Episode 7, Part 3: Expert Profile, Dr. Lailea Noel

[0:00:00 Speaker 1] We are a resource for learners, including every member of the Livestrong Cancer institutes on track Educational pipeline from middle school to residency. We are growing collection of interviews, talks and experiences that uncover the myths and the uncertainties of cancer and careers in cancer in order to empower and inspire generations of thinkers and leaders. This is cancer uncovered an education and empowerment podcast by the live strong cancer institutes. Welcome Back to Cancer uncovered an education and empowerment podcast by the Livestrong Cancer Institutes and Emerging Academic Cancer Center at Dell Medical School, which is part of the University of Texas at Austin. This is Kristin Winn, senior programme coordinator with the L. C. I. Happy to be back in your ear buds this month as we take a deeper dive into the work and career journey of Dr Lillian Noelle. As you may recall, from Episode seven Health Disparities and Cancer, Dr Noel talked about her work and community based cancer research and helped us understand why we need to focus on disparities in cancer care and cancer research and how to move forward. If you have not listened to that episode yet, I would highly recommend it. It is worth all 28 minutes of your time lately. You know? Well, is an assistant professor at the Steve Hicks School of Social Work and also has an appointment with Dell Medical School’s Department of Health Social work and the Department of Oncology at the University of Texas at Austin. I absolutely loved getting the opportunity to sit down with Dr No. Well, she is so inviting, so real and such an amazing example of perseverance. Listen to this interview to find out more about her work and career journey in social work, cancer and community based research, but also because she reminds us that you can turn your own heartbreak into what pushes you forward. Dr. Noel. Hello. Welcome back.

[0:02:18 Speaker 0] Hello,

[0:02:19 Speaker 1] Kristin. Thanks for having so great to have you. I wanted for our listeners. I wanted them to hear from you

[0:02:26 Speaker 0] about how

[0:02:28 Speaker 1] you got here and how you ended up doing this type of work.

