Episode 1: The Livestrong Cancer Institutes Clinical Team

[0:00:00 Speaker 0] We’re a resource for learners, including every member of the live strong cancer institutes on track Educational pipeline, from middle school to residency. We’re growing collection of interviews, talks and experiences the uncover the myths and the uncertainties of cancer and careers and cancer in order to empower and inspire generations of thinkers and leaders. This is cancer uncovered, uneducated, in and empowerment podcast by the live strong cancer institutes. Hello, This is Kristen Win, and I am part of the Live Strong Cancer Institute at the University of Texas at Austin Del Medical School. The live strong cancer institutes is a brand new cancer center in Austin, Texas, that is here because the live strong foundation gave a generous gift to Dell Medical School to start a cancer program that would revolutionize patient care and experience in order to make that a reality. Here, Adele, See, I we conduct cancer research. We treat patients in our clinic following the call model of whole person care, and we educate students of all ages and walks of life, which is why you’re hearing my voice right now. This is our very first episode of cancer uncovered an education and empowerment podcast the L. C. I creates educational experiences and opportunities for Central Texas students and teachers from middle school through residency, and we’re thrilled to extend our work beyond the learners were able to reach in person. We hope this monthly podcast empowers you to follow your aspirations of a career in health care and

[0:01:45 Speaker 2] cancer.

[0:01:47 Speaker 0] All right, now that we’ve met, we’ve got so much to share. Let’s get started in full transparency. After all, we are cancer uncovered. We are premiering this podcast In a season of unrest in this nation and across the world, we have gone through at least a half dozen iterations of what this first episode should be about and what we want to share with you during this time. This is an education and empowerment podcast, and in taking that title seriously, we will always aim to provide honest, relevant, resourceful perspectives and information.

[0:02:33 Speaker 2] Our

[0:02:34 Speaker 0] fearless leader, our department chair Dr Gail Eckhart, built this cancer center on the idea that we are a team of teams that no job is too big or too small and that every team in the cancer center is of equal value to the whole department in this episode, you’ll hear about the incredible work of our clinical team, the people that care for and treat those facing cancer and also facing the cove in 19 Global Pandemic. The live Strong Cancer Institutes Clinic with UT Health Austin opened its doors in December of 2018 l. C. I is a little different than most cancer clinics. Following the call model of whole person care. I’ll have an Courtney Advanced Oncology certified nurse practitioner explain.

[0:03:22 Speaker 2] I didn’t practice my elevator speech, and I haven’t done it well. But, um, so you know, I think that what I normally explain to patients is that, you know, our model is a little bit different than other physicians offices. And I usually say something like, You know, normally, when you go into an office, you normally just see the physician. Or maybe you just see the nurse practitioner, maybe just two of them, and that’s usually about it. And then often they’ll say, You know, you could really use, you know, social worker. You could really use a dietitian or you could really use this. And then it’s sort of like, Well, we’ll find this person somewhere, right, And I think like so are what we are deemed The SWAT team is this, like, mobile, completely comprehensive unit. That sort of is able to be deployed at any time. And so really, the whole idea is that we have this whole support team in addition to the physician. So we usually explained that the physician holds a really, really important role in the care of the patient for oncology. If I usually say, um to patients like there’s a whole lot of other stuff happens besides just your chemo in your cancer, you have a whole life that we have toe help, you know, support. So that means you still have, like working your kids and your dogs and laundry and like bills to pay. And you still have all these things to try to coordinate, and that’s where our team comes in. And so we’re able to really help with the psychosocial and emotional and, you know, relationship component. And how How does your marriage change with all this, like, how do you know in the relationship with your kids and and what do you do about fertility? And what do you do about your nutrition or advance care planning? and the ability for us to be able to have these conversations as a team when you’re literally on the same phone call. I mean, that is really unheard of, like it doesn’t happen that you’re actually able to debrief as a team. And I think a lot of you know, the cancer centers that do have some of these components of other providers, you know they have them, but I think the difference is they don’t all come back to the same huddle room in the morning and in the afternoon and, you know, sometimes in the evening. But let’s be real. We all work all the time, but I mean, I think like you’re the differences, we’re able to talk about patients in a very different light with this collaborative approach on DSO, really they I mean, I hope they feel like they have a whole team besides just the medical oncologist, um, and so on. And so it’s been really cool because we really, truly have deployed in a mobile fashion, be a zoom, and so a lot of those zoom calls we have all you know, five or six of us on with the patient and their family in another city

[0:06:12 Speaker 0] and is referring to the changes recently made to care for patients during the Cove in 19 Pandemic. Let’s let her talk more about how telehealth and using platforms like Zoom is changing the game for health care.

