey. Some part of our trajectory doesn't go as planned. Having gone through that, can you talk a little bit about what would you have done differently or how would you have thought about it differently? - For me, I didn't have a luxury of taking a gap year. My parents were like, no, you're gonna get a job. So where's a lot of people are like, oh, my parents always told me I had to go into medicine. My parents were like, why do you wanna do that? You should, you know, get a job type of thing. And they were very proud of me that I wanted to do that, but it wasn't something that was going to be an easy, well, you know, get a job for a year and focus on a lab or something like that. So the financial constraints had me a little bit concerned about that. And so I was spinning my wheels a little bit too much, but I do think that trying to push something that just doesn't feel right was one of the lessons learned for me that perhaps moving forward, I would have if I had done it again, thought a little bit more carefully about what I really needed to take the MCAT appropriately, how I really needed to think about what schools I was going to apply for and, you know, what was a reach versus what was, you know, potentially something more realistic. - You know, and then as I now see your trajectory, I'm seeing getting into medical school oncology and then somehow now becoming the president of the medical staff at MSK, starting a podcast. I mean, you've done some things that are very different or unique to a typical physician trajectory. What has been the inspiration behind these moves in your trajectory? - That's such a great question. And I hope that one of the things that I can convey to the listeners is to say that, you know, all of us and you've had some giants in medicine on this pod before. And I think we don't recognize that a path to leadership is clearly through traditional academics, but there are so many other opportunities in terms of how we can be leaders in innovation and change in medicine. Just think about what you're doing now with a podcast and how much you're teaching people and what that does in terms of having an impact of who we are and who we want to be as physicians, like incredibly powerful and very helpful. And I think all of us have these passions that we think, oh, no, I can't do that 'cause I'm supposed to go in the lab or I'm told that I have to get a high impact paper for this journal. And for some of us, that's incredibly important. And for others, it's like, no, I just don't have that passion, but I know I could be really good at communications and education or I know I could be really good in underserved communities, whether it's in Nigeria or in Nebraska. And those are sort of moments where you're like, you can feel it. And I think we all understand what we're good at and our skills. And it's not to say that, you know, you shouldn't try for those really important papers and we shouldn't kind of get out of our comfort zone and do what's uncomfortable. But I think it's always important to sort of take a look and say, how am I doing? Am I where I want to be today? And then equally, if not more importantly, is it helping me get to where I want to be tomorrow or in the next two to five years? And I think you just have to sort of figure out what best works for you. - And what experiences have helped you develop these innovative ideas, right? Like a lot of people have ideas, but very few people are able to actually take an idea and then make a product out of it and then execute that product. How has that journey been? And how have you been able to actually bring a product out of a concept? - Yes, I think for example, the podcast was one that I had the same conversations kept coming up in clinic. And clinic with 15-minute visits and other things, sometimes can't get hard. And you often end up taking five minutes with that patient because you know you need to spend 40 minutes with the next patient who has some problem. But there were important things that patients wanted to hear about the role of nutrition and exercise and sexual health and caregivers and end of life that we don't do a great job in addressing at a society level, as well as in all walks of medicine, I think we could do a little bit better. And so I sort of, believe it or not, reached out to our communications and our marketing folks and they're like, that's not really something that we're really into doing and that's not something that we would do. And finally, I literally sat down with my nephew who is a pre-med student and we just started thinking about the different conversations that, and he was recording for me and helping me with the editing. And I started to just interview some of my colleagues and I put together about eight episodes and then I gave it to the head of marketing and I said, this is what I think we need to do. And she was like, okay, I get it. And so with their backing, I was able to make them a little bit prettier and edit it a lot better. And so it just worked out and I'm just, it's been a labor of love and it kind of took off now because I think we're sort of hitting an unmet need. And I think, again, in the world of medicine, we have so many unmet needs. And so there's not a one size fits all on how one might approach these different things. But I do think thinking about what unmet need you feel you'd like to address and then trying to find the right people in stakeholders to help you get there can be very helpful. - You