December 11, 2024 • 25 mins
Dr. Michael Ogawa joins us for a heartfelt conversation as we trace his compelling path from a childhood in Garland, Texas, to becoming a dedicated medical oncologist in St. Louis. His journey through the halls of Washington University and Texas A&M is more than just a career story; it's a testament to the power of passion and perseverance. Alongside reflections on his cherished partnership with Dr. Mira Rana and the joys of family life, Mike opens up about personal challenges, including a recent ankle injury, offering a window into how these experiences have deepened his empathy and approach to patient care.
The landscape of cancer treatment is ever-evolving, and this episode takes an insightful look at its promising advancements. We discuss the transformative potential of treating cancer as a chronic condition, akin to diabetes, and the groundbreaking role of immune therapies in modern oncology. With honesty and optimism, Mike and I explore the collaborative magic of tumor boards, where specialists unite to push the boundaries of patient care. Together, these collective efforts are leading to improved survival rates and a better quality of life for those living with cancer.
Success is redefined as we discuss family values and the enriching power of professional friendships. It's not just about individual accolades but about nurturing happiness and well-being within our families and communities. Parenting's journey is shared with an understanding of its challenges and rewards, painting a picture of true wealth found beyond material gains. The episode concludes with a tribute to the strength of professional bonds, as Mike and I express gratitude for a supportive work environment that has been a cornerstone of both our personal and professional growth.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hello, my name is Jason Edwards and this is Doc
Discussions.
I'm excited to have a specialguest.
This is my good friend, drMichael Ogawa.
Mike is a medical oncologist,which means he treats patients
with chemotherapy andimmunotherapy and targeted
therapy for cancer.
And before we start, I justwant to say Mike, when I think
(00:24):
about him, he's he's such a ahard worker, a very smart guy,
but a very kind and upbeatperson, and I think all the
people who work with you verymuch appreciate your personality
, and I know our mutual patientsdo too.
So, mike, welcome.
Speaker 2 (00:38):
Thank you, thanks for having me and thank you for the
very generous and veryflattering introduction.
So thank you.
Speaker 1 (00:43):
Yeah, I try to flatter you, to kind of get you
off balance, and then we canreally hit you.
It's okay, it works.
And so, mike, you're from Texasoriginally, right?
Speaker 2 (00:54):
Yes, originally from Dallas.
I grew up in one of thenortheastern suburbs of Dallas
called Garland, texas.
Okay, kind of a small kind ofan immigrant population there.
So my parents are originallyfrom, my dad was from Japan and
my mom was from Vietnam and mydad actually moved to Texas for
work, so that's kind of how theyended up there.
But I grew up there and livedmost of my life actually in
(01:17):
Dallas.
Speaker 1 (01:18):
How about that?
And that explains the big hair.
Yeah, the big hair.
Speaker 2 (01:21):
You know, I don't have a cowboy hat, but I do have
some cowboy boots, yeah.
Speaker 1 (01:25):
They always say the girls in Dallas have big hair.
I don't know, that's probablychanged since the 80s, but
anyway.
Speaker 2 (01:30):
I know, maybe now more and more guys have perms
yeah.
Speaker 1 (01:35):
And then you did your undergrad here in St Louis at
Washington University.
Is that right?
Speaker 2 (01:39):
That's correct.
That's correct.
So I did my undergrad here atWashington University and so I
kind of had a good group offriends here.
I ended up going back to Texasfor medical school.
I went to Texas A&M.
It was actually one of thecheapest medical schools I could
go to right around $20,000 ayear.
It was great.
So I went there for four yearsand then I still had some
(02:00):
friends here in St Louis and Idid like St Louis a lot.
So I came back up here for aresidency, actually at St Louis
University.
My wife moved up from Texas tokind of be with me and she's a
lawyer.
So she took the Missouri barand then she was like I'm not
taking another bar exam.
So we ended up staying here 10years later.
You know we have a daughter, wehave a house here, and so I've
been here ever since.
Speaker 1 (02:20):
Yeah, and then and you also did part of your
training with Dr Mira Rana,who's our other medical
oncologist- that's right.
Speaker 2 (02:27):
So she and I go back pretty far.
So she and I met actually thefirst day of residency so we've
known each other for eight, nineyears now and so she went off
to Wake Forest for a fellowship,but her husband and her family
live here in St Louis, so wewere very welcome to, very happy
to have her back actually afterthat was done.
Speaker 1 (02:47):
Yeah, I think you helped recruit her here, and so
we're also indebted to you forthat.
