Pulling Back the Curtain: Michael Linenberger, MD

Professor of medicine in the Division of Hematology, Robert and Phyllis Henigson Endowed Chair in Hematology, and director of the Hematology/Oncology Fellowship Program at the University of Washington School of Medicine in Seattle. Also medical director of apheresis and cellular therapy at the Seattle Cancer Care Alliance and a member of the Fred Hutchinson Cancer Research Center.

What was your first job?

I grew up in rural Kansas, so there were plenty of opportunities for employment – most of them were in agriculture. When I was 13 years old, though, I worked in a used-car dealership, detailing cars. Cars would roll into the lot, and my job was to wash, wax, steam-clean, and vacuum them, and basically get them into good shape for resale. Believe it or not, I worked 50 hours a week. At 13 years old, I learned responsibility and accountability, and – most importantly – I got to drive the cars around the lot.

Did you think about sticking with it and becoming a used-car salesman?

No, that was a short-term job, but I did appreciate being in that environment. Since most of the jobs for kids my age were working on the family farm or, if you lived in town, babysitting or delivering newspapers on a paper route, the car dealership was a different setting. And, actually, I’m one of the best car-washers I know. If you have a dirty car, I know how to get it clean!

The next summer, when I was old enough to work in the cornfields for a seed company, I detasseled corn. I walked down each corn row, reached up to the top of the stalk, and plucked out the tassel. That was the job that convinced me to rule out farming and follow my passion for science. Many of my friends ended up working on farms or in agriculture-related businesses, but I never saw myself going into any of those careers.

What other non-medical careers did you imagine yourself going into?

I grew up in a strong Catholic family, and a few of my family members were in the clergy; two aunts were nuns, and my father’s cousin was a highly ranked priest of the Precious Blood order. He would come home for visits and tell great stories about the work being done in the Vatican in Rome. I was impressed by his intellect and worldliness. Also, the nuns at my school were the smartest people I knew! I always had a desire to do service of some sort, so, up until about seventh grade, I thought I might become a priest. Then I hit high school…

What – or who – led you into medicine?

I was always interested in science, but I had no idea what a career in science could be. My father was the first to pique my interest – he was an electrician and knew a fair bit about electronics – but I gravitated more towards biologic sciences. I even loved microscopy as a kid. But, again, I had no idea how I could translate that passion into a career.

When I went to college, I thought medicine might be a good fit for me, but I wanted to check it out more and see if I could relate to folks struggling with illness and uncertainty. So, I became an orderly and worked in the intensive care unit (ICU) of the hospital in my small hometown. After a couple of summers working there, I knew that medicine was the career for me.

This was about 40 years ago, when being an orderly was a hands-on experience. At that time, orderlies (and nurse’s aides) were responsible for assigned patients, which meant handling everything from answering call lights and giving bed baths, to cleaning bedpans and giving backrubs.

Being an orderly was also a great experience because, while I learned about anatomy and physiology in college (the aspects of biology that drew me to medicine), I also learned about service. The head nurse of the ICU was a friend of my older sister – who also was a nurse – and they taught me compassion and the humanistic side of medicine. Of course, at the same time, I learned how to read electrocardiograms and observed procedures in the ICU and operating room. It steered me toward medical school and away from considering graduate school and a research career as a technologist or PhD.

When did you know you wanted to specialize in hematology?

After graduating medical school at the University of Kansas, I did my internal medicine residency at Rhode Island Hospital in Providence. I was a naïve midwesterner at the time, and the East Coast was an exciting, but very different, place – culturally, socially, and politically. Brown University’s medical school was still relatively young when I joined in 1982; it had an outstanding academic primary-care internal medicine training program, but much of our teaching and patient care experiences in categorical internal medicine came from dedicated, community-practice–based clinical faculty.

During my time as a resident, I cared for many patients with complicated, challenging hematologic disorders, both malignant and non-malignant. Because there were few fellows in hematology and oncology in Providence at that time, we were fortunate to be the primary providers for these patients on the wards. Our faculty mentors were tremendous role models and compelled many of us in the Brown residency programs to pursue fellowships in hematology and medical oncology.

I was also in Providence during a colorful time in the city’s history when a number of high-profile incidents and scandals kept this capital of the “Biggest Little State in the Union” in the public eye. Raymond Patriarca, the acknowledged head of the New England mafia ran his crime syndicate out of Providence and died of a heart attack in our emergency department in 1984 – luckily, I was not on duty at that time. Needless to say, as a hayseed from Kansas, Providence was a thrilling place to live.

What mentors played a role in shaping your career?

