In this edition, Alexis A. Thompson, MD, MPH, speaks about her career studying and working with patients with hemoglobin disorders – and discovering a centuries-old link to medicine. Dr. Thompson is head of the hematology section of the Division of Hematology Oncology Transplantation at the Ann and Robert H. Lurie Children’s Hospital of Chicago, where she also serves as the A. Watson and Sarah Armour Endowed Chair for Childhood Cancer and Blood Disorders. In addition, Dr. Thompson is associate director of Equity and Minority Health at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. She is 2018 President of the American Society of Hematology.
What was your first job?
When I was 16 years old, I worked at McDonald’s. My first paycheck was a whopping $74.
What was your dream job when you were growing up?
I briefly toyed with the idea of becoming an elementary school teacher. But really, medicine was an early and consistent career goal. Neither of my parents was involved in medicine – my father worked for a telecommunications company and my mother was a stay-at-home mom before becoming a nurse later in life. I’m the second of four children. We were born and raised in Los Angeles in a very modest home. My parents were supportive of education, in general; to them, it boiled down to working hard and doing what was necessary to achieve your goals.
My brother and I attended college together in Claremont, California. We shared an old blue Volkswagen Beetle, as well as an interest in medicine. He is now an emergency-medicine physician in Los Angeles.
What was it about medicine that attracted you?
Two things: I loved science and I wanted to make a difference. I saw medicine as an agent for social change, and when I started medical school, I envisioned becoming a primary-care physician, working in a community-based practice. I suppose I still see myself as an activist, hoping to make a difference, but now in a slightly different way.
I also had an interest in genealogy, which led me to a more ancestral connection to medicine: Sophia B. Jones was one of the first black women in the U.S. to attend medical school, graduating from the University of Michigan School of Medicine in 1885. Her younger brother was my great grandfather. They were born and raised in Canada – the children of free people of color – and the family returned to the U.S. to live in Ann Arbor when Sophia started at the University of Michigan. She was one of the founding faculty for a nursing school at Spelman College. I have an old sepia-toned photo of her in my office that has looked over my shoulder and has kept me company through most of my career. I graduated from medical school 98 years after her and our birthdates are just shy of 100 years apart. I can’t help but admire her pioneering spirit.
When did you decide to focus in hematology?
I did an elective in pediatric hematology with Kwaku Ohene-Frempong, MD, when I was a fourth-year medical student at Tulane University. He became one of my first mentors. He was a remarkable clinician-scientist who directed the sickle cell and thalassemia programs. It was inspiring to watch him switch gears from interacting with a group of patients with complex diseases to explaining the molecular basis of sickle cell disease or beta-thalassemia, then engaging a family about a patient’s diagnosis. He set a striking example of the type of hematologist I wanted to be.
Through residency, I was fortunate to have many experiences that brought me to hematology, including opportunities to work alongside other talented hematologists and oncologists. There are so many that I can’t single any one out! Mentorship has played a large role in shaping my career journey.
Was Dr. Ohene-Frempong also your entry into the field of hemoglobin disorders?
Yes, he was instrumental in that decision. My time with him inspired me to continue growing my knowledge base and deepened my excitement about the field of hemoglobin disorders. With his guidance, I opted to do my training at the Children’s Hospital of Philadelphia (CHOP), which is where he trained, where many of my future mentors had trained, and where I spent a good portion of my career.
It was while I was at CHOP that my excitement about the lab truly took hold. As a physician in the laboratory, I saw that discoveries made in the lab had an enormous potential to make an impact on patients’ lives. So, when I continued my training at CHOP, I was working with other investigators who were making seminal observations in the laboratory about the pathophysiology of sickle cell disease and looking at new molecular tools to be able to characterize new forms of beta thalassemia, which is another inherited blood disorder caused by mutations in the same gene as sickle cell disease.