[0:06:25 Speaker 2] I have no doubt it’s gonna look different. I think that, you know, telehealth. You’re also talking to someone who is very passionate about telehealth even prior to this. And so I definitely coming from a different lens. And I was very excited, you know, prick a bit. And so I have no doubt that this is going to change healthcare. I think that, you know, we really have Thio rethink what delivering care looks like. And I think that you know, patients. There’s a lot of patients who are very, very happy that they’re able to see their provider. I think one of the coolest things is being able to see patients you know at home, and let’s say their child is in another state or city or whatever, and they want to be able to participate in that call with the team to make sure that they have a big picture that has been one of the best things. And I think anyone who has experienced their parents being ill and, you know, I’ve dealt with this personally, living in another state. It is so hard to get a good sense of what’s actually happening. And now being ableto like Zoom in, you know, family members, beautiful. I mean, that’s been really cool. I think there’s always gonna be that little bit missing, right, like things that you know, hug a lot of my patients before they left. And so there was, like just that. Little bit of you know, there’s always something that changes with one physically in person, right? And so I think that it’s been really great for the patients that we already have that really personal relationship established. And now we’re moving over Zoom. It’s been a little trickier for patients who were meeting for the first time on Zoom, and so I and this is like we’ve never done this before, literally as like a health care system. So I think it will be interesting to see, like what happens after we meet them in person. So what is it like going from his newme relationship only to now being in person. And will that be better? Worse? I’m not, You know, I’m not sure. Eso eight You know, on the flip side, I get to see their living room every I’ve seen so many ceiling fans, right? I mean, I get to see, like, their their life and their dog. I mean, like, that just doesn’t happen. I think there’s also an element of humanity that we’ve been able to see. I mean, like, All right, let’s get real. So this morning I had a call with this patient who is a transplant patient, and we were talking about the meant, you know, the mental benefits of having a dog. And he said, Well, I only want a non setting dog. So here I picked, I reached down, I grabbed my poodle mix my little mini poodle mix, and I sit here. Here’s an example of a poodle dog I would like that did not happen right? And I think like that. Then we’re able to connect over my poodle dog that that’s another level of connection that we have as a provider and patient that I would wouldn’t be able to do in person. So I think like it kind of goes both ways, um, with establishing a different type of personal relationship,

[0:09:30 Speaker 0] I was lucky enough to catch a few other members of our busy clinical team and get them in a socially distanced conversation altogether. Hi, I’m Amanda Matthews,

[0:09:39 Speaker 1] and I’m the oncology nurse here. It live strong cancer institutes.

[0:09:42 Speaker 0] Most of what

[0:09:43 Speaker 1] I do is on the phone. During my day, I made triage calls. Is they come in or I’m a set up and coordinate some of the procedures and things that are patients need. I do see patients when they’re in the clinic, at times when they need procedures or lab draws and and things where I may be assisting. But for the most part, I really do a lot of telephone work in triage. In such

[0:10:04 Speaker 3] Hi, my name is your arms. I’m a guest for internal intestinal medical Uncle Largest um, and I, also as a clinician scientist at the list from Cancer Institute. So I look after patients with the gastrointestinal cancer and specialized in medical treatment, and also I do research in pancreatic cancer in the lab. I’ve been with the Live Strong Cancer Institute for one year and three months.

[0:10:31 Speaker 4] Hi. My name is Monica. Um, the medical assistance for that strong. Um, I’ve been here for the famous An like, a year and a half, almost two years since the beginning. That clinic open. I’m pretty much in the first person or one of the first person that the patient sees when they come to the clinic. I do. I room patient’s vitals, um, go through like, pretty much all their intake medications, allergies, and I’m also here and there and get records for patient on. Make sure like that. I’m everything is ready for the provider when they see

[0:11:08 Speaker 2] the patient. Physically.