When I arrived here in Seattle, the faculty in the Division of Hematology was filled with amazing talent, including John Adamson, MD, at the University of Washington (UW), who had succeeded Clement Finch, MD, the first chief of Hematology at UW and the “godfather” of iron metabolism. Thalia Papayannopoulou, MD, DrSci, at UW; Gerald Roth, MD, at the Seattle Veterans Hospital; John Harlan, MD, at Harborview Medical Center; and Richard Counts, MD, and his outstanding group of medical directors at Puget Sound Blood Center were all wonderful role models and clinical mentors. During my clinical training, I was also privileged to work with E. Donnall Thomas, MD, and his team of pioneers in the bone marrow transplant program.

The mentor who played the biggest role in shaping my career was Janis L. Abkowitz, MD. Dr. Abkowitz, the head of the Division of Hematology at UW, was my research mentor as a fellow. It was a tremendous fit; we worked together for many years on hematopoiesis research in both feline and human models and I continued to work side-by-side with her in the lab until I moved to the Seattle Cancer Care Alliance’s Fred Hutchinson campus in 2001.

There have also been amazing people in American Society of Hematology (ASH) leadership who have reached out to me and other young individuals every year, to promote opportunities and scholarship within the Society. For me, that was James N. George, MD, who was ASH president at the time I was asked to co-chair the education program for the annual meeting in 2005. That annual meeting was notable for a last-minute change in venue from New Orleans to Atlanta because New Orleans was devastated by Hurricane Katrina in the fall of 2005. During that challenging time, I witnessed grace under pressure by Dr. George and the ASH staff. Since that time, Jim has been an incredible support and advocate for my career. It probably helped that we share midwestern roots – he from Oklahoma and I from Kansas.

How did these people affect your career? Did they offer any specific advice that you’d like to share?

Great mentors offer valuable perspective. As you enter your career and try to find your niche in research or the clinical domain, you have to know yourself – what drives you and where your passions lie. If you want to go into academia, that passion has to be powerful enough to tolerate the disappointments of, say, having your manuscript rejected or being denied a grant opportunity. You have to continue to ask the probing questions, dig deeper, and take risks along the way.

On the practical side, I learned from my mentors that to be a good hematologist/oncologist you have to be an excellent clinician. My experiences as an orderly helped prepare me for that; I quickly realized the importance of communicating and connecting with patients and caregivers on a personal level, to have excellent bedside skills – from both the social and clinical side.

Also, versatility is vital. If a project doesn’t work out, you need to be able to troubleshoot and understand new ways to approach a problem. Patience is certainly important, but so is good mentorship and the humility to know when you need help. I would advise young hematologists to seek out individuals who can support you and offer honest advice – which means you have to be ready to accept constructive criticism.

What have been your greatest career accomplishments? Have you had any major disappointments, and how have you dealt with those?

My move from UW to the Seattle Cancer Care Alliance’s Fred Hutchinson campus about 15 years ago was a major career shift. I transitioned from a physician-scientist to a clinician-scholar career track. It was disappointing to leave the “bench,” but the move took me in new directions. I had supportive people who allowed me to make that switch to another area of academia. I’m happy to have had the opportunity to develop new skills and do important work as a clinical researcher and education administrator.

I’m also happy that I’ve been able to make these contributions as a teammate or “foot soldier,” working as a member of a crew of brilliant, visionary people who are leading the charge and getting things done. I’ve seen this type of community spirit over and over in my career, and it’s always been incredibly rewarding to be part of the team.

It is also a position that meshes with my personality; I’m an introvert, but I’m not shy. As a hematologist, or a clinician in any field, you can be reserved and reflective, but you have to be there “in the trenches” with your patients and your colleagues.

What do you and your family do in the “off hours” – if you have any?

My wife, Sallie, is a family practitioner who recently retired from her practice, so we have a few more “off hours” than normal. We try to take advantage of everything the Seattle area has to offer: sea-kayaking in Puget Sound, day trips to the San Juan Islands, and live arts performances. I’ve always loved photography, so I try to fit that in when I travel.

We’re also active members of the Unitarian Universalist church, where I’ve served as a mentor for adolescents in a coming-of-age program for the past few years.

Can you tell us something about yourself that people would be surprised to learn?

I was the co-editor of my high school yearbook in 1974. (It might be surprising for people who are familiar with my writing at the time.) This was around the time that the National Lampoon published an issue that perfectly parodied a 1964 high school yearbook. The funny (and sad) part was that our actual yearbook looked similar in many ways to the parody issue – right down to the formatting, cheesy captions, and staged action pictures. It was hilarious, and somewhat sobering.

I learned project management skills as the co-editor, but it did not teach me to write. That was something I learned in college – and continue to work on in my academic career.

If you could have dinner with one person – living or dead – who would it be?

I think Leonardo da Vinci would be a fascinating person to have dinner with. He was the quintessential “Renaissance man,” with wide-ranging interests that span art and science. Multi-talented individuals with broad experiences and perspectives have always been the most interesting, remarkable people I have met and worked with over the years.

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