Speaker 2 (02:52):
Oh no, she's definitely a welcome addition to
the group.
Speaker 1 (02:55):
Yeah and so yeah.
So you mentioned your wife andyour new young daughter.
Who is?
Is she two now?
Speaker 2 (03:03):
Yeah, that's a good memory.
She's two and a half years oldand she's really coming into a
fun age.
It's exciting.
There's a lot of fun new thingsthat I get to experience every
day, both her and myself so it'sbeen kind of interesting to
both kind of navigate that, butalso it's been probably one of
the most enjoyable times I'vehad in my life.
Speaker 1 (03:24):
That's beautiful, it's been good.
Yeah, you learn a lot from yourkids, you know you learn a lot
about life through kind ofliving it on the other side of
the lens, as a parent, for sure.
Speaker 2 (03:35):
Yeah, very much.
So you know it's kind ofinteresting.
I guess you can't see throughthe podcast, but you know I
actually was recently injured,right, I broke my ankle and I
had surgery, and so I think thatthe same thing, when it comes
through with children, it kindof gives you a new perspective
on kind of life.
I think you kind of get intothe grind and you get used to a
certain routine and so kind of.
(03:55):
When you see the novelty in theway your kids see things, it
kind of brings excitement toyour life.
And the same thing, being onthe other side of things, like
being a patient, also kind ofwakes you up to kind of the
things that they have to dealwith every day and it kind of
gives you a new perspective oncoming to the hospital and
health care.
Speaker 1 (04:13):
I totally agree.
My experience as being apatient was maybe five years ago
.
I was having heart palpitationsand I called Craig Reese, our
chief of cardiology, and he saidwell, you know, maybe come on
in and get checked out and I wasactually worried.
You know it's your heart and Ithought, you know I'm a pretty
healthy guy.
But you know you could tell hewas a very competent physician
(04:36):
and that and his kind of commandof the situation very much put
me at ease and I feel like Ibecame a better doctor for that.
What did you learn through yourmedical experience?
Speaker 2 (04:57):
You know, I think that I definitely have the same,
I think, level of like fear,anxiety and almost helplessness
I think that a lot of patientshave when they come to see me, I
think level of like fear,anxiety and almost helplessness
I think that a lot of patientshave when they come to see me.
You know, I think as medicaland radiation oncologists we
never meet people on their bestday, all right.
So, you know, I think peoplecoming to see me are always
worried about things and even ifthey're not coming for a cancer
(05:18):
diagnosis, when they walk inthe doors and it says you know,
blood and cancer center, that'ssomething that is definitely at
the forefront of their mind.
It's something they're worriedabout.
And the same thing with me too,you know, I think.
You know, when I broke my ankle,I was really worried about kind
of what would happen, not justin the in the short term as far
as healing and the surgery, butlong-term, like what would that
look like for me?
You know, moving forward and Iactually had a had a very
(05:40):
similar experience with you iswhen I came to the hospital here
.
Actually, I had my surgery hereat St Luke's.
You know I was not familiarwith the surgical surgery
department very, very much.
But everyone was so nice.
You know, it was a very kind ofwelcoming environment and they
and actually people who I hadshared patients with came by and
kind of wished me good luck onthe surgery.
(06:01):
People I've actually never metbefore wanted to come by and
just say hi, and it was reallynice.
It took my mind off of theupcoming surgery and it made me
also feel confident that thepatients that we sent to get
procedures done are in reallygood hands.
Speaker 1 (06:16):
Yeah, I agree, when you're afraid, it's nice to see
some friendly faces.
It's nice to see some friendlyfaces.
It's nice to see some peoplewho are in control and they know
what they're doing.
And I agree with you as well itmade me more confident in being
a St Luke's physician.
Now the Larry King questionhere is what kind of dance move
(06:39):
were you trying to do when youbroke your ankle?
Speaker 2 (06:42):
Obviously not a good dance move.
You know, I think that I have avery Enthusiastic dancer.
I probably Enjoy it.
I guess my enthusiasm outweighsmy skill, put it that way,
right.
And so I think my wife Not sokindly reminded me that I'm not
as young as I used to be.
Yeah, and I need to be morecareful, but I don't
(07:02):
particularly remember the dancemove, but I do remember slipping
, yeah, and so, although I didend up breaking my ankle, it was
a very memorable and funwedding.
No regrets.
Speaker 1 (07:14):
Yeah, you know I don't like your wife's
negativity and I think you stillgot it.