[0:11:11 Speaker 0] Since we’re investigating cancer careers, I asked Amanda, Jaw and Monica about the best, but also the most challenging parts of their work. The best part of my

[0:11:21 Speaker 1] job, I feel right now, is really that I get to see kind of everything as it goes, a lot of on college or a lot of nursing jobs. You kind of jump into patient situations and then you’re out of it as well, so you may only see them for a few days if you work in the hospital or you may just give chemotherapy if you’re in the infusion center and then you don’t see a lot of the patient outside of that. And so my current job actually get to be a part of the patients team from start to finish, as as I can kind of follow along and see how they’re doing and help them through everything that goes on. The other part of that is our program, specifically is trying to do something very different in medicine, and that’s exciting to see how we may be able to change just medicine going forward. Andi, how things were done The hardest part of my job actually comes from that piece in that because we’re creating something unique and different. Ah, lot of things that in other jobs may have been pretty easy to thio operationally do just kind of run through things very quickly. Ah, lot of what we’re doing is re creating those easy tasks in a different way that’s more meaningful to patients and so recreating pathways that you’re used to working very easily could be tricky.

[0:12:42 Speaker 3] Yeah, so I think the best part of my job is of other dynamism associated with my job so I can interact with the patients, patients, families, the team, all the teams and clinical team, also the team that are really supporting us to do a good, very good job in the clinic. So, um, that interaction is quite a stimulating, and that time is this challenging. But I think we’re all working together to really provide the best care for the patients. And also we interact with all the training, medical students and the professionals in different multiple dys multi disciplinary team. So that really is the exciting part of my job. And also, um, you can get a lot of satisfaction for really providing the best care to the patient. That really makes a difference to their against you. The challenging part off, probably the most difficult part is based in preparing patients from transitions to active care to the relative care best supportive care. So I think the that really is a delegate thing to do for a clinician and clinical team, because they sometimes we really feel that we haven’t really prepared the pages enough to really to be ready to go into the relative get phase or the dominant phase of their illness, and I don’t think that it’s the right way to do it. One particular right way to do it. There’s a institution is very complex, and we have to adapt and make sure that patients already. But I think I really feel that sometimes I haven’t really done my job well, so I think that is the most challenging part.

[0:14:21 Speaker 4] Um, the best part is, um, interacting with patients. Um uh, like just Molina them and writing their names on the board whenever they come in. Um, even though, you know they’re coming in for a hard you know thing or something that is going through their body, I mean, just making little details. Making a difference in their appointment makes a huge difference. Eso I just like to bring a smile to my patients. Um, the other thing that I enjoy it, you know, my others, my other language, which is Spanish Eso that bonding with my Spanish speaking patients? Um, I really enjoyed because, you know, those patients feel more like I guess somebody’s connecting with them on their language. So that’s what I am doing connecting with patients. Um, one of the hardest things I would say is technology, um, from me personally, but I guess also, you know, with patients, you know, like right, um, are telehealth patients, you know, some are more old school. Um, they don’t really know how to download soon or stuff like that. So technology, and then making sure you know, patients get links or, you know, like records, All that stuff that’s been like one of the challenges, this technology with a cove it right now.

[0:15:33 Speaker 0] I asked the team what advice they would give someone that was interested in pursuing a career in health care and specifically cancer. Here’s what they said I would challenge

[0:15:43 Speaker 1] people to kind of dig in deeper before they make a decision on that. Um, what I found over the years, there are a lot of misconceptions about what it’s like to meet working in cancer, one of the biggest being that people think that it’s the status thing that could happen and all of your day is filled with sadness. But what I say is that that is not typical, and that is not what we see. And, um, even before I got into oncology, I had some of those same misconceptions. So I would say talk to someone who is in the field of cancer, find out the things that they can share with you to see if that is something that you would really be interested in. It’s a it’s a great place to be and it’s a fun place to be in a lot of cases and very uplifting on DSO ITT’s. That that would be my advice is to think about that

[0:16:34 Speaker 3] from our from a heck of delivery point of view. We are trying our best to really deliver the best care, but I think we really cannot really underestimate what our patients are going through at this very difficult time. It must really be very difficult for them to get against the diagnosis and really to adapt to this horrible situations and then then also they are very high risk off the glove in Kobane 19 and with all this communal expression. So I really feel for them and then I think that’s the we should really definitely to try to improve as we go along, just to really we think about what they’re really going through and how can how we can really improve to, even to help them better.