know, you touch on a really important topic and I think you've experienced leadership at a time of crisis. How has that changed what leadership in medicine means to you? - In many of the leadership roles I've had but particularly during the crisis of COVID, the importance of collaboration and partnerships is something that just has to be overemphasized. It was about all hands on deck in terms of the administration, the clinical staff, the environmental services, the folks that were helping us put together the different protocols and a technical perspective from the computers to literally and figuratively putting windows indoors so that we could identify our patients 24/7 and not be potentially going in and out all the time. And it was fast and agile. And I think we in academic medicine typically, I wish the one silver lining of COVID was how agile we were. You know, now it's like you can't do anything without, you know, 18,000 people saying no and no one saying yes. During that time, it was just everyone worked together in this harmony that is actually rare. We don't get that as much in leadership anymore, but it's possible, you know, but it definitely takes a partnership and a collaboration and understanding of all the key stakeholders, what we're really trying to do and change. And I think it also takes inspiration, you know, like I think that we all want to inspire each other to know that we have common ground here and that we want to move towards something, you know, important to change and implement. - Well, this is phenomenal. It kind of makes me think about why they focus so much on building teamwork as a muscle all throughout medical school and residency. And we don't really connect it to, it's the key skill of a leader, right? We think of teamwork as being different from leadership, but effectively, that's what we're doing. - Exactly, yeah. And I think that leadership, you know, we and medicine are very, you know, it's a gift and a privilege to be in the roles that we're in, but I do think it comes down to an understanding of we are responsible in some ways to lead by example. - No, this is beautiful. This is really beautiful. When I think of what you've talked about so far, I'm hearing passion, I'm hearing innovation, I'm hearing leadership. So I'm getting a really good feel of what success means to you. But if now I were to take you to the other side of this coin and talk about failures and talk about challenges and those moments in medicine that really taught you something, talk to me and give me a couple of stories or anecdotes that shed some light on that side. And what that means specifically to me as a resident, like what I can learn from that. - So whenever I start a lecture with my residents, medical students, fellows, both surgical, medon, great art, I like to share a story. It's a hard story to listen to as clinicians and even, and I do for nurses and APPs too, but I share it because it's honest and transparent about some of the challenges that we're gonna have in medicine. And so my story starts, I was probably attending maybe two years and I was caring for an amazing woman. She understood that she was getting sick and her husband, who would be in the room with her, was very angry. And I think that in retrospect now, I learned so much from the experience about why he may have been angry, but at the time I didn't really recognize and I was really focused on the patient as opposed to her caregiver. And room number one is like cancer is a family disease, any medicine disease problem, but I think recognizing that in retrospect, I didn't. He would start to get angry and then she would say, you need to leave the room. And so then he would leave the room. And then I was like, okay, well, he left the room. And so then we would have these conversations on what was important to her and what she would want. And this probably happened at least two or three times where again, he would leave the room. She opted to go on hospice, but probably about three months into hospice she passed. And her husband called and essentially said, I killed his wife and that he was going to do everything he could to make sure I never practiced medicine again. And I was obviously devastated. And so to make a long story longer, a couple of months go by, I don't hear anything. And then one day, it was a Saturday. And one of the nurses, one of the head nurses on my floor, which is like one of the floors where GI cancers took, oral patients were called and said, Dr. Eddy, there's a protest outside in Mexico. And they have your picture of the poster. - Oh my God. - And there were about 30 people rotating your avenue with pictures of saying that I did wrong by this woman. And I wanted to die because I couldn't get over that this was happening. And then I immediately called my mentor, which I could talk about a little bit later, many salts who was an absolute amazing soul. And anyway, that protest went away, but that caregiver ended up staying in front of the hospital for eight months, eight months. And then finally left after eight months, just one year after the anniversary of her death, he just left. The moral of this story though, was one of our chair of psychiatry, who's also just an absolute extraordinary soul. He said, you know that was all about his own guilt and was never really about you 'cause he had talked to him a lot. And I thought I should have focused on the caregiver more. We do not focus on caregivers enough. I should