After fellowship I further honed my skills in the laboratory, working with Randolph Wall, PhD, at the University of California in Los Angeles (UCLA) and learned so much from his graduate students and postdocs. I appreciated the support I received from Stephen Feig, MD, my division chief, that allowed me to get a stronger foothold in the lab. The culture of scientific discovery at the UCLA Jonsson Comprehensive Cancer Center and in the clinical programs were so nurturing
Throughout your career, I’m sure you’ve had opportunities to mentor younger hematologists in training. What advice do you share with them as they start their careers?
I strongly recommend that they focus first on their craft, whether in the lab or at the bedside, and taking themselves, their careers, and their skills seriously. When I entered medicine, there were so many things that I wanted to do to change the world immediately; I advise younger trainees to stay focused. Later in their careers, they can expand, but at least early on, becoming excellent in one area will allow them to be more effective in the long run. I also strongly encourage them to find mentors as they begin to take on more and more interests and projects. It’s the challenge of harnessing their excitement and energy at the beginning of their careers – it certainly inspires me!
One of the opportunities that I was able to take advantage of while I was a junior faculty member was receiving funding through the Robert Wood Johnson Foundation’s Minority Medical Faculty Development Program, which gave me a four-year period of financial support and protected research time. Eventually, that program spawned the ASH-Harold Amos Medical Faculty Development Program (AMFDP), which was renamed and expanded in honor of Harold Amos, PhD, who was the first African-American to chair a department at Harvard Medical School.
Knowing that I benefited personally early in my career from having a lab mentor and other career mentors through that program, I became a strong advocate in support of initiatives like the ASH-AMFDP and Minority Medical Student Awards Program. I’ve worked with many students in my laboratory or acted as mentor for their clinical research or for career development, largely because I know that I benefited from having those relationships and guidance. I’m happy to pay it forward.
What aspects of medicine have changed the most from since you started your career?
The diagnosis and management of hemoglobin disorders has changed dramatically since the start of my career. We have taken the fundamental observations about a disease’s pathophysiology that were being made as I began my career, converted those into diagnostic testing that launched newborn screening, and now, fast-forward to a time when those discoveries are being translated into therapies today. It has been extraordinary.
Certainly, this includes gene therapy: We are at a point now where we can take the beta-globin gene itself and modify it to treat these conditions. It’s rewarding to have been a part of that, working alongside an extraordinary group of people who have contributed to these advances. In science, it is never just one person, but a collective. The hematology community has been a major contributor to advancing gene therapy, both in developing new techniques and in understanding hematologic disorders, malignant and nonmalignant.
I believe that what underlies every inch of progress in collaborative clinical trials and clinical research skills has been a core belief to develop hypothesis-driven studies that improve patient care. Of course, now we can use molecular or genetic tools to look at prognosis for a variety of conditions. This means we can have conversations with patients’ families that are evidence-based, and we can offer them new therapies that address the specific molecular mutations discovered in the lab.
There also have been monumental changes in the ways we think about caring for individuals with complex illnesses. Practicing hematology allows us to have remarkably intense and meaningful relationships with patients, making a difference in their lives while also moving the field forward.
What is the best part of your day, and what is the worst?
Every day, I look forward to walking in to the office and engaging with my team, which includes physicians, nurses, clinical researchers, and professionals. They all come to work each day just as committed to serving our patients and conducting research that can make a difference in our patients’ lives. The worst part of my day is billing, which I think many readers can identify with. It’s a tedious but necessary task. Enough said.
What do you enjoy doing outside of work?
I spend as much time as I can with my husband Garry. We enjoy traveling and visiting family and friends. Our favorite place to travel is Barcelona and the area of southern Spain – we love the architecture and love, love, love the food. We’re finishing renovations to our brick American Foursquare house that was built in 1918, and sometimes it’s great just to spend weekends at home with Garry and our chocolate Labrador Retriever, Coltrane, just working in the garden or going to the beach. This year, we’re growing a variety of vegetables and flowers. Digging in the dirt isn’t something everyone wants to do, but it’s therapeutic for me. And yes – Chicago has beaches!