S2 Ep 4: The Cancer Conversation Nobody Else Is Having | Dr. Chadi Nabhan | Bench to Bold

What happens in the room when a doctor delivers a cancer diagnosis — and what should happen next? In this episode of Bench to Bold, Marnie and Alisa sit down with Dr. Chadi Nabhan, internationally recognized hematologist, medical oncologist, author, and host of the Healthcare Unfiltered podcast. Dr. Nabhan walks through his new book The Cancer Journey, published by Johns Hopkins University Press, explaining why cancer hits psychologically different than any other diagnosis, how to build the right medical team, why second opinions are never offensive, and what AI is doing right now to speed up clinical trials and get life-saving therapies to patients sooner. Marnie also shares the deeply personal story of her son Jonathan's neuroblastoma diagnosis at nine months old — and how she learned to put together a team worthy of the fight. This one is equal parts medical clarity and emotional depth.

EPISODE HIGHLIGHTS:
00:01:43 — The Book That Started It All
00:02:43 — Why He Wrote The Cancer Journey
00:07:12 — What Drew Him to Oncology
00:11:25 — We Win More Than We Lose
00:14:46 — Marnie's Son, Neuroblastoma & the Armageddon Analogy
00:21:11 — AI in Cancer Care
00:24:42 — Environmental Toxins, Roundup & the Cancer Nobody Talks About  Pesticides
00:27:21 — Practical Wellness
00:34:12 — The Power of an Advocate

ABOUT DR. CHADI NABHAN:
Dr. Chadi Nabhan, MD, MBA, FACP, is a board-certified hematologist and medical oncologist with over two decades of clinical experience treating cancer patients at Northwestern University's Robert H. Lurie Comprehensive Cancer Center, the University of Chicago, and Advocate Health. He has authored or co-authored over 300 peer-reviewed manuscripts and abstracts, and currently serves as Chief Medical Officer of RYGHT AI, an artificial intelligence company focused on accelerating clinical trials. Dr. Nabhan is the author of two books published by Johns Hopkins University Press: The Cancer Journey: Understanding Diagnosis, Treatment, Recovery, and Prevention (2024) and Toxic Exposure: The True Story behind the Monsanto Trials and the Search for Justice (2023) — the latter drawing on his experience as an expert witness in the landmark Roundup litigation linking glyphosate to non-Hodgkin lymphoma. He is the creator and host of the weekly Healthcare Unfiltered podcast, a sought-after speaker on global oncology stages, and a member of the editorial board of JAMA Oncology. His website is chadinabhan.com.

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Transcript

SPEAKER_02 0:08

So welcome to Bench to Bold. We're excited to be here. Today we have Dr. Shadi Navan, who is an internationally recognized hematologist and medical oncologist, and we're so happy to have him. Welcome.

SPEAKER_00 0:20

Thank you so much for having me and for kindly say I'm internationally recognized. That's probably an exaggeration.

SPEAKER_01 0:29

I doubt it. But I think, first of all, before we get started into the nitty-gritty of uh talking about cancer and the serious stuff, your voice, I think, did they train you in medical school to have these soothing voices when you're talking about heavy conversations? Because automatically I feel whatever you're gonna tell me, no matter what it is, I'm like, okay, I can make this. I can handle it. So are there voice training classes in med school?

SPEAKER_00 0:57

I wish because I've always felt um, you know, uh I don't have a good voice. One of those things where uh you tape uh you tape something, you tape a podcast, and then you feel strange listening to yourself. Um, but that's very sweet of you to say. Uh no, no, I have no voice training, and uh I could tell you that my children advise me to never ever try to sing. Uh so it's clearly I have not captured their hearts when it comes to voice.

SPEAKER_02 1:25

Oh well, I can identify with you when you say you hear your voice on a podcast or you listen back to it because I have a very southern accent, as you well can hear. And but people love it and I hate it. So I hate to hear myself a little bit.

SPEAKER_00 1:39

So put me in the camp of people who love it.

SPEAKER_02 1:41

Same here. Okay, good. Yes. So when I got home from the Super Bowl, um had this fabulous book, some of my name from you in my mailbox. And I have started, um, just started because I just got home on Monday night, but I looked at this yesterday, and and I mean, I I'm my undergrad's in social work and my first job was at hospice. And so some of this, you know, has been a uh navigating, you know, helping people navigate through a cancer diagnosis or or family members, um, dealing with a a loved one that's been diagnosed with cancer. I had both parents um were in hospice and and both passed away in hospice care. So um the cancer journey is near and dear to my heart and grief counseling um as well, being a hospice social worker and navigating um grief counseling after family members lose their loved one. So talk to us a little bit about your book.