Speaker 2 (07:18):
So tell her.
I said that I thank you.
I do have a spare leg so I canstill dance a little bit.
It's pretty good though.
Speaker 1 (07:24):
Yeah, um, and you know there there's.
This is another kind oftentative life is.
There's always adversity.
There's always.
It's going to come in differentforms.
It's going to come at differenttimes.
I think sometimes, when it'sthrough a fault of our own,
whether it's um, break yourankle while dancing or or
getting into a car wreck, it'sit's sometimes harder to accept.
(07:45):
But the the first step isreally acceptance and saying,
hey, this is where I'm at Likeand I've got to objectively find
a way to kind of move forwardfrom here.
Whether it's a broken bone or acancer diagnosis, you've got to
regroup and say, okay, how dowe move forward objectively to
optimize our situation?
Speaker 2 (08:05):
Yeah, I agree with that.
I think that I definitelyexperienced some of that, you
know, in the beginning, becauseit was something that was silly
and possibly could have beenprevented, right.
And you know, the two weeks Iwas laying on the couch
recovering from surgery, Idefinitely had time to mull that
over and I kept going back andforth between being, you know,
saying the same thing thatyou're saying, like, hey, you
know it happens, you got toaccept this, it is what it is
(08:25):
and we and we can move forwardfrom this, but also, like you
know, how could this happen?
This is, you know, never a goodtime for something like this to
happen.
And you know it's a busy timeat work.
It's tough, I'm out.
It's a busy time for my family,it's hard for my wife, my
daughter.
But, you know, I think we kindof tell our patients the same
thing, right, hey, like you know, this is something that's
unexpected, this's somethingthat we can definitely get you
(08:47):
through, right, and so, you know, we allow them to process it,
but definitely, after you knowthey've come to terms with the
diagnosis, it's something thatwe would love to help push back
on, right, it's time for us tofight back against the cancer.
It's time for us to kind of getyou back to do the things that
you like to do, right, and Ithink that that's really the
benefit of modern medicine, youknow, even for diseases where we
(09:09):
can't cure it, if we can getyou back to doing the things
that you like to do and gettingback to a fairly normal life, I
think that we've been successfulin what we can do.
And I tell my patients you know, there are lots of diseases
where right now there isn't acure, but every time that
there's a conference that comesout or there's new data that
comes out, I know it's a happyday for people, right?
Because that just means that wejust need to get you to the
(09:31):
next good drug out there, thenext good treatment, and then we
start seeing cancer less as aterminal diagnosis but more of a
diagnosis that we can managelong-term, like diabetes or high
blood pressure, and I thinkthat that takes some of the fear
and some of the control awayfrom the diagnosis itself some
(09:52):
of the control away from thediagnosis itself.
Speaker 1 (09:53):
Yeah, so when somebody comes into our office
my, whether it's mine or yours,you know the first rule is to
always be completely honest.
Or you could say, always tellthe truth and never tell a lie,
and those are two differentthings.
And so we're honest with thepatient.
But part of being honest is tonot say hey, the clinical trial
(10:13):
that shows the best treatmentfor your disease, which is the
treatment we're going to do,which we call the standard of
care, shows that patients fiveyear overall survival, meaning
the amount of patients who arealive five years later, whether
it was from a cancer or carwreck or whatever it may be is
this number, say, 75%?
But that's just the knownknowns.
(10:34):
So, like Nassim Nicholas Talebwould say, there are also
unknown unknowns.
And there are known unknowns,and the unknown unknown I guess
it's a known unknown is thatthere has been continued
advancements in each diseasesite and the cure rate of every
cancer over time, and that willlikely continue, and maybe even
(10:59):
during the course of yourtreatment, and that itself may
prolong your life life.
And it's an exciting timebecause you have this not only
new systemic therapies that youuse with your patients, but
there's like new classes ofsystemic therapies, so like
whole new families of systemictherapies.
(11:20):
Immune therapies were kind ofthe big thing maybe 10 years ago
and continue to be a big deal,but that's been an exciting time
to be a.
An exciting but difficult timeto be a medical oncologist,
because the amount of drugs youneed to know it has expanded
exponentially.
Speaker 2 (11:36):
You know, and I definitely agree with that, I
think that, like for a while,you know, the way we treat
cancers hadn't changed for 30 to40 years, and then now, really
over the last five to 10 years,we're starting to see a lot of
new drugs come to the market anda lot of new research coming to
the forefront, which is reallyexciting.
