In this edition, Hetty Carraway, MD, MBA, talks about keeping medicine close to home and the importance of loving what you do. Dr. Carraway is program director of the Hematology/Oncology Fellowship Program at the Taussig Cancer Institute at Cleveland Clinic in Ohio.
What was your first job?
My first job was working in a mom-and-pop donut shop, along with my older sister. She and I are Irish twins, so we often took on new things together. I learned to swim a year earlier than I should have for the same reason.
The customers we dealt with were almost always friendly and made the job fun. They were delighted when we learned their regular orders and had them ready in the blink of an eye.
Those were long days, though. We’d get to the donut shop at 5 a.m., stay until all the donuts were sold, clean up the greasy trays and counters, then go to basketball practice for 4 hours. Still, I loved working with my sister – and we managed to convince our friends from the basketball team to work with us at the shop, so there were always ongoing shenanigans and camaraderie.
At the end of the day, we smelled like grease, coffee, and cigarettes, but the work was gratifying. And who isn’t happy when you have constant access to donuts?
What did you want to be when you grew up?
As a freshman at Wachusett High School, my biology class went on a trip to Acadia National Park in Maine, where we spent a week camping, hiking, and learning about the environment. I remember spending hours searching the tide pools of the Atlantic Ocean, finding anemones, sea urchins, starfish, and the like. After that, I got excited about marine biology. At that time, I was also an avid swimmer, lifeguard, and swim instructor. So, naturally, I decided that the best job ever would be to work at SeaWorld. It combined everything I loved at the time: marine science, swimming, learning about and training animals, and performing. When I left for college, my family encouraged me to pursue a degree in marine science.
Was anyone in your family in medicine or science?
Both of my parents are basic scientists: My dad, Robert Carraway, PhD, is a biochemist and my mom, Margaretha Carraway, PhD, is a molecular biologist. Having two scientists in the house certainly influenced my education. Many of our dinnertime conversations were about their lab-based work, problem-solving, and biology.
Growing up in a family that shared my excitement about science was fulfilling, and it also taught me the importance of persistence. My family has affected me in so many ways, and continues to encourage and support me. My sister, Dorothea Wang, MBA, is a mechanical engineer and her enthusiasm about her work inspired me to pursue an MBA. Though we have many differences, she has been a constant pillar of strength for me. I’m fortunate to have a sister as my best friend.
My mother started working as a lab technician at age 20, after she emigrated from Holland to the United States. Her original plan was to stay for 1 year, but that changed when she married my dad and had children. We grew up knowing that she had given up her homeland to raise my sister and me in the United States. We could speak Dutch and were lucky enough to spend summers in Holland whenever possible. She went back to school to finish her college degree (my sister and I remember waiting for her in empty classrooms while she attended a lecture in the next room), and eventually earned her PhD the same year I graduated from medical school. She taught me to stay true to my dreams. It was not an easy road for her, but she kept at it.
What compelled you to switch from biology to medicine?
I clearly remember the turning point. I was at an appointment with my primary care doctor,
Abigail Adams, MD, for the mandatory annual physical required to participate in high school sports, when she spontaneously said, “I love my job.” It was a defining moment for me, because I knew that I wanted to love my job – whatever I ended up doing. At that point, I had never heard an adult say, unprompted, “I love what I do.”
During that visit, I realized I wanted to be in a place where I was enjoying the moment so much that I shared it with a random stranger. The bottom line is to be passionate about what you’re doing, and, if you don’t love what you’re doing, you have the ability to change that.
Why did you decide to specialize in hematology?
At the University of Massachusetts (UMass) in Worcester, where I went to medical school, all students had 2 years of focused curricular work learning about medicine. Early in the curriculum, I took a pathology course taught by Guido Majno, MD – one of the most inspirational and gifted teachers I’ve ever had.
Dr. Majno would magically relate the pathogenesis of disease to life events. He didn’t just teach pathology, he taught the art of inquiry and encouraged exploration and intrigue. He taught this by sharing the way he pursued inquiry with other colleagues throughout his career. Often this began with a letter he wrote (or a conversation he had with someone), and then developed into a relationship of scientific discovery that unfolded into figuring out how to treat the disease. It was fantastic.
My class had approximately 100 students, and four students decided to do an extra year of pathology training after taking his class. I was one of them.
