Mikkael A. Sekeres, MD, MS
Current Role: Chief, Division of Hematology, Sylvester Comprehensive Cancer Center, University of Miami
Previous Role: Director of the Leukemia Program at Cleveland Clinic and Vice Chair for Clinical Research at the Taussig Cancer Institute.
As soon as Dr. Mikkael Sekeres walks into the exam room, he shares test results with his patient. When he talks to patients, he does as he would if he ran into them in the supermarket checkout line. And he wants you to know that leukemia can be cured.
As the Director of the Leukemia Program at the Cleveland Clinic, founding editor of the American Society of Hematology’s Clinical News magazine, and the author or co-author of more than 200 papers and six books, Dr. Sekeres is one of the world’s leading oncologists. As a regular contributor to The New York Times, he represents and explains his specialty to readers around the world. As a member of Figure 1’s advisory board, he is contributing that expertise toward our vision of delivering life-saving medical knowledge anywhere and at any time.
Here’s an introduction to Dr. Sekeres and how he practices medicine.
What does your average work week look like?
My work week is varied – my favorite part is always seeing patients! I get to meet the neatest people, and have the privilege of learning about their lives when they are particularly vulnerable – at the time of a cancer diagnosis. They sustain me and remind me of why we need to work tirelessly to find better treatments. I also conduct a bunch of clinical research, mentor fellows and residents, edit the American Society of Hematology (ASH) Clinical News magazine, write for scientific and lay audiences, and am involved in administration – I head clinical research for our cancer center, and chair the Cleveland Clinic Pharmacy & Therapeutics Committee.
What’s the predictable high point of your week?
At work, it’s seeing patients, and watching the careers of trainees and junior faculty flourish. At home, it’s my family. I learned early that if you keep your family as your priority, you always make the right decisions and have a fulfilling life.
What makes a case difficult?
I work at a center where we see so many people with leukemia and related disorders, we always see the subtypes that only affect, say, 1% of patients. So, a rare condition isn’t so much difficult, but a challenge to see how our team can do best by our patient. What makes a case difficult is most often when families don’t align on goals of care.
What makes a case rewarding?
Working with families so goals of care match a patient’s goals. Even if those goals involve declining further therapy, there is so much value to helping with a good death.
What phrase do you find yourself using over and over again?
“Take my wife, please!” jk, that’s Henny Youngman’s phrase. I always tell my patients “You’re the boss.” My job is to educate and support their decisions.
In several of your Times columns, you explain how you talk to patients, stressing the importance of maintaining eye contact and leading with the exam results. What else can a young doctor do to improve this vital communication?
I am convinced that, while communication training is so important, it sometimes conveys the opposite message as what is intended. I remember receiving such training when I was in medical school and thinking “They must be teaching me how to communicate because I have to do it differently as a doctor.” So I started to be more stiff with patients, and erect barriers. It took me years to undo that, and just talk to people as I would someone I run into at the supermarket – and not differently because he or she has leukemia. My best advice on communication – don’t change how you do it because someone is wearing a hospital gown, or has cancer.
We increasingly hear that doctors don’t recommend medicine as a career. Do you?
I do! But so far only 1 in 3 of my children is listening to me. You can go in so many directions with a career in medicine, from traditional paths such as seeing patients, doing research, or both, to taking on the administrative aspects of health care or the business side, to writing or other creative pursuits. And it is so fulfilling. What other professions allow you to meet and help people from every imaginable background, encourages daily creativity, and includes the reward of others’ gratitude?
What in your environment contributes to burnout?
Electronic medical records and contract research organizations (which administer clinical trials). There is a special place in the 9th circle of hell for both of them.
If you weren’t in your specialty, which specialty would you be in?
I’d probably be an English professor. That was my out if I didn’t get into medical school.
Who had the biggest impact on your clinical training?
A few people had a big impact on me. When I was in medical school, Brian Strom, MD, MPH was my mentor in epidemiology. He taught me to be rigorous in reading medical literature and that one person can set the tone for the culture in a department. He returned my manuscripts to me, edited, within 24 hours. Everybody in his department was efficient and respectful of deadlines as a result. In residency, Tom Lynch, MD, was a lung cancer doc who could make a personal connection with every patient he met, no matter how obscure. And he would remember that, say, one man’s grandson played lacrosse for a certain high school.
In fellowship, Richard Stone, MD, taught me how to treat leukemia, has an encyclopedic knowledge of every study ever published, and reminded me that it’s okay to joke around with your patients. Stephanie Lee, MD, MPH taught me how to ask research questions about what really matters to patients, and is so clever at designing studies that ask those questions.
What’s a common misconception or myth about your specialty that many of your colleagues hold?
That everyone with leukemia dies. Leukemia needs a better press agent, to be sure. We cure a lot of people.
What’s a nerdy bit of technical knowledge you use all the time?
I did some computer programming in high school and college, and can sometimes still talk the talk. I also can convert metric units to the British/American system pretty quickly, which helps when trying to figure out the temperature in other countries! But neither of these are facts I would admit to on a first date. Or second. Or within the first 5 years of marriage.
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