[0:17:23 Speaker 4] um, I would say I mean, of course, like, you know, every it’s a everyday changing. Um, there’s not pretty much like any single day that goes by the same. There’s also a lot of learning. Um, even though you I mean, I’ve been here almost two years and I still learn lots of new things every single day, you know, like every patient is different. Um, even, like, you know, even like blood results or chemo therapy. Um, it might be different for every patient. So it’s a learning experience. And also, um, it’s for somebody who really, really like enjoys, you know, talking with patients. Um, even though, you know, health care careers, you do have cooking interactions, but in oncology, I mean, it’s a different kind of interaction. You know, you have to be there pretty much throughout. They’re hold time.

[0:18:12 Speaker 0] I also asked the same questions of an Courtney. What are the best and most challenging parts of your job, and what advice would you give to someone who wants to pursue cancer as a career?

[0:18:26 Speaker 2] I would probably say the best part of my job is being able to really help make the whole journey through the cancer treatment a little less scary on DSO. Being able to really help support them a za team. Andi, especially their families. Um, I feel like that’s really the best part. Is being able to support them in the way that I would want to be supported with either myself or my my own family? So that feels really good. I would say the hardest part. Um, it changes, but I would say even right now in light of cove, it it’s honestly actually trying to keep up with the constant updates. Um, you know, we just I had a meeting about this earlier that it Zhar, you know, we’re all on, you know, email fatigue. We get tons of updates, you know, on a daily basis. Some of them are really important on DSO. I think that’s probably the hardest. Is trying Thio keep up with all that in real time? Well, im so biased. Of course. I think that it is honestly one of the, you know, greatest gifts toe work in oncology for like, several reasons. I mean, I think it’s really it’s really, honestly an honor to be able Thio participate in one of the most intimate, you know, experiences of someone’s life And to be able to have an impact on that s o I think from, you know, an emotional human connection. You you know, there’s very few things that consort of top that. And then there’s all the other components to just a career that can be really exciting. So, you know, thesis I inst and clinical trials theme the you know, the experiences working with co workers. I mean, you really get such a great, well rounded experience being in the oncology setting, and you kind of get thio cherry pick the really like top priorities that you have in your life and all the sort of segments on DNA make it a really pleasurable experience as a human. I think that’s I have nothing but great things to say. And I think even even the really sad times I would say that you know, all of us right who have been in the cancer world. You just It actually makes you really appreciate life, and you look at things with a different lens, and that’s like a gift to be able to dio

[0:20:54 Speaker 0] For more information about the UT Health Austin Live Strong Cancer Institutes clinic Visit UT health austin dot org To find out more about the live strong cancer institutes, check out del med dot utexas dot e d u. You can read more about the com model of care in The Oncology Times, the Journal of Clinical Pathways and the Journal of Clinical Oncology. There are also some great videos on YouTube, giving a crystal clear look into how the call model of care works, and you might even get a chance to see an and Monica. You can also follow Gail our chair on Twitter at S scale. Eckhart Eckhart is spelled e c k h a R D t. If you have questions for an Amanda Jaw or Monica or more cancer questions that we can uncover, email us at live strong cancer institutes at del med dot utexas dot e d u. Please make sure institutes is plural. If you like to this podcast, please make sure to subscribe. Way will plan to visit with the other teams within our department in episodes coming soon. In the meantime, for our second episode as our nation finally begins to address centuries of systemic racism, We will hear from dull medical school students of color in a discussion about their experiences with race, medical education and the future of health care. We hope you will join us for this important conversation. This is cancer uncovered. Thank you for listening.