[0:02:34 Speaker 0] Okay, So, first of all, I want to say thank you for inviting me back to the table. Um, I really enjoyed the conversation that I had with you and Dr James a couple weeks ago, and I want to also say that I am so impressed with those students who are taking the time to listen to a podcast like this, because when I was in middle school and high school, I knew that I wanted to be in the healthcare field. But I didn’t have a resource like this to be able to find a mentor, to be able to hear from people who have done amazing work in the field who looked like me. I’m an African American woman from Michigan who, you know, grew up with a teenage mom who did the best she could to raise me, and I didn’t know anyone who was a doctor. I didn’t know anyone who was working in healthcare policy or health administration. And so I really appreciate podcasts like this and other opportunities that you and the live strong folks are offering to these students. Really amazing. Um, so that being said, I think that first of all, I have a PhD in social work, and I also have an undergraduate degree, a bachelor of science from the University of Michigan and I was a pre med student at Michigan, but I majored in anthropology because I’ve always been interested in people and how people live, and what do they need to live? Well, so I majored in anthropology, even though I was a pre med student, and then I moved to Chicago. I graduated from my bachelors from University of Michigan, where I worked for a year at a drug treatment center with the teenagers on the in patient unit before starting my masters in social service administration. And I actually had a concentration and health administration and public policy from the University of Chicago. And it was during that time at the University of Chicago when I was studying Health Policy and Health Administration that I started to first learn about disparities to learn about inequities and health. Even though I grew up, my family may not have had the best healthcare platform. I still didn’t understand why there were differences across the country, and here I was in a program and a very prestigious program at the University of Chicago. And yet there were still people in Chicago who were dying from health related diseases, and I was really confused as a all of 23 year old or something like that. As to what was happening in the world. So I decided instead of going to medical school that I would continue to work in the community a little bit after graduating with my master’s degree, and I still kind of wanted to get a medical degree. But I started working for a clinic in the far south side of Chicago called Altgeld Gardens, and it was in Section eight, housing community. And while I was there, I was the assistant to the medical director and actually, literally like when I finished my masters, I went down there and said, I want to be you someday I want to get an M D. And I want to run a clinic and I want to help people, you know? And so she’s like, Okay, so why don’t you be my assistant for a little while and you can see what happens? And that’s when I started learning about differences in insurance and uninsured. And when I saw how socially isolated communities where this community was so far removed from Chicago that the train system didn’t even go this far south, they literally would have had to take a couple buses just to get to a train to take it to downtown. That’s how far they were also removed by a wall of sanitation like they would take the sanitation dump. They were on the opposite side of that from the city, so they were surrounded by it. This environmental atmosphere that was not conducive to good health. So as a result, this community was experiencing high rates of asthma, high rates of cancer, diabetes, heart disease. There was a lot happening in this community, which again confused me, broke my heart because I couldn’t understand. Why are we not as a country providing proper health care to everyone? But it also opens my eyes to systematic inequities that there’s so much more to this story than just genetics and biology. So I think that’s when my eyes first started to open. I started working for the American Cancer Society in Chicago. I was originally the field representative for the South Side of Chicago, so I was living out of my trunk of my car, helping people understand when they get screened and where they can go for screening for that education piece. But I quickly became the manager of cancer control programs for the city of Chicago, which meant that I worked with all the hospitals and all the nursing departments to provide what they needed for patient support services. And then I moved back to Michigan as the executive director of the American Cancer Society’s office in Ann Arbor, Michigan, that was responsible for three counties surrounding Ann Arbor. One county was very rural. One county was a little more urban around Ann Arbor College Town, and then one county was very poor. There was very few resources, very few primary care physicians, very few dentists. It was just very resource poor. So I got a kind of a feel for the differences and then what the needs were and how to sort of distribute the American Cancer Society’s resources equitably. After being executive director, I took a job in Detroit as the manager of community and corporate health for Oakwood Hospital. I was one of three managers, and my role was the corporate piece, so I would go into the various factories like General Motors and forward and help them set up programs that would help improve health and the wellness of the workers. So things like smoking cessation or exercise or walking program. But I miss cancer. I think for me I was sort of, you know, still interested in that cancer piece. I switched from Oakwood Hospital in Detroit to the University of Michigan’s Comprehensive Cancer Center in Ann Arbor, as an administrative director of the bone marrow transplant clinic and as a clinic director. My role was to support the nurses, social workers and physicians that were providing care for cancer patients through the bone marrow transplant center. So I was working in a role more of an administrator, Good position again. I was, I think, on the younger side of my career. And I just think that how do I say this in a kind way? I think the politics of working for a very large cancer center or hospital health care center kinda got to me as a young person again. I didn’t understand that there’s this. You need to learn the balance between budgeting and providing care for patients and that thing, and I think I was so concerned with the patients getting everything they needed, and I was getting frustrated that they wanted me to spend more time on the budgeting. So when 9 11 happened. 9 11 happened while I was there, and I spent the whole day trying to keep the clinics open and getting making sure the patients got their chemotherapy. But it was very, you know, it was a hard day because everybody was distracted by the televisions. And when I went home that night and had a chance to sort of reflect on the day, I think I it hit me like, you know, there are people there still women that I go to church with or I live with who are dying from breast cancer black women, young black women who are dying from breast cancer before the age of 40. And I’m working at one of the best, if not the cancer center in the country, and I’m pushing papers. I am writing budgets and processing grants, which again, I think it’s a wonderful thing for those people who want to do that. But I was again. It was confusion for me because I was going back to the community and people were dying from breast cancer and I couldn’t understand the disconnect. I think it was then that I decided to get a PhD because I wanted to do more than just write budgets. I wanted to be again boots on the ground with the people trying to get more people into care for cancer. I decided to get a PhD, and I had started working for a professor of social work at the University of Michigan School of Social Work, an African American man who had a program where he encouraged more people of color and women in the academic academy. So he was trying to encourage more people of color and women to get PhDs and to work in the field. He had a program, a national program. It connected faculty of color and women from across the country online with each other so they could write papers together. They could write grants together, they could mentor each other, senior people could mentor junior people, and I was the administrator for this program, and I remember asking him one day because there I was a young black female who was like I had never actually experienced a black professor before because I went to a pretty much predominantly white institutions, and I asked him, Can I do this? I had no idea that people did literally. I think this was the first time I realized that people could do more in this area of health than just be a doctor, that there were other people that were helping help. Besides being a doctor and a nurse, there were other ways to help, and I could actually get a PhD and make a difference. And he said, of course. And so he helped me and I ended up starting my PhD program at the At Washington University in ST Louis, and my advisor there had just received a big grant to do a community based participatory research project on the north side of the city with African American women and breast cancer, which was perfect. And so I became her student for five years, and I worked in the community and conducted research projects and helped to decrease barriers secure for women, African American women in ST Louis. And after graduating with my PhD, I became a professor at the at New York University at the School of Social Work there and then came to Texas as a visiting faculty member and loved it, And so now I am a assistant professor at the School of social work at the University of Texas, and I’m also an assistant professor of oncology and health social work at Dell Medical School. Working with live strong and your initiatives. I think I am now at the stage where I’m ready for a position like this again, coming full circle from my position with the University of Mission Cancer Center and with the American Cancer Society. I feel like I’ve learned a lot and I’ve grown a lot. And I think I want to say that to the young people who are listening to this, to not be afraid to take that first job, even if it’s not the perfect job, to not be afraid, to explore and to try different things because you never know where it’s going to lead. If you had told me 20 years ago that I would be in Texas working for live strong, and for every school of social work at the University of Texas, I would have laughed because there was no way I was probably going to ever leave Michigan. But you know, I think that and I love it. I absolutely love. It’s a perfect fit for me and so I just feel like I talked to a lot of young people. And when they come out of there bachelor programs, I think they feel like they need to get that perfect job or they have to go to medical school or they have so much pressure on themselves to be perfect at 22 years old. And I don’t think you need to be perfect At 22 years old, I actually think sometimes exploring some options can help shape who you are as a young professional. And if you still decided to go get a medical doctor, it that’s great. We need in these who care about diversity and who care about equity. So I applaud that. But I also applaud if you want to explore and if you want to talk to and have mentors and do research projects with mentors to see if you want to be more in a different field. So I’m very happy having a PhD and doing the work that I do to decrease cancer disparities and improve equity for people facing cancer.