SPEAKER_00 2:43

Yeah, thank you. Thank you for giving me the platform to talk about. Um it's one of those things that um I wanted to look, let me step back. Um the most precious thing that we have is our health. That's that's really the most precious thing. We there's very little that you could enjoy if you're really not healthy. And when we are threatened with any health issue, we are extremely vulnerable. I mean, from the simple fact let you know, you have a cold and you're coughing and sneezing in in bed and you feel so powerless, and we're talking just cold, we're not talking anything that we would consider serious. So we all know how valuable our health is. But you know, it's interesting, the human psychology, when we're feeling well, like the three of us today, hopefully we're feeling well, we cannot think we're invincible, like you know, we're feeling well, nothing's gonna catch us until unfortunately something happens. And when it comes to health threats, something very different about cancer than any other thing, whether it's uh cardiac disease, GI issues, and so on, because the minute you hear the word cancer, you feel your world is upside down, frankly. And you start thinking the worst thing possible. It's a very different dynamic than when somebody says, Well, you have an issue with the heart and we're gonna fix it. Somehow, it's just psychologically, we just think that this is really the worst. So, and as I progressed in my career, I've noticed that no matter where you are in life, this is when if this strikes, you are going to feel more vulnerable than other scenarios, and your world could crumble down, and then you go and search for answers, and you need to have the medical team and so on. And you have to make these decisions very rapidly because you think you're in race against time and you want to get the trusted people and so on. So I thought to myself, well, what if? What if I'm able to find to write something that helps all of us, whether we are patients, caregivers, neighbors, friends, family members, nurses, social workers, pharmacists, even doctors, primary care doctors, and so on, to understand their journey, but more importantly, to have a guide for all of us when we need it most. And yes, there's a lot of information out there on Google and social media and AI and Chat GPT and everything. But you know what? None of this replaces having the trusted physician and the trusted medical team that you're gonna have a conversation with. So I sought to write this book, which uh took me about two years, and basically the book takes readers through the journey of a cancer diagnosis, literally from A to Z. But I did not want to write a textbook. This is not a textbook, this is not a medical book. I thought the best way to write something like this is plain language, easy language. If you're a sixth grader, you're gonna be able to understand it fully and using patient stories, people I personally cared for over the years. Nothing resonates more with people than storytelling. If I tell you a story, you're gonna remember that story. And if I'm able to communicate to you the value proposition of something through storytelling, it's gonna resonate with you more. So the book is a collection of stories of people I have cared for over the years. Using these stories, I'm explaining the cancer journey, whether it is diagnosis, screening, staging, clinical trials, all types of therapies, chemotherapy, radiation therapy, and so on. But I'm using plain language and storytelling. And um, I am getting good feedback because I feel there's something that is missing. Um, a lot of books out there are medical textbooks, too complicated, the language is not easy. So hopefully, I remove these barriers and hopefully people are finding this as a useful resource.

SPEAKER_01 6:55

So, Doctor, how did you first get interested in being an oncologist and going into the cancer world? What was that? Was it a family thing, or when you said I'm gonna go to medical school to solve this problem, or or what is the history and the genesis behind all that?