And I think that you know, asdoctors, we never like to say
(12:00):
we're wrong, but I do say thatthe thing that I'm happiest that
I'm wrong about is sometimeswhen I meet patients and they
always ask you know so, hey, doc, how long do I have?
What does this look like?
And I find that I'm becomingmore and more wrong when I give
them the answer based on thehistorical numbers that we've
seen over the last 20, 30 years.
Right, a lot of the survivaldata we have is based off this
(12:21):
national SEER database and someof those outcomes that we see
there are now being eclipsed bythe new data.
So when I tell someone, oh hey,on average people have nine
months to live with thisdiagnosis, these patients are
now pushing two, three years.
And then it used to be thatthese were the outliers and now
we're moving more toward wherethis is the median.
(12:41):
This is what we see on averagethat people are living longer
and longer.
Not necessarily just becausethe cancer care is better, but
our supportive care medicinesare a lot better.
People are able to toleratetreatments a lot better and the
hospital care is a lot betterwhen people do get into problems
, you know yeah so, you know, Ithink that there's a lot of
things that we do here at stluke's that uh make, uh, you
know, kind of just kind of moveus inches at a time but move us
(13:04):
along toward getting people tohave better outcomes and longer
periods of cancer-free remission, like we do tumor board all the
time, where you know, youmyself, the other medical
oncologists, the surgeons arethere, the radiologists are
there, the pathologists arethere and, you know, we have 20
doctors in a room and justtalking and kind of thinking
about the case and looking at itunder a new light, and I think
that it gives patientsopportunities to to have uh
(13:28):
different opinions about theirtreatment and their care and it
might open, you know, the doorto something that even I hadn't
thought of alone.
Speaker 1 (13:36):
Yeah, it's been good.
Yeah, I agree.
And specifically with oncology,one of the things I really like
is that we have doctors atdifferent stages in their career
and I think having thatdiversity of age can be very
beneficial, just becausedifferent people kind of have
different viewpoints based offdifferent experiences.
(13:57):
And it's it's tumor board isnice and we get you know, I feel
like it's very cordial and weget along well and take each
other's recommendations, youknow, um um, into account and,
and I agree, I think it it'sbrick by brick, inch by inch,
every bit of it, um, whether itbe the supportive care with the
nurses in the infusion area orin the hospital, all of it
(14:20):
ultimately amounts to betteroutcomes.
And it's nice to be in a statewhere we're not a steady state
but things are continuallyimproving and my hope and
expectation is that, as timegoes on, that continues to
happen.
Speaker 2 (14:34):
Yeah, very much so, and I think that you made a good
point.
You know, in our group we have,I think, six people who are
still practicing medicaloncologists and I would say half
of us in our group we have, Ithink you know, six people who
are still practicing medicaloncologists and I would say half
of us are in our 30s to 40s andthe other half of us are in our
70s.
You know, I think I sit next toDr Van Amburg and he's 77, still
going strong, still sharp, andyou know, while I bring, I think
(14:56):
, optimism and maybe the newcutting edge treatments, he
definitely brings a lot ofexperience to the table.
Right, he kind of knows, youknow, how hard to push and how
hard not to, and I think thatwisdom there is definitely
something that you can only gainover years and years of direct
patient care and just kind ofseeing these things in real life
.
Also, you know, even at 77,he's still a pro using the
(15:19):
computer.
So I can't complain at allabout using our medical record
system or anything, and so he's,you know, he's an encouragement
to what I could, you know, seemyself doing one day.
But definitely having a big mixin both experience, age and
knowledge definitely helps ourgroup a lot.
Speaker 1 (15:36):
You know, the other thing I like about St Luke's
Oncology is that we're all busy.
We're all not only busy, butvery busy, and that means that
if you see a lot of patients,it's just like anything else in
life it's reps, and so patientsaren't reps, but it's more
experience.
And so if you say you're afootball player and you run a
play and practice five timesversus 100 times, you are going
(16:00):
to understand the nuance of thatplay a lot better, and so
anytime you do something a lot,you figure out how not to do it,
and you figure out you know whyyou need to do it this way
instead of that way.
And I think being busy makesyou a better doctor too, just
getting in more reps, moreexperience, and so and I know
(16:20):
you're you're a busy doctor, drRana and Dr Soken, and so but I
think that makes people bettertoo.
Speaker 2 (16:27):
I think so and I agree with that.
You know, people always ask,people always say, like you know
, you should choose the doctorsthat your doctors choose.