have brought in patient rep. As soon as I saw that he was so angry, I didn't, I was so focused on the patient. And the patient and I knew where she was going and she was gonna be okay. I mean, she was comfortable with the decision she was making, but there is, I would say responsibility to at least be aware of those types of things. And so I share the story, not to say run now away from medicine, but to say there are lessons learned in those failures and in those challenges of how we can be better communicators. But at the end of the day, it was sort of a moment that I can reflect now and say, had I done things a little bit differently, maybe you wouldn't have been out there free months. - My God, my God, what an experience. And I'm shocked at how positive you are in coming out of it and actually taking something out of that experience. And that is such a huge lesson for me. Now, let me push on that 'cause now you've hit the red button of the podcast, the call to Lenny Saltz, right? How quickly that call was made. And you know, reach out as a theme we talk about incessantly on this podcast, but talk to me a little bit about why was that call made so quickly? And what's been the overall impact of mentors in your life and any wisdom you have around mentorship for us? - Absolutely, so yeah, I mean, he was the first, but before I call my husband, I called my mentor, I said, "You're not gonna believe this." And he's very witty, so I can't remember exactly what he said, but there's something like, oh my, oh well, that's something new. You know, and I thought, oh my God, I'm like, oh my God. (laughing) So, of course, I laughed. And, you know, I think the importance of mentorship on so many levels of what we're trying to do and what can happen, the good, the bad and the ugly, it's the mentorship that helps you through that. And that could be a mentorship for life, like Dr. Lenny Saltz is for me, or it could be in that moment. So we don't have to have the same mentors all the time. You have to feel out what's the most appropriate moment for you and the mentorship there, but at least for me in that moment, you know, Lenny's always been a person who first taught me how to think critically, both in the clinic as well as in research, you know, he's somebody that on the research side had said to me, if you're gonna connect a clinical trial, think carefully about what is the clinical significance, not the p-value of the statistical significance, but like, what are we trying to do here, you know? Don't throw together drug A and drug B, like 95% of us do in the world of medicine sometimes. Let's be rational and thoughtful about that. - You know, you talk about some great mentors. And if, let's say, I want Lenny Saltz in my life, right? What are some things I can do to help attract that kind of mentor energy in my pathway? Not everyone is lucky enough to come across, but if I were to make some efforts, what are a few tips? - Yeah, I mean, I think the mentorship piece is a two-way street, right? And sometimes it's like everything in life, it's about timing and it's a feel, right? Like, how do we choose the right medical school, the right residency? It's a feel that we have. And I think, you know, and depending on the type of programs that you have, at least for fellowships, you get to sort of often see different attendings and residency as well. And sometimes you say, oh, I really want to emulate that. And sometimes you say, oh, I'm never going to do that. But that's important learning, right? So you get an understanding and feel of how that person practices and the research that they conduct. And then I think it's a conversation with that person. I mean, I had, you know, another person that I thought would have been wonderful to be a mentor. And I could tell you, I sat down and I was like, oh my goodness, it did not go well at all. And I thought that the person did not appreciate what I was trying to do and understand. And it just didn't gel. And that's okay. 'Cause, you know, I went out to the next one. So I think the mentor has to be interested in wanting to mentor you. 'Cause you may be an absolute rock star, but if they don't have the time, then it's not going to work. And so, you know, I think that you want to make sure that that relationship is one that you feel like there's going to be a trust, a social contract, if you will, that you're going to put your heart and soul, but they are too, back into it, that they're going to give you the time and the dedication that you really need to do whatever, you know, that moment in your mentoring requires. 'Cause you don't necessarily need someone like Lenny who's going to be a lifelong mentor at any one time. But I do think as you go through life, the acknowledgement that that person is important to you and that they want to be able to play that role for you is something that's going to be important to think about. - No, this is great wisdom on mentorship. You spend a lot of time, not only talking to patients in the clinic, but talking to them on a podcast and really diving deep and getting to know issues that affect them. So if there's one thing that you see trainees, fellows around you doing when they're walking into the room, that you would advise us to change, to think more about, something that's critical, that you've just seen, take the physician-patient relationship to the next level. What would that be? - So I joke around, give warm hugs. (laughing) - I do think the connection is so