[0:15:16 Speaker 1] To go back a little bit further for you. You’ve told me in other conversations that we’ve had together about how, When you were a really young person, the only way you thought you could

[0:15:32 Speaker 0] really help people

[0:15:33 Speaker 1] was to be a doctor, right? So it makes sense to me that you went off to college saying I’m going to be a doctor because that’s how to help people. Can you talk a little bit about that and maybe even just reiterate that for the sake of this episode of this podcast,

[0:15:46 Speaker 0] Yeah, I was around the age of 78 or nine years old. My grandmother died. My grandmother was 47 I think my mother’s mother, I think, was 47 when she died, and she died from complications from a mental illness as well as drug dependency. Eventually she had liver damage and passed away from liver damage, but and so my mother was the oldest of all. So Mom has five sisters and one brother. When I was born, my mom was 17 and the youngest one was nine. So they were all in between nine and 17, and I sort of came along as part of the pack, right? Yeah. I just remember the day that my gran died. I felt like the society or the world or whatever had let me down and had let my family down. I felt like that. Somebody should have done more to help my grandmother and someone let us down and that no other child, no other eight year olds, should ever have to face what I did. And I was determined to grow up and make sure that didn’t happen. So I was going to become a doctor and I was becoming the secretary of Health and human services, and I was going to make sure that no other family went through what our family went through. And as an eight year old, I had no idea what I was. I just thought I had to be a doctor because those are the That was the only career I knew about was that, and I figured that was only doctors affected health care. So I grew up wanting to be a doctor and my hole all the way through Michigan. I was pre med, and I was determined that that’s what I was going to do until I got to Chicago and I was exposed to social services and Health administration. I love that story, something that I’m helping Emily’s. I hope that I’m helping families. You know, you’re

