Wendy Stock, MD, the 2020 ASH Mentor Award recipient for clinical medicine, speaks about the joy of cultivating the next generation of clinicians and researchers.
Why did you decide to pursue hematology?
When I was in graduate school studying zoology, I became very interested in developmental biology, particularly how clonal hematopoiesis and selection pressures result in the development of leukemia. At that time, evidence for clonality in leukemia represented by cytogenetic changes were being described by remarkable scientists like Philip Fialkow, MD, and Janet Rowley, MD, whom I had the tremendous honor of working with many years later.
Then, in medical school, I was drawn to the grace, courage, and gratitude of the patients whom I met during a special rotation in leukemia at the University of Minnesota. I was amazed by that whole community – the patients, the people who cared for them, the faculty members – and the opportunity for connection.
Later, my residency solidified that interest. The field of hematologic malignancies melded my biologic fascination, the human component of medicine, and my desire to improve patients’ lives. The patients gave the science meaning. Finding meaning and purpose to what you are doing is the key to life.
Who were the important mentors throughout your career?
Richard Larson, MD, has been a mentor to me since my training, and he has been a mentor for many generations of leukemia trainees here at University of Chicago. His clinical and academic rigor and passion for understanding these terrible diseases has been inspirational to me.
Carol Westbrook, MD, PhD, an intelligent and thoughtful researcher, was my mentor in the laboratory at the University of Chicago. At first, she was not excited by my idea to work in correlative science studies. But she taught me how to use basic science techniques to ask questions, and allowed me to explore my own path and address some more qualitative scientific questions relating to clinical outcomes.
James Vardiman, MD, inspired me to look at the morphology of leukemia cells and link that to patient care. It was the triumvirate of Dr. Vardiman, Dr. Rowley, and Harvey Golomb, MD, who inspired me to make my initial foray into linking disease biology with clinical outcomes in leukemia subsets.
“The patients gave the science meaning. Finding meaning and purpose to what you are doing is the key to life.”
There are so many others to include: When I spent a month in Minnesota, I worked with a young attending physician who later became head of the cancer center there, Philip McGlave, MD. During my first job at Loyola University, Sucha Nand, MD, was a wise and gentle clinical colleague and mentor. Charles Schiffer, MD, and Clara Bloomfield, MD, were mentors within the Cancer and Leukemia Group B (CALGB), now called the Alliance. As I began my studies into adolescent and young adults with acute lymphocytic leukemia (ALL), Archie Bleyer, MD, and the late Jim Nachman, MD, were tremendous advocates whose wisdom and clinical acumen were invaluable!
It was an honor to learn from incredible women like Drs. Bloomfield and Rowley, who shaped the field of leukemia biology, at a time when there weren’t many women role models.
Mentorship is not at all limited to people more senior than you. Peer mentoring is important, especially during the early fellowship and academic years, when one is looking for help and support from kindred spirits facing similar challenges. It is a critical time in one’s career, especially for younger women who may be trying to start a family at the same time they are trying to start an academic career. I am so grateful to my many colleagues during my residency, fellowship, and faculty years who have also become lifelong friends.
What do you enjoy most about being a mentor?
I enjoy sharing my enthusiasm and, in turn, learning from my mentees. Because mentees have a fresh perspective, their interesting questions, even if naïve, are often so very insightful.
When I was in their position as a mentee, I worried that asking for direction or advice might be viewed as a burden or an obligation. I now understand that mentoring is tremendously fun and hugely rewarding. I truly feel that I benefit and learn as much from my mentees as I hope they learn from me. Mentoring is such a natural part of the medical “life cycle” – to learn with, and from, colleagues the mechanisms and the tools for developing as a clinician and researcher is just part of the natural order!
What advice do you share with mentees?
When first entering the world of medicine, people are pressured to know exactly what they want to do. One of the biggest lessons I learned from my own career, which I try to impart on others, is that it’s probably better that you don’t. As you gradually acquire knowledge and clinical expertise, you will find something that fascinates you – that’s what will launch your career trajectory.
Early on, I felt that same pressure, and it made me insecure. I think absorbing what’s around you and pursuing what interests you is a plausible way to develop a career path, because you might stumble upon something and say, “This is exactly what I want to do.” After that, everything will fall into place. Of course, you need to work hard and continue exploring, but avoid that pressure to have everything in place right off the bat.
That’s how it happened for me with my interest in why outcomes were different for young adults with ALL. The results of that initial foray into looking at differences in outcomes led to a 20-year investigational bounty in an unexpected area of research. It’s an iterative process: You have an initial interest, develop that interest, and something within that discipline sparks your interest even more. Hematology might branch out into leukemia, then ALL, and all these little segments, and each step can be serendipitous.
“I truly feel that I benefit and learn as much from my mentees as I hope they learn from me. Mentoring is such a natural part of the medical ‘life cycle.’”
Do you share those personal experiences with mentees?
Yes. By sharing my story, it might help alleviate some of that pressure. In academic medicine, there are real superstars, and then there are the plodders, like me, who keep going along, doing their thing, and every once in a while, get lucky. No matter which path you take, along the way, you’re going to gain wonderful patient experiences and build rich interpersonal relationships with families, patients, and colleagues.
By nurturing your intellectual curiosity, you can often launch into something that’s unique and fitting for you. That doesn’t happen overnight – it is a long and winding road.
What is your proudest accomplishment as a mentor and a clinician?
One of my mentors, Dr. Larson, told me many years ago that watching his mentees, or academic progeny, was one of his greatest thrills. I thought, “Really? Because it doesn’t seem like it!”
It is absolutely true, though, because now I can see an entire generation of young leukemia clinician-researchers all over the country whose training I had a role in. Many of them are pursuing things related to what they learned from me, but with their own independent and creative input.
It is a thrill for me to see them at each step of the academic ladder: I love when the medical students end up wanting to go into hematology/oncology. I’m excited when trainees want to go into the blood malignancies and leukemia. I’m delighted when my mentees go on to develop their own careers and find success as academicians, clinicians, or translational researchers. It’s a lovely product of an academic career. I cannot think of anything nicer, other than improving and prolonging patients’ lives as a clinician.
What do you think are the biggest challenges facing today’s trainees?
Finding an institution that will support your intellectual and human development is definitely a challenge. You don’t work and learn in a vacuum. So, if possible, carefully choose the place where you start your career. It is not the be-all and end-all, because I certainly changed my location several times, but it’s helpful to start out in a nurturing environment.
In this era, clinical productivity seems to be measured only in terms of the number of patients that you see and how quickly you can get them seen. It’s daunting, unsatisfying, and challenging for trainees. Then, you are thrown into an academic position where you have to produce quickly in the laboratory and in clinical research. The financial pressure is immense, and I worry about that. That has always been true, but is maybe more apparent now in this economically challenged time in medicine.
At the same time, trainees are fortunate to have so many interesting new techniques and technologies available to them. Our fellows are so well-trained and have so much more expertise in so many different areas: statistics, bioinformatics, genomics … I never would have dreamed of working with this level of information. Today’s trainees are becoming more sophisticated earlier in their careers.
How do you think mentors can help them overcome these challenges?
In a sense, these are not new challenges. Everybody needs somebody that they can talk to. Everybody needs a little pat on the back now and then for encouragement. That is a quality that defines a good mentor: accessibility.
On the other hand, the mentor-mentee relationship is not a one-way street. It is symbiotic, and each side has obligations to the other. With anything in life, if you stand by and expect someone to hand you everything – even if people try to give it to you – you will not get much out of the experience. You must immerse yourself in the relationship and the discipline.