SPEAKER_00 7:12

You know, what attracted me into oncology and the cancer world was not the science at all. Initially was the human connection. And I'll share with you a story since we're talking about storytelling, and I mentioned that in a couple of my books. Um, it was my internship year, and as an intern after um, you know, medical school, you you're just wanting to make sure you don't mess things up, and you're just trying to make sure that you're doing the right thing. It's very scary as an intern. And it was the fourth month of my internship, and I was assigned to the oncology ward. I was working at Loyola University here in Chicago. And um, at the time, you know, you walk into the room, and the vital signs are on a clipboard by the foot of the bed. And uh, I walked into this room um early morning, maybe uh before my attending was going to make medical rounds. So just checking on the patients I was assigned to. And there was this woman who was probably in her mid-40s. Um, she was strikingly beautiful. I think it's like honestly, like it's it's almost like an angel, if I have to give you an analogy. Like, and she was wearing this uh uh headscarf because she was bald from chemotherapy, and on the couch by her bed, there were two two her daughters, two daughters that she had, they were with her. So I walk in the room and I look at the clipboard and I'm writing the vital signs on a piece of paper. And um, I just asked her how she was doing, and she, you know, looked at me, she smiled a little bit, and then she said, Um, I have to ask you, do you think I'm gonna live until Christmas? Now, this was October when she asked me that, and I was taken aback. I was not sure how to answer this. First of all, I didn't really think I was qualified to answer, I did not know enough about ovarian cancer. She had ovarian cancer. And number two, I wasn't, I did not know how to communicate something like this. Even if I knew this, I just this is a difficult conversation. I did not feel like it too. And as if she recognized that I was stumbling, as if she recognized I was flabbergasted, as if she recognized I was, did not know what to say. And she, this lady who was who had ovarian cancer, who was gaining chemotherapy, she's in distress, she was the one she wanted to ease that burden off me. And she looked at me and she said, you know what, just don't worry about this. Um, I'll look forward to seeing your smile tomorrow morning. And I walked out of the room, and I like to this day, by the way, I remember how she looks, I remember the entire process. And I walked out of this day, I'm like, I can't believe that all this patient wanted is probably a human connection. Like she completely did not really care anymore about the situation, just wanted to see a smile. She wanted to see me tomorrow morning. She somehow connected with me. And I said, I want to take care of these people. I really feel uh just like just like that, I felt this probably is my calling. And um, after that day, I'm I want to do oncology and I want to take care of these people who um crave the human connection. Of course, with time, I was now very interested in the science, in everything that we're doing, in the advancement, in how we are curing more patients, and so on. But all of this started because of this one encounter I had in internship year. And um, unfortunately, my patient never made it to Christmas.

SPEAKER_01 10:52

Wow, I know. I mean, you have so many. I I'm I'm sure that you have many stories like that um, family. And then you have stories on the other side which are probably uh positive that there's a good outcome. So I mean, how what would are there any um kind of broad strokes that would create a good outcome for a patient, like early detection, uh, the right doctor? How would somebody um be better equipped to have a good outcome?

SPEAKER_00 11:25

First of all, you're absolutely right. We win more than we lose. This is very key to your listeners, to your viewers, everybody who's listening to this. Uh, the latest uh cancer statistics 70% of patients with cancer are alive at five years after diagnosis. So we must celebrate this. This is not all doom and gloom. But I do believe these unfortunate stories keep us grounded and remind us that we should do more and that the battle, if I use this as a metaphor, is not over. As far as going back to your question, uh the first the first thing I tell people, you must recognize that cancer is not one disease. This is really important because we do have the impression that cancer is just you know one disease, like, but it's not. Breast cancer is different than neuroblastoma, which is different than kidney cancer, which is different than bladder cancer, different than colon cancer, and so on. That is important because commonly people ask you, well, how come you can't cure cancer? And the answer to this, well, we cure more cancers than ever. It's just not all the same. In fact, this is the I opened the book with a story happened to me on an airplane where people were asking me, like, wow, can't we cure cancer and so on? Um, the the the best way to get the best outcome, number one, be knowledgeable of the problem that you're facing and understand there are nuances in the disease that you have, God forbid, that people may not have. Because what's gonna happen? You get diagnosed with something, and your neighbor says, Well, you know, I mean, you know, you must get X, Y, and Z. And the next door neighbor, the other neighbor says, No, no, no, no, you have to get my doctor told me you gotta get the supplements, the chemotherapy, and and all of a sudden you're bombarded with all of these recommendations. But what they dealt with likely is different than yours. Even within the same disease, when you talk about breast cancer, not all breast cancers are the same. There's triple negative breast cancer, there's hormone receptor positive breast cancer, and every single disease is different. It is critical to understand the disease that the patient has and that it is different than what other diseases, that not all cancers are the same. Number two, it is very important to get the best team. And this is really important. Now, best team does not mean you have to always go to university or large centers and so on. Get people who are equipped, and I go through that actually about how to select the right team and so on. The team that can communicate with you is very key. You must be empowered to ask questions. I strongly recommend second opinions. No one should be embarrassed of asking for a second opinion. No physician or medical team should be um, should should they we should always facilitate this. Um, yes, early detection helps in certain cancers, not all cancers, but I think being knowledgeable, getting the right team, understanding your disease is different than others because you're gonna hear a lot of noise, and then you gotta stay positive. There's a lot more wins than losses. You have to stay positive, and I think you'll position yourself for success.