Right, because, and in the sameway, like the guy who did the
surgery on my leg, he is anankle guy so he does lots of
ankle surgeries.
I was his third ankle surgeryof the day, right and so, and
then I guess it's that sentimentwhere you know, if you kind of
see a lot of different diseasesand you see them often you kind
(16:48):
of understand the nuances of howto treat things and it makes
you as a practitioner morecomfortable with any kind of
issues whenever they come up.
Speaker 1 (16:57):
Yeah, same with tattoo artists too.
If you're going to get a tattoo, um, you don't want them like,
right, as they get the needlehumming, to say, hey, this is my
first one, hopefully it goeswell.
Right, you want somebody who's,like you know, done a couple of
thousand maybe a couple more.
Yeah, for sure, for sure, Mike.
Um you're, um, you've told mebefore that your uh work ethic
(17:18):
to some comes from yourexperience with your parents and
seeing how hard they work.
Can you talk about that alittle bit?
Speaker 2 (17:25):
Yeah, so my parents, they were immigrants.
My dad was born in Japan and mymom was born in Vietnam, and so
coming to the United States, Ithink, was definitely a
difficult transition for them,but I could definitely see that
when they came here, almosteverything they did was to help
(17:47):
us succeed and help us make itin our lifetime.
You know my mom when she washere she worked at Pizza Hut for
a while, and my dad, he was ajanitor, and so kind of seeing
them come up from humblebeginnings and even though they
didn't have the sameopportunities I had, they worked
hard to make sure that I couldpursue not only primary
(18:08):
education but secondaryeducation and to make sure that
that was something that I foundimportant in my life.
I definitely learned from themthat you just need to kind of
have a goal in mind but alsoevery day work hard and make
sure that that's something thatis always in the forefront of
(18:31):
your mind, and it definitelykind of motivates me to know
that my successes are not my ownnecessarily, but they come from
generations of my own familyand other people around me
working hard to kind of put mein a good place where I have the
opportunity to come and learnthings that I would never have
imagined and help people in waysthat I would only dream of
(18:52):
before.
Speaker 1 (18:53):
That's beautiful.
And when I think of my ownchildren, you know, I think it's
a much better life to try tolive your life for something
bigger than yourself, and youhave.
You can look internally, andyou can only do that for so long
before you.
You know, for most people ittends to get kind of ugly, but
(19:14):
you have the whole universe thatyou can focus on instead of
yourself, and that's actually amuch better way to go.
Are there problems?
You know problems out there forsure, but living your life to
sacrifice yourself for yourfamily is, as I'm kind of
learning over time is, um, youknow, probably a better way to
go, um, to try to live for ideasor things that are bigger than
(19:37):
you.
Um, and so when I think aboutyour parents' life, you know
they've, you know, worked hardwith for you and your siblings
to do well, and you know thesame with my parents as well.
And I used to be kind of likethe wide receiver on a football
team who would like, when hewould catch a touchdown, he
(19:57):
would like pound his chest andsay, look how great I am.
And I feel like I'mtransitioning more to a running
back where I'm thinking myoffensive line and having a
little bit more gratitude aroundthe people who help you get to
where you're going or who tookthe time when they didn't
necessarily need to help youturn this way instead of that
(20:19):
way, and sometimes that's justthe grain of rice that tips the
scale.
Speaker 2 (20:24):
Yeah, I agree with that.
I think that you know, eventalking about children, right,
you know, I think that the waythat sometimes we see success in
the media is always portrayedas people who are famous or
people who are wealthy, and Ithink financial success is
something that people kind ofput a lot of weight in.
But I think that, you know,just seeing my parents and kind
of reframing what they see assuccess, you know, I think that
(20:46):
their joy doesn't necessarilycome from having two or three
cars.
It comes from seeing theirchildren successful and happy
and comfortable and they can seethat all their years of
dedication to help us get wherewe need to be has paid off.
And I think that, you know, Isee that now as a goal for
myself.
I think, you know, people havecareer goals and career
(21:07):
aspirations but, like I think,seeing the way my parents were
with me, I put a lot, I guess Itry to focus on the goals I have
for my own daughter, notnecessarily that she needs to
have a certain job or be, youknow, successful in whatever way
she wants, but, you know, tomake sure that she is well, you
know, well adjusted and happyand ends up in a place in her
(21:29):
life where she feels comfortableand and just enjoys that, you
know, and I think that that'sthat's.