Between my second and third year of medical school, I worked as a pathology resident (sort of like a medical apprenticeship in Oslerian terms), doing the grunt work in the pathology labs: accessioning tumors, doing autopsies, presenting pathology results at tumor board conferences, and working side-by-side with pathologists. Because of this focused time in the pathology department, I gained firsthand experience in diagnosing and witnessing the effects of inflammation, infection, and carcinogenesis. I was encouraged to inquire, pursue, and explore to better understand pathogenesis of disease – this was the kind of physician I wanted to be for my patients.
During that year, I had an elective rotation in hematopathology and worked with Bruce Woda, MD, who was chief of the Division of Anatomic Pathology and vice chair in the department of pathology at UMass. This was the launching point of my interest in hematology/oncology.
How do you think hematology or medicine has changed since you started your career?
The information infrastructure and how we collaborate with one another has changed immensely. I remember making photograph negatives to organize my slides in the projector wheels for formal talks. We had to plan ahead, since it was not possible to make last-minute changes in presentations. Technology has launched us to a fantastic place where we can now easily update and finesse talks and distribute them immediately. Our research community is well positioned to collaborate more efficiently, and we are more interconnected than ever before. I believe that these changes are already affecting what we can do long-term – that possibility can’t be underestimated.
In a typical day, what is your rose, and what is your thorn?
I’m grateful for so many things in my life, including my family and my husband and my kids. At work, the rose is being part of a team and feeling like we can make a difference at the end of the day. I believe that if you work at a place you love, with people you respect, and where you have a team mission, then everything’s worth it.
For many of us in medicine, we do what we do because we affect peoples’ lives – whether it’s helping patients or teaching fellows and residents. Being able to help others is certainly the best part of my job.
The thorns are the systems we need to overcome to complete that mission. There are so many places we can get stuck – and some days are more painful than others – but those are also opportunities for learning. Sometimes the best way to deal with obstacles is to reframe them and surge ahead.
What do you and your family do in the off hours – if you have any?
My motto tends to be “work hard and play hard”– that’s just life. I’m excited about my work and equally excited about my hobbies and the time that I spend away from work. My husband, Craig Peacock, PhD, is from Perth, Australia, which is literally on the opposite side of the globe from our current home in Cleveland. He is an immunologist. We have two sons: Lachlan (7 years old), and Finnegan (6 years old).
In my off-hours, you can find me joking around with my children and playing practical jokes on my husband. I am an expert at Super Mario on the Wii and can beat all three of them in a donut-eating contest any day.
My other hobbies include swimming (or boogie-boarding) and running and hiking when I can steal some time away.
I am also a big fan of women’s college basketball. My sister and I try to go to the NCAA Women’s Final Four basketball tournament every year and root for UConn, which we have been doing for over 15 years. That’s time we try to protect, and I can’t wait until my kids are old enough to join us.
Basketball became an even bigger part of our lives when we moved to Cleveland about 3 years ago. Last year, we were headed to a baseball game at Progressive Field and walking by the “Q” when one of my boys recognized a photo of LeBron James. He turned to me and asked, “Well, when are you going to play with his team?” I didn’t have the heart to tell him that would be impossible!
Of course, it was delightful to get that peek into a 6-year-old’s brain: It never occurred to him that a woman couldn’t play on the Cavaliers, or that his mom couldn’t play with LeBron James. To kids, anything is possible. It’s a great mentality to have, and I love when my kids remind me of that.
Do you try to keep a separation between work and home, and is that difficult?
My husband and I have somehow managed to create a balance. Home is a safe place and can be a sanctuary for relaxing and being with family as well as (when needed) an environment for burning the midnight oil. It helps to have a sense of humor since I am not always able to keep everything in separate worlds. I sometimes need to make phone calls from home to complete all the work for my day. I feel fortunate to have a husband who is supportive and can help me find the missing sock in the clothes dryer or send me the PubMed citation for a paper directing me as to which PDX model might be best for the next leukemia xenograft.
Honestly, we don’t shy away from discussing our work around the dinner table or on long car rides. Typically, though, most of our conversations at home are dominated by SpongeBob or Minecraft or Super Mario Brothers. I am fortunate that my husband and I can navigate those topics as well as we can discuss hedgehog inhibitors.
If you could have a superpower, what would it be and why?
Obviously, the first one I would choose is the ability to cure cancer. But, for a more impractical power, I’d love to be able to slam dunk. My sister is much taller than I am, and I’ve been jealous of that my whole life.