SPEAKER_01 14:46

It's so interesting about when you talk about team because obviously we all, you know, we're big fans of professional sports, and that's all about being on the team. And then when you look at a team in totality, there's different players that do different things and different coaches that bring different things to the, you know, to the playbook. When um my oldest son, Jonathan, was nine months old, he was diagnosed with neuroblastoma. And um, I think the movie Armageddon had come out a couple years prior to that. And that movie was such a motivational movie for me because I was like, well, Bruce Willis put together a team of people, and they were kind of they none of them seemed to all, they were all very different, but they got together as this team to go get the asteroid, and then it was kind of my mission, the same thing as a mom with the child who had cancer because he could not put his own team together. But it's like you have to figure out what is the best team. But I mean, how if you don't know how to do that? I was fortunate. I was at a great hospital in a city with a lot of doctors and professionals and advisors. But if you don't know how to put together a team, how does one do that?

SPEAKER_00 15:59

Yes. Um, so let's let's think how usually things happen. Whoever diagnoses the cancer or the problem, it's usually rarely the oncologist, right? You get referred to the oncologist. Usually it could be a primary care doctor, it could be obigni, could be ENT, whatever it is, specialty. Oftentimes, this person who diagnosed the disease will give you recommendations of who the person you should see. And this is generally uh in the same institution where you're diagnosed, the same clinic, based on relationships that they have and things of that nature, which is okay. I mean, this is how it is. Um if you trust that physician who made the diagnosis that you've been with, then you trust that um referral. But I always say trust but verify. There's we live in an era right now where we have a wealth of information, a lot of access. Yes, I mean, I don't believe anything online, everything online. Frankly, let's face it, somebody could go online right now and write something bad about me. I mean, nobody is preventing that from happening. There's no like filters. So you have to trust but verify and do the research who this person is. Do I know somebody that actually has been cared for by this individual? And things of that nature. And then, yes, you should go and see that person, and you gotta trust your gut instinct there. I advise patients that all the time. And what do I mean by that? If you are in the room and you're asking a lot of questions and you get this rolling of the eyes, or somebody being like a little bit fedgy and uncomfortable because you're asking too many questions, honestly, that's not the right person. And I say that it firmly, because if you are diagnosed with a disease that's serious and you're not even given the room to ask enough questions when your life is being threatened, then what's gonna happen when, God forbid, like two weeks from now, you have a little bit of nausea, you need to get some help. I mean, you need to have that feeling that this individual is gonna be with you throughout the journey, the cancer journey, because it's not gonna be all nice and dandy. There will be some good days and some bad days. And while we celebrate the good days, we need that person, that team in front of us. And then you have to know who is also supporting that physician, the nurses, the staff, the front desk. I mean, all of this come together. You may need some records. You gotta call the front desk and ask, are they nice to me? Are they friendly? You get that vibe. And I do recommend getting a second opinion to better assure that the recommendations you're being provided are actually accurate. And then you have to pick which one you are going to see. Um, but I I say you have to look at the whole picture, not just the the recommendation. Um, am I are they gonna be there for me when I need them? If I need something at midnight, what is the process? Am I gonna go to the ER? Is there a phone line? All of these are important. I actually go uh in one of the chapters, I list type of series of questions that need to be asked. But my pet peeve, if you are if you feel you are not given enough room to ask the questions that you need, it's a warning sign. I'll say one thing. Um physicians were all overwhelmed, and burnout is rare among physicians and so on. So, yes, sometimes if you have a hundred questions, I may not be able to answer because there are other people waiting in the room. But the way to handle that is I will look you in the eye and say, you know, we spent an hour, you still have a lot of questions. Uh tell me which ones are really critical because I will finish the clinic and then I will call you later in the evening and we'll go through the remaining questions. That's that's a polite way of explaining. I can't be two hours with you because otherwise the other patients won't be served. But I'm not dismissing your concerns. I'm telling you, you know what? I will call you in a few hours when I'm done with the clinic. You, as a patient, as a family member, will respect that, will understand that because you obviously realize there are other patients, but you you understand you're not being dismissed. You're just he's politely asking you, just I need to see other people. I will call you in a few hours to go over remaining questions now that we've addressed all of the pressing ones. Because some questions may not be critical, but they're important to you. But clearly, you know, um, there are schedules that have to be followed. So there are ways of handling this and trust your instinct. I see a lot of people who go against their instinct, against their gut feeling, because somebody is luminary in the field, but unfortunately, that person is not always available who need them the most. So trust and verify. Get look at the entire picture, trust your gut instinct and get a second opinion.