That's something that maybe Idon't ever see that much
emphasize, see that emphasize onTV that often, but I think it's
something that maybe I don'tever see that much emphasize on
TV that often, but I think it'ssomething that I know my parents
have kind of shown me is a wayto bring happiness even after
I'm done working, even after I'mdone with everything here.
Speaker 1 (21:50):
Yeah, yeah, your parents are incredibly wealthy
and incredibly successful inthat regard, and I think that's
the best regard to to live lifethrough um, and and you make a
good point you know it's that isnot emphasized enough um, and,
and, and it's it's somethingthat should be, um, venerated,
(22:11):
it's something that should berespected and um, and that's
(22:32):
that's what we want, right?
Speaker 2 (22:33):
our children um children and our community to
live the longest life and thebest life, the integral
happiness curve right credit forwhen I was 18.
Speaker 1 (22:39):
For sure, but yeah, and so, and we will be imperfect
parents, for sure, but theeffort will be there, yeah.
Speaker 2 (22:53):
You know, and I think I actually look to you a lot
whenever my daughter was bornright, I think I as a new father
it was very difficult, Like Iwasn't sure, and I think your
reassurance and your advice wasjust like you know, you take it
one day at a time, right, andthen when they're young, you
just try to keep them alive andit'll be okay.
Speaker 1 (23:04):
Right.
Speaker 2 (23:05):
Everything will be all right.
And I think that idea of justkeep looking forward, you know,
keep moving forward and do thebest you can every day, I think
that's probably sage advice forfor every stage in life you know
, yeah, and we're all winging itas parents, right, it's all our
first go, so, like we're doingthe best you can, um uh, the um.
Speaker 1 (23:25):
One of Mitch Albom's books says um uh, you know your,
your children, are like crystalglasses.
You will get fingerprints onthem, but don't shatter them.
Speaker 2 (23:34):
So, yeah, I guess I'll tell you how it goes in 18
years.
You know how good my parentingis.
But uh, give me give me 35years.
Speaker 1 (23:42):
Okay, that's fair, all right, mike.
Well, mike, I um, uh, Iappreciate working with you so
much and I, um, and and and Ithink I think when I think of
you, I think of somebody who'sit's kind of weird, but you're
an extremely hard worker butalso have a very good and
(24:02):
positive attitude, and you don'talways see those two things
kind of side by side, but Ialways love talking to you.
You're a dear friend and Iappreciate working with you.
Speaker 2 (24:12):
Thank you and I would definitely like to reciprocate
that sentiment to you and thatyou know this is my first job
out of training and I've beenhere now for for four years and
you know, part of my success andpart of who I am today, I think
, is because of the peoplearound me, and you guys have
definitely helped shape theperson I've become now and shown
me kind of really what not onlywhat I need, but what patients
(24:35):
need when they come to us in adifficult time, right.
So I definitely thank you somuch for having me today, and
then I do consider you a dearfriend and I really kind of
enjoy our both personal andworking relationship and I'm
looking forward to more yearstogether.
Speaker 1 (24:52):
I couldn't agree more .
Thanks so much, Mike.
Hello, my name is Jason Edwards and this is Doc
Discussions.
I'm excited to have a specialguest.
This is my good friend, drMichael Ogawa.
Mike is a medical oncologist,which means he treats patients
with chemotherapy andimmunotherapy and targeted
therapy for cancer.
And before we start, I justwant to say Mike, when I think
(00:24):
about him, he's he's such a ahard worker, a very smart guy,
but a very kind and upbeatperson, and I think all the
people who work with you verymuch appreciate your personality
, and I know our mutual patientsdo too.
So, mike, welcome.
Speaker 2 (00:38):
Thank you, thanks for having me and thank you for the
very generous and veryflattering introduction.
So thank you.
Speaker 1 (00:43):
Yeah, I try to flatter you, to kind of get you
off balance, and then we canreally hit you.
It's okay, it works.
And so, mike, you're from Texasoriginally, right?
Speaker 2 (00:54):
Yes, originally from Dallas.
I grew up in one of thenortheastern suburbs of Dallas
called Garland, texas.
Okay, kind of a small kind ofan immigrant population there.
So my parents are originallyfrom, my dad was from Japan and
my mom was from Vietnam and mydad actually moved to Texas for
work, so that's kind of how theyended up there.
But I grew up there and livedmost of my life actually in
(01:17):
Dallas.
Speaker 1 (01:18):
How about that?
And that explains the big hair.
Yeah, the big hair.
Speaker 2 (01:21):
You know, I don't have a cowboy hat, but I do have
some cowboy boots, yeah.