[0:17:33 Speaker 1] absolutely helping families, and I think not that I’ve known you for very long. But it’s so it’s so easy to see your gift of being able to connect with people you spend just a couple

[0:17:45 Speaker 0] of minutes with you. And yes, I mean, I feel like you

[0:17:49 Speaker 1] really are using your gifts to make such an incredible

[0:17:52 Speaker 0] difference. It’s funny along those lines. When I was in ST Louis and I was interviewing, I would go into the home to interview African American women about their the process that they had to go through to connect with care between the community and the community health clinics and connecting with cancer care downtown at the cancer center like what was that process like? Like what steps that they have to go through? And who did they talk to? Who do they come in contact? Who helped them that sort of thing. So I went into the homes and I interviewed them and I spend time with them and it was so interesting how like like you just said, like I built this sort of report and trust with them from the moment they opened the door. And I think in part because they didn’t expect a young black woman to be on the other side of the door because it was a PhD student. And I think again because they’re not exposed to too many ph. Black PhDs when they open the door. And they saw a black female PhD student, they were like, Oh, and I really got that a lot like Are you the student and wash you? And I’m like, Yes, it’s me. I had my bad and they’re like, Come on, even, baby, you know, I’m invited to Sunday dinner. I think that there was some sense of pride from the community in my PhD so that when I wrote my dissertation the women that were part of my dissertation in the community that shared with me they had a sense of pride and accomplishment in helping lift me into that role. It was a very overwhelming and emotional experience for me because I didn’t expect that I expected it from my family, but not from the family of women that I was seeking to help. What

[0:19:37 Speaker 1] an incredible experience to end up sort of being folded into this pack of women. They are supporting you and your supporting them, and you’re all sort of lifting each other up to help others, right? Like the research that you’re doing well, then go on to help other communities. So I wonder, then that chapter of your life seems beautiful, right? And then you end up here in Texas. And

[0:19:59 Speaker 0] I

[0:20:00 Speaker 1] know recently you’ve done some work in rural Texas. Totally different set of individuals, right? Like you’re moving from

[0:20:08 Speaker 0] to a totally different regions. Urban environments of rural environments. Yeah,

[0:20:12 Speaker 1] exactly. And so I wonder, can you talk a little bit about the work that you’ve recently done here in Texas?

[0:20:18 Speaker 0] So there’s two different things. I did a cancer project with live strong and real Texas and I did a access to mental health project with the Health and Human Services Commission through the state of Texas. Gotcha. And I see them kind of at some point emerging. But the knowledge that I’ve gained over the last two years from traveling around the whole state of Texas and getting to talk to communities in rural areas of Texas was, I think, just invaluable, right so it’s just sort of like a master class in rural Texas, like I literally didn’t just read about their experiences. I actually we actually drove out there with the Health and Human Services Commission, and I actually like set up these community meetings where I actually did a research method called Group Model Building. But just for sake of the students are listening. It’s basically pulling together a group of community residents to talk about. What’s it like to connect with care? What’s it like to be in their shoes? What’s needed in their community to connect with care? We also met with service providers, so we met with Silver Service friends. We met with sheriffs, judges, emergency room workers, nurses and community members to sort of talk about access issues. So I have patients and their family. There’s administrators who actually have some Sam was delivered, and then the nonprofits who are trying to provide that bridge or those services in the community boots on the ground services, talking about what’s the disconnect and how can we connect this? And as a result, I heard and learned a lot of different. I heard the voices, so this is how I see my work, like my role is to bring the voice of the community to the table. So when Dr Eckert says lately a what are you hearing from the community about this? I can say, Here’s some of the narratives I’ve heard from the community about what’s needed to connect people with care.