SPEAKER_02 20:56

Okay, so I'm I'm really intrigued about um your studies with AI because AI is huge right now. Um, talk to us a little bit about how you're utilizing AI with the cancer journey and a cancer diagnosis with your patients and loved ones.

SPEAKER_00 21:11

So this is not a plug, but I have a I do have a book coming out later in the year on AI and cancer care. Um and uh um basically it's because there's a lot of questions about AI. And I thought to myself, again, my style is can I simplify something that could be consumed by the general public? I don't want to write for tech people or medical people. So you're absolutely correct. AI is integrated throughout the cancer journey, really from A to Z. Um, and that's a whole completely different topic, but I'll tell you a few areas, for example, uh, just to give a flavor of where AI is being integrated. Um there's a lot of interest in applying AI in screening. Let's take screening mammography as an example. There are a lot of times where you know a woman will have a mammogram, screening mammogram, and then she gets called back that, well, we saw something, we're not sure we need to do additional imaging. That recall, that anxiety that stays with the woman until she gets that additional is big. But AI can help with that. Because what AI is you're training the machines on millions of images. And if you train the machine on because on millions of images and teach the machine that whatever you see here is benign because we know the output, the outcome, and this one will be more suspicious, then the machine and the AI can help the radiologist decide whether this, what they see, is actually something that nothing to worry about or something that they need to pursue further. And this will help the patient. They don't have to really go through the anxiety and so on. And that applies across uh other uh things of screening and not. What I'm interested in in a lot right now, and what I do day in and day out as chief medical officer of Write AI, which is an AI uh company, is focusing on how artificial intelligence can accelerate clinical trials. Clinical trials are the conduits that we had and we continue to have to bring these new therapies to people that need them the most. Everything that we use today in cancer that we celebrate has gone through clinical trials. So if we speed clinical trials, these medications could arrive to patients that need them the most faster and sooner. So hopefully we can save lives. So what we're doing is we are helping any any type of clinical trial or a protocol by sponsors and the folks who run these clinical trials to find the proper sites that are able to execute on these studies. So if you're able to find the right sites that are able to execute on these clinical trials, you're likely going to cut the trial shorter. It takes about 10 to 15 years for a trial to read, and almost$3 billion. And 90% of the drugs don't even work, and they get shelved because they didn't really work. So we really need to do a better job in bringing this innovation, this technology to speed things up.

SPEAKER_01 24:29

So, what about toxic illnesses and things that maybe you just pick up from being around an environment that is unhealthy and but you don't even know it?

SPEAKER_00 24:42

This is a real uh a real deal, and I'm glad you asked because it's sometimes the um forgotten problem that we face that could have significant impact on our health, and sometimes cancer. Um I uh I'm very passionate. I'll give an example. Sometimes giving examples or stories resonate with people, but um pesticides and herbicides that are being used on the food, these are uh a big problem. Um Roundup, which is um the main ingredient is glyphosate, uh, which is really the herbicide and pesticide being used the most uh in the in the country, if not the world, is all over the you know crops. And so you actually see it in cereal, in in bread, and and that's a problem because it has been linked to a form of cancer called nonhotchkin lymphoma, as well to other things that we it's been published about, how it affects fertility and other things, and and we are all being exposed to that. So trying to figure out how we can eliminate certain things in our day-to-day life, such as are we able to eat organic food as opposed to, I mean, these are things that we could do, avoiding sun exposure, of course, tobacco and alcohol, the things that we know we can actually avoid. So avoiding anything in the environment that we know might actually have an impact on our health is key. That's one thing. And then couple that with situations where you can screen for certain diseases early, hopefully, this allows us to continue more progress. And once the diagnosis occurs, then we have the novel therapies that we have accelerated through clinical trials. So all of this is like a well-oiled machine that we are able to hopefully help patients with.