Speaker 1 (01:25):
They always say the girls in Dallas have big hair.
I don't know, that's probablychanged since the 80s, but
anyway.
Speaker 2 (01:30):
I know, maybe now more and more guys have perms
yeah.
Speaker 1 (01:35):
And then you did your undergrad here in St Louis at
Washington University.
Is that right?
Speaker 2 (01:39):
That's correct.
That's correct.
So I did my undergrad here atWashington University and so I
kind of had a good group offriends here.
I ended up going back to Texasfor medical school.
I went to Texas A&M.
It was actually one of thecheapest medical schools I could
go to right around $20,000 ayear.
It was great.
So I went there for four yearsand then I still had some
(02:00):
friends here in St Louis and Idid like St Louis a lot.
So I came back up here for aresidency, actually at St Louis
University.
My wife moved up from Texas tokind of be with me and she's a
lawyer.
So she took the Missouri barand then she was like I'm not
taking another bar exam.
So we ended up staying here 10years later.
You know we have a daughter, wehave a house here, and so I've
been here ever since.
Speaker 1 (02:20):
Yeah, and then and you also did part of your
training with Dr Mira Rana,who's our other medical
oncologist- that's right.
Speaker 2 (02:27):
So she and I go back pretty far.
So she and I met actually thefirst day of residency so we've
known each other for eight, nineyears now and so she went off
to Wake Forest for a fellowship,but her husband and her family
live here in St Louis, so wewere very welcome to, very happy
to have her back actually afterthat was done.
Speaker 1 (02:47):
Yeah, I think you helped recruit her here, and so
we're also indebted to you forthat.
Speaker 2 (02:52):
Oh no, she's definitely a welcome addition to
the group.
Speaker 1 (02:55):
Yeah and so yeah.
So you mentioned your wife andyour new young daughter.
Who is?
Is she two now?
Speaker 2 (03:03):
Yeah, that's a good memory.
She's two and a half years oldand she's really coming into a
fun age.
It's exciting.
There's a lot of fun new thingsthat I get to experience every
day, both her and myself so it'sbeen kind of interesting to
both kind of navigate that, butalso it's been probably one of
the most enjoyable times I'vehad in my life.
Speaker 1 (03:24):
That's beautiful, it's been good.
Yeah, you learn a lot from yourkids, you know you learn a lot
about life through kind ofliving it on the other side of
the lens, as a parent, for sure.
Speaker 2 (03:35):
Yeah, very much.
So you know it's kind ofinteresting.
I guess you can't see throughthe podcast, but you know I
actually was recently injured,right, I broke my ankle and I
had surgery, and so I think thatthe same thing, when it comes
through with children, it kindof gives you a new perspective
on kind of life.
I think you kind of get intothe grind and you get used to a
certain routine and so kind of.
(03:55):
When you see the novelty in theway your kids see things, it
kind of brings excitement toyour life.
And the same thing, being onthe other side of things, like
being a patient, also kind ofwakes you up to kind of the
things that they have to dealwith every day and it kind of
gives you a new perspective oncoming to the hospital and
health care.
Speaker 1 (04:13):
I totally agree.
My experience as being apatient was maybe five years ago
.
I was having heart palpitationsand I called Craig Reese, our
chief of cardiology, and he saidwell, you know, maybe come on
in and get checked out and I wasactually worried.
You know it's your heart and Ithought, you know I'm a pretty
healthy guy.
But you know you could tell hewas a very competent physician
(04:36):
and that and his kind of commandof the situation very much put
me at ease and I feel like Ibecame a better doctor for that.
What did you learn through yourmedical experience?
Speaker 2 (04:57):
You know, I think that I definitely have the same,
I think, level of like fear,anxiety and almost helplessness
I think that a lot of patientshave when they come to see me, I
think level of like fear,anxiety and almost helplessness
I think that a lot of patientshave when they come to see me.
You know, I think as medicaland radiation oncologists we
never meet people on their bestday, all right.
So, you know, I think peoplecoming to see me are always
worried about things and even ifthey're not coming for a cancer
(05:18):
diagnosis, when they walk inthe doors and it says you know,
blood and cancer center, that'ssomething that is definitely at
the forefront of their mind.
It's something they're worriedabout.
And the same thing with me too,you know, I think.
You know, when I broke my ankle,I was really worried about kind
of what would happen, not justin the in the short term as far
as healing and the surgery, butlong-term, like what would that
look like for me?
You know, moving forward and Iactually had a had a very
(05:40):
similar experience with you iswhen I came to the hospital here
.
