In this edition, Dan Pollyea, MD, MS, talks about his early experiences as a “physician’s assistant” and how he learned to talk to patients. Dr. Pollyea is clinical director of Leukemia Services and associate professor of medicine at the University of Colorado Cancer Center.
Hear more from our interview with Dr. Pollyea in Sound Bites.
What was your first job?
Officially, my first job was as a counselor at a summer day camp when I was about 14 years old. The camp was in Columbus, Ohio, near where I grew up, and one that I had gone to as a camper for many summers.
Unofficially, I served as unpaid labor for my dad. He was a primary-care doctor in a community hospital in an underserved area of Columbus, and he gave all of his patients our home telephone number.
He was not an early adopter of answering machines, so my two sisters (one younger and one older) and I grew up answering the phone and taking messages from his patients. Looking back on it, it seems weird (this was definitely a pre-HIPAA era), but we got pretty good at it! We’d record their names and phone numbers, why they were calling, and what problems they were having. My dad would give us feedback about the notes we took, and we got to know the frequent callers and their problems pretty well. It was good training for taking a patient’s history!
He’d also put us to work filing in his office – there weren’t any computers, either – and sometimes I would tag along when he would round on patients on the weekends. I was always underfoot, I guess.
Did you choose to go into medicine based on those experiences?
It was a big part of the decision. I enjoyed learning about the patients’ lives and what my dad did to help them, and I wanted to keep learning more about that.
When you started down the path to becoming a doctor, what drew you to hematology?
Honestly, I hadn’t given hematology much consideration before I entered medical school, but when I was a resident at the University of Chicago and trying to figure out what I wanted to do, Andy Artz, MD, MS, spent an extraordinary amount of time and effort mentoring me. He was my fellow when I was an intern, and he introduced me to the field of malignant hematology. He also introduced me to Koen van Besien, MD, PhD, the head of bone marrow transplant at the University of Chicago at the time – and a devoted and invested mentor. Their enthusiasm was contagious and, ultimately, I was able to see a career path that would be equally exciting for me.
Part of what attracted me to the field of malignant hematology was its highs and lows. When you treat patients with acute leukemia, you need to be comfortable in the intensive care unit and in the clinic and you need to be ready for patients to quickly transition between those extremes.
You also have the opportunity to deliver the best possible news a person could imagine – and the responsibility to deliver the worst.
I appreciate the balance between our great potential to cure these horrible diseases and the respect for how destructive they can be to patients’ lives. There is something about the balance of those two extremes – being at the intersection of those two dynamics – that appeals to me. Every patient interaction is unique, and it’s never monotonous … but I could get used to staying out of the intensive care unit and just giving good news all the time.
What advice or knowledge would you pass on to early-career doctors and trainees?
I’ve been fortunate to work with great mentors and some giants in the field, so anything I have to share with younger doctors comes from what I observed my mentors doing.
Once I became a fellow, Beverly Mitchell, MD, was the best mentor, leader, person that I could imagine. She was incredibly encouraging and supportive, but – and this has always been the most important thing for me – she truly led by example. She would never ask anyone to do anything that she wouldn’t do herself; that’s an important lesson in being an effective leader.
Stanley Schrier, MD, is an incredible resource and arguably knows more about hematology than anyone who has ever lived. Still, while I was working with him in the clinic or accompanying him at the microscope, he never hid when he didn’t understand something or didn’t know the answer to a trainee’s question. To hear Dr. Schrier say “I don’t know” is an incredible thing, because it teaches everyone that it’s okay to admit this, and it’s important for early-career folks to hear someone they respect and admire say this.
Also, since coming to the University of Colorado, I’ve had the privilege to work with Craig Jordan, PhD, as my division chief. He’s supported my career and helped me grow in ways that I could never have imagined. He, along with my clinical division chief Clayton Smith, MD, demonstrate extraordinary leadership with their ability to bring together many different people and personalities with competing views and interests. I admire (and aspire to) their skill for consensus-building and getting the best out of everybody.
Mentoring the next generation of clinicians and researchers is crucial, and something we should prioritize. It can be tough because I measure myself against the giants I worked with and work with; I hope in time I can get closer to where they are.
What do you see as the challenges to becoming a great mentor?
There are many challenges. The chief one, of course, is time. And then there’s the actual work of making mentoring a priority; everyone recognizes the importance of mentorship, but when the rubber meets the road, it’s a hard thing to do. Very few people do it well, and I wish I could do it better.
In a typical day, what is your rose and what is your thorn?
Documentation and anything medical record–related are the thorns – those are never fun. What I look forward to the most each day is giving good news, or if that’s not possible, providing hope to patients.
Where did you learn to talk with patients and have difficult conversations, like giving bad news?
It’s something that you learn as you observe the people you work with and admire. It also is an ongoing effort; it starts during training, but it requires constant work, refinement, and practice. Every day, I am a part of conversations that can go well or not, and it’s important to learn from each one and ask, “What went well?” or “What happened to make things go off the rails?”
For me, it comes back to the golden rule: Do unto others as you would have them do unto you. That means putting myself in the other person’s situation and thinking about how I would want to be treated. What would I want to hear? How would I want the conversation to go? It’s a simple and old-fashioned principle, but one that is valuable when having tough discussions with our patients or their caregivers.
Are there any hobbies or interests that you’d want to explore if you had the time?
I love to travel and would love to do more of that. I also love writing and I’ve often thought about writing a novel. It’s only in my head for now, but some of the things that go on in our world and in academia are so bizarre and funny that they would only work in the setting of fiction.
It’s hard to find the time to devote to those interests with three young kids – ages 9, 7, and 4. My time outside of work is mostly spent trying to keep up with them and my wife, who is a graphic designer. So, that means getting them to all the activities that kids are involved in and chasing them around; it gets busy, but the best, most fun type of busy.
I also try to spend as much time outside as possible – whether that’s hiking, running, biking, or going to the mountains … It’s what I loved about being a camp counselor when I was younger, and that hasn’t changed much.