SPEAKER_01 26:34

Yeah, I mean, I think that the whole thing, I think we're now as educated consumers and educated humans, it's great that we have the ability to have this information that we can then decide what we want to do with. But I think for some people it's harder for them to eat organically and eat healthy. So well, it's expensive, right? It is. I mean, so and and also they might not have it available to them or even know about it. So, how how does somebody uh for the normal, you know, everyday human, what are some things that people can eat and do? Obviously, you know, exercise and some healthy foods and things just to try to maintain uh a healthy, um, a healthy long life?

SPEAKER_00 27:21

I I I I do like what you said. A lot of people may not be able to afford expensive food, organic food, they may not be available. We have to be cognizant of that. So I do think that's where our government and regulators should really look behind, pull the curtain, and say how can we really prevent this from happening and maybe put certain bans on certain pesticides, herbicides because they're harming people. You just look at the health of you know, and how we have changed over the years, and and you'll realize that this is an important part. Yeah, there are certain things that we can all do, like you said, we can obviously avoid tobacco, alcohol, sun exposure. We could definitely get you know vitamin D. We can um sleep better. I think stress management is very key. I think if somebody knows me that's listening to this, they're gonna probably um think I'm because I don't sleep very well, unfortunately, but I'm working on it. But sleep, sleep well and stress reduction is very, very, very key. Um I I think when it comes to diet, it's actually interesting. I I um there's a lot of data out there, it's not always scrutinized, it's very difficult to know sometimes how much is real data versus not. Like you sometimes you open the paper and people say coffee causes cancer, and then the next day coffee prevents cancer. And my answer to patients you know what, if you like coffee, drink coffee and enjoy it. In moderation, right? In moderation. Is it good to have six cups of coffees? No, is it five? No, I don't know. But moderation is moderation, it's very important. Um, cutting on red meat, I do think is actually important. I mean, people you should, in my view, you should not be having red meat all the time, but should you indulge every so often? Sure. Like, you know, if you like to have steaks, I usually tell people, again, randomly, you should not have that more than twice a month. Now, why'd I pick up twice? I just thought it's a reasonable number, it's moderate, and so on. I prefer to replicate with fish, with chicken, with other things that are a little bit more the white meat as opposed to the red meat. Having fiber in the diet is actually key. There are a lot of data out there on plant-based diet as well as on keto diet. Keto diet specifically has gained a lot of popularity. In my research, I have not seen it does anything for cancer. It does certainly help weight loss. People can lose weight with keto diet, they can uh it could have some um uh good uh you know cardiac effects and so on, but cancer, I haven't seen anything. I think trying not to be obese and overweight is very important. Um I it's a health issue, uh, frankly, regardless of the association with cancers. So there are certain things in our control, right? I mean, you know, there are certain things in our control, but also, you know, um, just with moderation. I mean, I don't like when people say, well, I never eat French fries, because I like French fries. If you hate it, don't if you hate it, don't eat it. But it's okay to have it every so often. We live one life. Let's just be again, I mean, we're gonna, we're gonna, you know, we live one life. We have to enjoy certain things with moderation, even with alcohol. Alcohol is associated with cancers, but every so often you can have a glass of wine, or if you like to have a beer and so on, it's fine. It's just not really the excessive things. So um I like to balance these recommendations against the fact that quality of life is important and we live one life and we must really enjoy it.

SPEAKER_01 30:58

And so, how often should people go to a doctor and get a checkup?

SPEAKER_00 31:02

Well, it depends a little bit on uh their family history, their overall overall health status. I think once or you know, once or twice a year is really important just to keep up with everything that is out there. Even there's not a whole lot going on. If you have a good primary care physician, they are abreast of what's happening. And uh most women, they usually to go to obigaine in general until they get a little bit older, and then they may have obigni plus a primary care physician, because you know, in the 20s and 30s, you probably don't need more than just obigani, who's really well knowledgeable in ordering certain tests and so on. I would say once uh or twice a year at most, if you are healthy, and then depending on if they find anything, they may actually want to see you sooner rather than later. But I wouldn't do more than that for now.

SPEAKER_02 31:51

Well, we're super excited about your new book launching, so hopefully we can have another podcast day with you.

SPEAKER_00 31:58

I'd love to. We'll be an honor to come back.

SPEAKER_01 32:00

So, are your children following in their father's footsteps and going into medicine?

SPEAKER_00 32:05

I failed to inspire them miserably.

