By Dr. Jan Bonhoeffer. Originally published 5/26/2021 in Thrive Global.
Can you tell us a story about what early experiences brought you to choosing a career in the medical profession?
I was always known to be a great listener. As a little girl and young adolescent, I would listen to my friends openly, without judgement, to their concerns and woes. In addition, I was always a keen observer of the world around me, able to pick up on minute clues of a person that helped me aid others. Also, I was always interested in science and art. A visual learner to the core, pathology was a natural fit.
Can you share the most interesting story that happened to you in your career as a doctor?
There are many interesting stories that come to mind…however, early in my career as an FNA (fine needle aspiration) specialist, I learned to become a true detective. A woman was referred to me for a neck mass. She had been putting on makeup a few days earlier and noticed a left neck lump. She went to her ENT who then ordered an ultrasound to visualize it. He found that she had an adjacent mass in the left thyroid. He assumed that it must be thyroid cancer with metastasis to the nearest lymph node of the neck. When she came to me, I performed an ultrasound first to locate the lesions, then used ultrasound as guidance for my fine needle aspiration biopsy. Finally, when the slides were processed, I looked at them. The thyroid biopsy looked completely benign. However, the neck mass biopsy looked very malignant. I thought that perhaps I missed the malignant portion of the thyroid nodule even though I sampled it well. Given that the needle is very thin, there is always a risk of sampling error. However, I needed to prove that the neck mass was coming from the thyroid. I did ancillary studies and to my surprise, the neck mass did not come from the thyroid or anywhere near it. It was a pure mystery. I recommended that the patient get imaging studies of her entire body. PET-CT showed that she had a huge mass in the ovary! Subsequent studies revealed that the neck mass was a metastasis from the ovary. From this story, I learned that I have to keep my mind open to all sorts of possibilities, not just the ones that are the most obvious.
Can you share a story about the funniest mistake you made when you were first starting out on your career? What lesson did you learn from that?
When I was an intern in Internal Medicine, I was in my usual clinic when one of my patients was waving his arms at me from behind the counter. I approached him over the nurse’s desk and asked if all was okay. He answered yes, however, he was trying hard to follow my instructions, but the nurses did not want to take care of it. At that time, to screen for colon cancer, we would send patients home with fecal occult blood cards. These are cardboard folded cards with a space inside for which to smear a sample from toilet paper after going to the bathroom. Instead, the patient presented me with a gallon sized doubled Ziploc bag of his poo. I learned that I needed to explain clearly even the most obvious instructions (to me) to my patients.
To #DareToCare means to survive and thrive in today’s medical world. How do you take care of yourself? What’s the routine you must do to thrive every day?
As a working mother of 3 boys, I like to delve into the creative. Sometimes, that means, while everyone is asleep, baking a cinnamon-chocolate babka. During the pandemic, I became involved in textile art: I made my own stencils (We’re all in this together) to paint t-shirts. I tie-dyed and learned the ancient Japanese art form, Shibori (I shiboried napkins, placemats, clothes, bedding, etc.). In addition, I learned to scratchboard, a form of art that was extremely meditative. Sometimes, just having a cup of tea before anyone is up is my daily ritual can be soothing.
I write a series of letters to my God-daughter in my latest book. In that same vein, what are 5 things you would tell your younger self?
It’s OK not to know exactly what you want to do in life. Nothing is written in stone. You can always pivot and change what you have chosen for your career or work. There are always other ways that you may not know of, to work around a problem and get what you want. Have confidence that you have the power within you and not be scared or intimidated by others who may make you feel bad. Try to enjoy the process of learning… not just to get through it to get to the other side.
How can medical professionals reclaim heart-based healing amid pandemic, political, and other pressures? Stay true to yourself. Keep hold of your true north (be it your mate, friend, experience, beliefs).
Is there a particular book that you read, or podcast you listened to that really helped you in your work as a healthcare professional? Can you explain?
I listen to The Daily (New York Times). It keeps me informed and opens my mind to things I may not be inclined to read.
Because of the role you play, you are a person of great influence in the healthcare community. If you could inspire other doctors and nurses to bring change to affect the most amount of good to the most amount of people, what would that be? Said another way, what difference do you see needs to be made for our collective future?
To quote the song, “people are people”… we are all of the same human species. We may come from different parts of the country or world, but we all bleed the same, we cry the same, we laugh the same, we have children, we love the same, and we all die. Not to trivialize the disparity between those with privilege vs. those without, however, our most base instinct, is to be tribal…to be fearful, or even hate, others that are not (on the surface) like you…but have we not evolved from that?