critical. We are humans and we're all having our human experience. And when you are being cared for by a doc, whether it's in a primary care role and there may be anxiety going on about high blood pressure, but that's a real issue for that patient or to the other side where you're about to have surgery and they're terrified or you have stage four cancer, these are all real concerns and fears for the patient in front of us and their family too. And I think that you could be the most brilliant person in the world as it relates to cardiology or gastroenterology or neurofrology, but if you don't make the connection, the patient's not gonna know that you care. And that's what really matters most, in my opinion, for a patient in a loved one to see that you care, but it really does come down to that connection of being able to say, I'm here and I'm listening and I wanna know what matters to you and I wanna be able to help you. - Beautiful. This has been such a delight, Dr. Reedy, really enjoyed having you on. I like to summarize a couple of things that I'm taking away. There's so many that you shared with us. And I'd say the first pearl and I'd like to group it together here 'cause I think you've talked on three themes in the beginning, passion, innovation and leadership as being kind of the integral values as I see a leading your journey. And a couple of words that I'm taking away, right? When we think of passion and we think of, okay, what should drive the decisions that I'm making? You tell us that true impact is not just the impact factor of a journal. The true impact is from our passion and what we're passionate about is gonna drive that impact. And so what's really important are the couple of questions that you've asked yourselves throughout your career? How am I doing? Am I where I need to be right now and where am I gonna be in five to 10 years? And having that recheck and calibrating passion, calibrating the impact that we aim to have. And so I think that that's such an important theme that you've given and just really wise to continue to stay on this track of creating impact through our passion. So I'd say that's the first. When I think about innovation, something that was just beautiful that you shared with us is innovation is not just a smart idea, really great thought. Oh, what if? You had an idea, you were told that we're not moving forward with the idea and then you went and created a product and gave it back. So really build the idea, build the prototype, don't just start and stop with ideas. And I think that's the key ingredient of being innovators, something that some of us fall short of, and the so many ideas that we have and I think we can take inspiration from this example. So that's the second thing. The third thing is there's so much focus on teamwork, teamwork, teamwork. And oftentimes we think that it's like opposite to leadership because leadership is about me and I'm leading and people are following. And teamwork is about all of us working together. But what your example of MSK leading the staff during time of COVID and a crisis situation taught you, the one thing that you got out of it was how important teamwork was in actually achieving positive outcomes. And I feel like that's so big coming from a leader saying teamwork was actually what got the work done. It wasn't the leader who got the work done. It was the team. And so I feel like focusing more on this as a core muscle that all of us can build when we're at the stage of needing to use that muscle, we're able to use it. And we're so lucky in the hospital every day, we're working in teams, none of this is in isolation. So I know that was a really long summary of the first part of what I learned from you, but that's the first passion, innovation and leadership. I'd say the second kind of dimension that I've picked up from the interview is about how to think about mistakes in life. Even mistakes that really aren't mistakes, like we could completely argue that it's somebody else's fault, but still taking the time to change our perspective and to think back, how is it that we can make the most out of this and actually learn and change practice so that we do better the next time? And I feel like the example that you shared with us, I mean, I've never heard something like this. It would be frightening for me if I were to go through this. I totally can experience the emotions. And then I think the podcast would not serve as purpose without reflecting on mentorship. And I feel like you've given us the time it took between you getting the call from the nurse and you calling Dr. Saltz, that time interval is reflective of the power of mentorship in our lives. And I feel that if all of us had somebody like that, it doesn't have to be in medicine. It could be somebody in your own family. But just having somebody who you can call that quickly with the assurance that you're gonna get some vital piece of advice that's gonna help clear the pathway forward, I think just explains how important mentors are and making a proactive effort to have more of them in our lives. And so that's third piece that I'm taking from you. So, so fortunate to have you on. I've learned so much. Thank you so much. - Well, thank you so much. Keep going. I think I'm listening and I love it. It's all good. - To our audience, thank you for tuning in with us here on the Medicine Mentors. Thank you for joining us as we learn from the Masters of Medicine. (gentle music) (gentle music) You You