SPEAKER_01 32:09

So they're rock stars, is what you're saying.

SPEAKER_00 32:12

I mean, I failed to, yeah. Uh if they're listening to this, they're gonna realize how no, no, I'm proud of them, of course. But one of them, uh they just started college. Um, they go to Purdue, they're twins, and uh, one of them is doing electrical engineering, and the other one is doing cybersecurity. And uh I thought one of them at least will get the bug and want to be a doctor, but um, I guess not. I think they probably see how my hours are and how much I work, and they're like, no, you know what, let me tell you, this current generation is a little bit different than the older generation.

SPEAKER_01 32:50

Yes, that is definitely true. Well, you know what, but a lot of times people decide later in life that they want to go into the medical field. So uh it's not, you know, I wouldn't, I wouldn't rule it out entirely, but it seems like they have a great future ahead of them as well in careers that are also very necessary for uh for this generation.

SPEAKER_00 33:11

So up with the cybersecurity guy, the engineering guy is a hopeless, he just loves engineering too much. He thinks everything's around engineering. I'm like, okay, if you say so, I guess everything's around engineering.

SPEAKER_01 33:24

Well, good for them. I'm sure that they're very proud of their father and uh and all the things that you've done to help others because truly, there's nothing like having a really compassionate, empathetic doctor during the darkest time. And obviously, you are that person. And uh the cancer journey is one that a lot of people don't want to be on, but if they are on this journey, then um having a book to guide them through that, which is like you said, not a textbook, but something that can really enlighten them and highlight the things that they might need to know, and even questions that people don't even know often, and this is my kind of my last question for you how important is it to have an advocate? So if you're the patient, how important is it to have an advocate with you during that time?

SPEAKER_00 34:12

Very, very another set. I mean, during the visits, it's very important to have somebody with you if you can. One of the biggest concerns I I had when I'm meeting a new patient is I'm gonna walk in the room and the patient is alone. Um, obviously, I'm meeting the patient for the first time. I don't know much about him or her, but I immediately get nervous inside, and I really want to understand why. Uh, because that's very important. What's why couldn't you bring anyone with you? Family, friend, neighbor, somebody who can be with you alone, even for one visit or two visits, just another set of ears, because when you're overwhelmed, sometimes you don't hear everything. So I I I've had situations where I get very nervous and I ask, you know, tell me a bit about you, just to understand the family dynamics, because this is a team effort. I know what's coming, right? I know the type of therapies I'm gonna prescribe, I know what they may go through. And if they have no advocate, if they have no one that's not only just advocate for them for their medical care, but also being there for them when they just need to. Sometimes you just need to talk to somebody to be able to vent, to be able to scream and to yell, and and you want to have that individual. So um I think having support groups is key here. I've relied so much on my social worker colleagues who really helped me identify avenues to help patients and families. One of the chapters I wrote is um caring for the caregiver. Caregivers go through a lot, and and you are a caregiver with your son, you mentioned with neuroblastoma. What you go through is very difficult as a caregiver. Because, first of all, you go through a lot of emotional issues as a caregiver, and you feel guilty voicing them because if you voice them, you feel you're taking attention away from the patient himself or herself who are getting through therapies. So you you're almost in your own isolated corner, having a lot of this emotional turmoil as a caregiver, and you have really no outlet out there, and and you don't like nobody is every all the attention is going to the patient who's your loved one, so you're happy about this, but you almost feel forgotten, and you get something called compassion fatigue, you get something called caregiver burnout. It really happens because you just feel guilty doing anything for yourself and even voicing any concerns. I saw this in my practice a lot, and I would sit down with the caregiver and and talk, and I have several stories I share in the book about this, but social work involvement is so important because I don't think physicians are knowledgeable enough with all of the resources out there. So I have I had a most of my patients, I would offer them social work help, a meeting, and so on. And the people who do social work and this counseling are angels because they they just sit down and listen. They actually try to understand what's needed, and then they are so resourceful, they find ways to say, you know what, how about we do this? How about we do that? I couldn't do anything that I did without them. That's why it's a team, right? I mean, this is, you know, yes, of course, I'm gonna think and decide on treatment, but how successful is the treatment going to be without my nurses helping, pharmacists helping, social workers, the everybody is working. It's a team.