[0:22:19 Speaker 1] Do you see this across the cancer world that cancer centers are bringing in other Doctor Noel’s to figure out sort of the barriers? Do other cancer centers do this?

[0:22:32 Speaker 0] You know, pushing this concept forward, I think it will become more of a of a push moving forward, right? And also, I think, our current climate that we’re in right now, where we talk about racial divisions and health equity and inequities. And I think the young people are demanding it. Which is again, another reason why this podcast is so wonderful, because the people who are listening to this, they’re the future of our country, and they’re going to demand that right when they get jobs, when they’re going for us, for jobs are going to be asking, Is this something that you care about? And so I think that it’s moving with proper leadership is moving in the right direction.

[0:23:12 Speaker 1] What have I not asked that I should have?

[0:23:15 Speaker 0] Oh, I know one question you did. What would I say to my younger self? Was something you said earlier?

[0:23:20 Speaker 1] Yes. What would you say to your younger self?

[0:23:23 Speaker 0] I think that if I was talking to that eight year old or seven year old how world I was when I was laying on that bed talking to God about the death of my grandmother, I think I would be I would encourage her. And I would say to her, Yes, you’re on the right track.

[0:23:39 Speaker 1] Stay strong,

[0:23:41 Speaker 0] Stay encouraged. You will come in contact with a lot of mentors along the way and 30 years down the line, you are going to be making a difference in women’s lives. Yes, you’re going to I would say to myself, You’re going to get tired a lot along the way. Don’t give up

[0:24:00 Speaker 1] with that message of Don’t give up. I think I often look at the health care system honestly is like, so broken and so backwards. Sometimes that I get discouraged. I look at and go like this thing is busted I’m so angry, right? So how do you stay the course?

[0:24:21 Speaker 0] And, you know, when I was exposed to a community in the far south side of Chicago and they had all of this environmental social isolation and they were suffering from all kinds of health concerns, I could have gotten discouraged by how I was feeling. But instead I let that I let that confusion in that despair pushed me to make a difference. And so I started working for the American Cancer Society. So I would say to be energized by those feelings that it’s okay to empathize. And it’s okay to feel this, you know, heartbroken. But let that hurt. And that anxiety and that discouraging that exhaustion push you to make a difference. Push you down a different path. Don’t let it discourage you to the point where you throw your hands up and say, there’s no future in this because there is, and I think that everyone listening to this call can make a difference in their own way. You may never be the secretary of Health and Human Services, but you might be the best darn community health worker. There’s anyone’s ever seen or practitioner. We need exactly everybody. All of it. Yeah, we each need each other. We can’t do this without each other. I encourage all of our middle school high school and undergrads who are listening to this to not give up. And I applaud you for listening to the podcast. I think that you are going to be amazing health care professionals, no matter what you decide to do.

[0:25:52 Speaker 1] Thank you, Dr Noel.

[0:25:54 Speaker 0] Thanks, Kristen

[0:25:56 Speaker 1] to hear more from Dr Noel. She’s got a great talk on the living beyond breast cancer site l BBC dot org called Breaking Down Barriers Getting the care you Deserve. You can also read more about her on the U. T. Austin website utexas dot e d u. You can find out more about the Livestrong Cancer institutes at dell med dot utexas dot e d u. You can find out more about the Livestrong Cancer Institutes clinic with UT Health Austin at ut health austin dot org. If you have questions for Lilia or if you have other cancer questions that we can uncover, please reach out and email us at Livestrong Cancer institutes at dell med dot utexas dot e d u Please make sure institutes is plural. You can also follow our chair. Dr. Gail Eckhart on Twitter at S Gail Eckhart Eckhart is spelled E c k h a r D T. This is Kristin Winn signing off this month for cancer uncovered. Thank you for listening and learning with us