During charity bike ride, oncologist discovers ‘the power of partnering with our patients’
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Editor’s note: This is the fourth in a series of five stories from ASCO Voices, a session during ASCO Annual Meeting focused on the human side of oncology.
Michael Serzan, MD, was inspired to become an oncologist by the Jesuit phrase “cura personalis,” which translates to “care of the whole person.”
Yet about a year into his oncology training, Serzan began to notice that he no longer felt quite like a whole person.
“Long hours and weekends on the inpatient service led to abandoned hobbies and time away from friends and family,” recalled Serzan, a medical oncologist at Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute. “Overnight call shifts led to sleepless nights, and I felt like no matter how many hours I was in the hospital, I was never giving enough.”
As he grappled with a feeling of professional burnout, one of his cases took a tragic turn.
Sam, a 23-year-old recent college graduate, had moved to Washington, D.C., to begin a career as a communications professional. He came to the hospital for vague symptoms: fever, chills, night sweats and weight loss. After conducting an exhaustive panel of lab tests and imaging biopsies, Serzan and his team diagnosed Sam with a rare and aggressive hematologic malignancy. Sam began a regimen of chemotherapy, but his symptoms continued to progress. Then, just 7 days after walking into the hospital, Sam suffered a spontaneous intracranial hemorrhage and died.
“As I sat in his ICU room with his devastated parents, I tried to find the words to comfort them in their time of unimaginable loss,” he said. “As I walked out of the room and down the hallway, I felt like I just couldn’t go on. The tears just started flowing — tears of frustration, sadness and despair for the tragedy of the situation. My patient and his family had trusted me with his care, and I had failed in the most ultimate way. After that, I started to carry that narrative with me.”
Missing ‘something deeper’
One of the themes of Serzan’s internal narrative was a crushing lack of self-confidence. He began to doubt his ability to truly make a difference in his job and became emotionally detached. He found himself going through the motions, even hoping at one point that the patients would “just stop coming.”
“My patient visits became shorter and almost transactional, and focused mostly on the cancer so I could get out of the room and get on with whatever was on my to-do list for that particular day,” he said. “On the surface, everything looked fine. I was scoring well in training exams and I was publishing papers, but there was something deeper that was missing.”
It was at about this time that Serzan began to work with a new mentor, a clinician admired not only for his academic rigor, but also for his intentional approach to patient care after clinic.
One day, Serzan’s mentor told him that he had formed a team to ride in Dana-Farber’s inaugural charity bicycle ride. Serzan was interested in joining the team, but concerned that the training and fundraising would stretch his already overextended schedule to the breaking point.
In the end, Serzan decided to go for it.
“The following day, I took the leap,” he said. “I joined that team, and the results were better than I could have imagined.”
‘To go far, go together’
Almost from the start, Serzan said his decision to go outside his comfort zone and join the cycling team was a source of encouragement and hope.
“I created a fundraising page and the money came in virtually overnight from supportive friends and family,” he said. “My training rides became a source of solace and introspection among my busy days.”
As Serzan began to learn more about cycling, he came across a mantra that he would remember each time he got on a bike: “If you want to go fast, go alone, but if you want to go far, go together.” On the day of the race, Serzan found himself riding in a group with two patients from his continuity clinic.
“As we navigated the twists and turns and the hills and valleys of our charted course, we started to share our stories about how each of our lives had been affected by cancer,” he said.
As the group rode and talked, they began to see the ways in which their lives and experiences were interconnected. One man who had been diagnosed with stage IV kidney cancer told his fellow riders about his experiences on an early-phase clinical trial of immunotherapy. He discussed his frequent trips to and from the hospital, his long hours in the infusion center, and the uncertainty that comes with being on an experimental treatment. Fortunately, immunotherapy had worked for him and he no longer had evidence of disease.
“Coincidentally, a second patient shared that not only did he have the same type of cancer as the first man but was on the same exact treatment,” Serzan said, “and he thanked that patient for taking a chance on a clinical trial so that he might benefit.”
As the ride continued, Serzan said he began to feel more connected with his daily sense of purpose as an oncologist, in no small part because of his interaction with patients at a personal level.
After the second patient thanked the man who had enrolled in a clinical trial, he turned to Serzan.
“He said, ‘Thank you, Dr. Serzan, for dedicating your career to helping patients like me. You make a difference,’” Serzan said. “What he said next has stuck with me: ‘You are the bright future of this field, and we’re counting on you.’”
A challenge to think differently
As the group crossed the finish line, Serzan truly felt like he was part of a team and that the barriers between clinician and patient had been broken down.
“When we came together, we were all able to accomplish things none of us could do as individuals,” he said. “I realized that my patient was challenging me to think differently about how I partner with my patients.”
The race had enabled Serzan to relate to his patients as people, and that turned out to be exactly what he needed.
“As I started to think more about this, the words of the great civil-rights leader, Brian Stevenson, came to mind,” he said, “He tells us we need to get proximate with those who are suffering.”
Serzan credited being proximate with his patients during the bicycle race with changing his perspective. His patients’ confidence in him reminded him of his responsibility as a clinician. He emphasized that this call to partner with patients is not his alone, but is a challenge to all medical providers.
“I stand here today because a mentor got proximate with me when I was struggling and showed me a different way,” he said. “I’m here today because my patients have gotten proximate with me and trusted me as a partner on their cancer journeys. For those of you who have come to ASCO because you believe in the power of partnering with our patients, I’m simply here to say that you are the bright future of our field, and we’re counting on you.”
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“If You Want to Go Far, Go Together.” ASCO Voices Session. Presented at: ASCO Annual Meeting; June 2-6, 2023; Chicago.
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