SPEAKER_02 37:56

It's so nice now. In the I know I worked at Wake Forest Baptist Medical Center on the unit there, the palliative care unit and the hospice unit. Um, and it's nice to actually um now they have implemented, uh you're very familiar with this, I'm sure, is nurse navigators. So when people Yeah, it's huge. You know, as a social worker, but you also rely on the nurse navigator because it's coming from a clinical um aspect with the nurse navigator, and the patients don't that are alone, or even the ones that do have family members that have nurse navigators, they don't get lost in the system, especially when you're in a big medical, um, medical school, medical institution like that, like the Wake Forest Baptist Medical Centers and the Duke and the Carolinas of the world, Northwestern and Chopped and all of them. It's it's it's overwhelming just to be, you know, navigating through the hallways of a medical university.

SPEAKER_00 38:48

I give an analogy. I tell people imagine that I just dropped you off in Beijing's airport in China, and you don't speak the language, and nobody understands you, and I just leave you there. It's gonna be very overwhelming. I mean, give that analogy to anybody like, yeah, that is what it is. Doctors and nurses and social workers, they live in the hospital almost. They understand it. But for a patient walking in these doorways, it's so overwhelming, so intimidating. And we have to ease this thing. We have to ease it.

SPEAKER_02 39:21

Just pulling in the parking deck at some of these bigger university medical school systems, hospital systems is very overwhelming. You know, patients have to be navigated in the parking deck, let alone once they step inside of a big medical center like that.

SPEAKER_01 39:38

Yeah, it's that analogy of being um dropped off at you know a major airport and you don't speak that language. That's what I would always say. I'm like, I feel like somebody just picked me up and put me in another country. I don't speak the language, I don't even know where I am, and I'm tired as well. And now I'm trying to figure all this, all this out. But we do it. And you know what? That's the thing is that somehow you find a way and you figure it out and you do it, and you find people within that system. And obviously, nurse navigators are great and doctors are great. You know, I've had friends who have been their advocate and caregiver, and the valley parking attendants would, you know, be so supportive and helpful, and just finding people that you can connect with. And there's so many compassionate, you know, the same way that you said that there's people that are out there that are, you know, beating cancer. There's so many more people that are compassionate and want to lend a hand than not. So I think just asking for some help and guidance, and um, usually you'll find it. So, how do people find you? If people are looking to find you and find your book, how do people find you, Doctor?

SPEAKER_00 40:46

I mean, I do have a website because everybody has a website. It's shadinabhan.com. So there's a lot of information there. Um, I have two podcasts, and uh, one is called Healthcare Unfiltered, and the other one's called Healthcare Unfiltered Express. The Healthcare Unfiltered Express is uh very clinically heavy, so patients may not really like that much unless they're very, very savvy in oncology. But healthcare unfiltered is broad general healthcare topics. This week, for example, I interviewed an author of a book on viruses and vaccines. It's called Kill Switch, and it's uh it's really about viruses in general, vaccines in general, and so on. So I think um a lot of information of this on the um on the on the website, as well as to find the books. The books are available everywhere on Amazon, on Barnes and Noble, on uh through my publisher, Johns Hopkins University Press. And um, yeah, I appreciate the opportunity truly. It's it's it's wonderful what you're doing. I always say it's all about communication, right? What you're doing is disseminating information, communicating with the public about certain topics. And if you help one person, literally one person, it was well worth all of the effort that you went through of taping this podcast and many other podcasts.

SPEAKER_01 41:55

Yes. Well, thank you for taking time away from your patience to uh to spend a little time with us. So I'm excited.

SPEAKER_02 42:03

I'm very excited about my book. Thank you so much for sending it.

SPEAKER_00 42:06

And thank you. Thank you for the opportunity.

SPEAKER_02 42:09

Yes, and we'll be in touch about when we can interview again for your next podcast on AI. I'm excited to learn more about it, of course.

SPEAKER_01 42:18

Yeah. And, you know, the name of the show is Bench to Bold. And obviously, uh uh, you know, you've had very uh prom a lot of bold moments, and we're glad you're not on the bench, is all we're gonna say. Is that we're glad you're living bold moments and doing bold things because you're helping so many people. Yeah. So thank you, Doctor.

SPEAKER_00 42:40

Thank you.

SPEAKER_02 42:42

Well, have a great rest of your week, and we'll catch up soon.

SPEAKER_00 42:46

Take care.