Physician uses life’s challenges to ‘change things for the better’
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Key takeaways:
- Monique A. Hartley-Brown, MD, MMSc, says through all the ‘hits’ you are going to get in life, learn to pivot.
- Hartley-Brown’s legacy is rooted in her three sons.
Monique A. Hartley-Brown, MD, MMSc, turns life challenges into the desire and initiative to “change things for the better.”
Hartley-Brown, a physician in the department of hematology/oncology in the multiple myeloma program at Dana-Farber Cancer Institute and assistant professor of medicine at Harvard Medical School, has used her role in the research arena to work toward bridging the gap between community oncology settings and academic centers to ensure that all patients — no matter where they reside — have access to the latest groundbreaking cancer treatments, particularly in the multiple myeloma space.
“The United States is an amazing country, but the resources are not divided equitably,” Hartley-Brown told Healio. “Patients at academic centers, such as where I practice, have access to more providers who are academically inclined to conduct research, and will participate in getting the important clinical trials up and running. Some of the pioneering treatments, like chimeric antigen receptor (CAR) T-cell therapy and bispecific therapy, are more of the pioneering therapies at this moment in the myeloma space, and a lot of the community oncology settings will not have access to these therapies.”
Her why
The one-on-one interactions with patients is what Hartley-Brown enjoys most in her career, but it is her mother who is her inspiration for her career and life.
“My mother is ultimately why I ended up becoming a physician,” she said. “She became ill while I was in college, and then during the early part of medical school. I didn't really understand what was going on and I was really worried about her.”
It turned out that her mother had multiple myeloma.
“With my mom being ill, I wanted to know more, and I wanted to do whatever I could to help her. When she passed away, unfortunately, I was in medical school. That is when I knew that this was what I wanted to do, and devoted my life to it,” she said. “We learn and grow in the realm of understanding myeloma every day. But it is an ongoing, humbling experience, because we learn more but we still don’t know enough.”
What is known is that certain subgroups and populations are at increased risk for myeloma, including those of Afro-descent.
“Globally, individuals of Afro-descent are two- to three-times more likely to develop multiple myeloma and have a higher incidence of the precursor conditions of this disease. Such that, monoclonal gammopathy of undetermined significance [MGUS] and smoldering myeloma are three times more prevalent in individuals of Afro-descent,” Hartley-Brown said.
Multiple myeloma is also a disease that has had a lot of research that has shown progress in terms of treatment.
“About 30 years ago, this was a disease that was given a prognosis of 2 to 3 years,” Hartley-Brown said. “Now we’re talking about beyond 10 years — even beyond 15 years — for survival, and that’s attributable to a lot of the medications that have been approved in this space.”
Yet, she said patients are still dying of the disease, and certain populations such as those of Afro and Hispanic descent are diagnosed at younger ages.
“The majority of the data support the fact that this is a disease that’s diagnosed in the late 60s. The reality is, there are subpopulations, including Afro-descent individuals and Hispanics, who are years younger at the time of diagnosis, and these patients are living with the disease while having to work and are of childbearing age,” Hartley-Brown said. This creates a very different disease management landscape, due to the medical and social implications for these patients. There is more that can be done, especially for the high-risk population and for those diagnosed at younger ages.”
Her advice
Hartley-Brown credits “the support, help and push” from others during challenging times throughout her career to getting her to where she is today.
“There are moments in career and life when traversing an issue that just seems so tumultuous at the time, you feel like giving up,” she said. “I have had so much support to guide, assist and give an extra whisper in my ear to say, ‘You can do this. You got this.’ That has allowed me to keep going and keep putting one step in front of the other. It is not an easy process. Being a woman of Afro-descent myself, of Jamaican heritage, trying to speak and interact with colleagues all throughout my medical career is a very different dynamic.”
Being the sole woman of Afro-descent in the room oftentimes is sobering, isolating and lonely for Hartley-Brown.
“Then having conversations with colleagues who may not have the same viewpoint, opinion and direction, and having to convince them otherwise to weigh in on thoughts, ideas and processes that you might want to put forth is not an easy journey,” she said. “But it’s been a good journey, and I am still very excited about my journey, and very grateful for and to the people I work with and the people who have been supportive of me through this process. To the person who is in medical training, going through this process in whatever field in medicine, I say, find those people who cheer you on, support and stand by you, because it does make all the difference.”
Her other advice to women in medicine is “learn to pivot.”
“Giving this advice on the days following the historic 2024 election outcome, I have to say that I am fired up,” Hartley-Brown said. “I am upset, but anger can fuel us to make change. We can use anger in a good way or in a bad way — any emotion can be used one way or another. I am the type of individual that when I am angry, I feel the desire and initiative to change it for the better. My advice to women in medicine is through all the ‘hits’ you are going to get in life, all the moments and confrontations — moments where things are just not going according to your original plan — learn to pivot. Life is change. That is the epitome of what life is. Nothing stays the same, and you want it to change.”
Learn to be flexible, she continued.
“You don’t necessarily have to completely cave in on your ideas, but you can change the approach and change the way you pursue the outcome that you’re looking for,” she said. “Don’t take everything to heart, because that can sometimes deter you from your goal. As women, nurturers, caretakers, emotional individuals and empathetic creatures, sometimes that emotional hit is the harder hit, and if we learn to hear the emotion, feel the emotion, and let it fuel the desire to change, then that is the better way to pursue things going forward, because it still allows you to pursue the goals you're looking for — just changing the trajectory of how you pursue those goals.”
Her legacy
As an individual who is rooted in family, Hartley-Brown said her legacy is embedded in her three sons.
“My legacy is for them to see me for who I truly am, and for them to understand that I am a part of who they are. I am 50% of them and if I can do all the things that I’ve done in my lifetime, then they have the world at the tip of their fingers, and they can do so much more,” she said. “If what I have done in my lifetime influences other individuals in health care and medicine, women in medicine, then I am truly grateful and thankful for that — but ultimately, my legacy is my boys, my babies.”
Hartley-Brown is proud of what she has so far accomplished in life.
“I am very proud of who I am,” she said. “I may not be the reflection of what is shown society-wise of the embodiment of what this world looks up to, but at the end of the day, I am the root of the tree that this country is built on. I am proud of that. As women, as women of color, and the folks who work tirelessly — especially in the health care community — we should hold true to that, and we should be proud of that.”
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