Actually, I had my surgery hereat St Luke's.
You know I was not familiarwith the surgical surgery
department very, very much.
But everyone was so nice.
You know, it was a very kind ofwelcoming environment and they
and actually people who I hadshared patients with came by and
kind of wished me good luck onthe surgery.
(06:01):
People I've actually never metbefore wanted to come by and
just say hi, and it was reallynice.
It took my mind off of theupcoming surgery and it made me
also feel confident that thepatients that we sent to get
procedures done are in reallygood hands.
Speaker 1 (06:16):
Yeah, I agree, when you're afraid, it's nice to see
some friendly faces.
It's nice to see some friendlyfaces.
It's nice to see some peoplewho are in control and they know
what they're doing.
And I agree with you as well itmade me more confident in being
a St Luke's physician.
Now the Larry King questionhere is what kind of dance move
(06:39):
were you trying to do when youbroke your ankle?
Speaker 2 (06:42):
Obviously not a good dance move.
You know, I think that I have avery Enthusiastic dancer.
I probably Enjoy it.
I guess my enthusiasm outweighsmy skill, put it that way,
right.
And so I think my wife Not sokindly reminded me that I'm not
as young as I used to be.
Yeah, and I need to be morecareful, but I don't
(07:02):
particularly remember the dancemove, but I do remember slipping
, yeah, and so, although I didend up breaking my ankle, it was
a very memorable and funwedding.
No regrets.
Speaker 1 (07:14):
Yeah, you know I don't like your wife's
negativity and I think you stillgot it.
Speaker 2 (07:18):
So tell her.
I said that I thank you.
I do have a spare leg so I canstill dance a little bit.
It's pretty good though.
Speaker 1 (07:24):
Yeah, um, and you know there there's.
This is another kind oftentative life is.
There's always adversity.
There's always.
It's going to come in differentforms.
It's going to come at differenttimes.
I think sometimes, when it'sthrough a fault of our own,
whether it's um, break yourankle while dancing or or
getting into a car wreck, it'sit's sometimes harder to accept.
(07:45):
But the the first step isreally acceptance and saying,
hey, this is where I'm at Likeand I've got to objectively find
a way to kind of move forwardfrom here.
Whether it's a broken bone or acancer diagnosis, you've got to
regroup and say, okay, how dowe move forward objectively to
optimize our situation?
Speaker 2 (08:05):
Yeah, I agree with that.
I think that I definitelyexperienced some of that, you
know, in the beginning, becauseit was something that was silly
and possibly could have beenprevented, right.
And you know, the two weeks Iwas laying on the couch
recovering from surgery, Idefinitely had time to mull that
over and I kept going back andforth between being, you know,
saying the same thing thatyou're saying, like, hey, you
know it happens, you got toaccept this, it is what it is
(08:25):
and we and we can move forwardfrom this, but also, like you
know, how could this happen?
This is, you know, never a goodtime for something like this to
happen.
And you know it's a busy timeat work.
It's tough, I'm out.
It's a busy time for my family,it's hard for my wife, my
daughter.
But, you know, I think we kindof tell our patients the same
thing, right, hey, like you know, this is something that's
unexpected, this's somethingthat we can definitely get you
(08:47):
through, right, and so, you know, we allow them to process it,
but definitely, after you knowthey've come to terms with the
diagnosis, it's something thatwe would love to help push back
on, right, it's time for us tofight back against the cancer.
It's time for us to kind of getyou back to do the things that
you like to do, right, and Ithink that that's really the
benefit of modern medicine, youknow, even for diseases where we
(09:09):
can't cure it, if we can getyou back to doing the things
that you like to do and gettingback to a fairly normal life, I
think that we've been successfulin what we can do.
And I tell my patients you know, there are lots of diseases
where right now there isn't acure, but every time that
there's a conference that comesout or there's new data that
comes out, I know it's a happyday for people, right?
Because that just means that wejust need to get you to the
(09:31):
next good drug out there, thenext good treatment, and then we
start seeing cancer less as aterminal diagnosis but more of a
diagnosis that we can managelong-term, like diabetes or high
blood pressure, and I thinkthat that takes some of the fear
and some of the control awayfrom the diagnosis itself some
(09:52):
of the control away from thediagnosis itself.
Speaker 1 (09:53):
Yeah, so when somebody comes into our office
my, whether it's mine or yours,you know the first rule is to
always be completely honest.
Or you could say, always tellthe truth and never tell a lie,
and those are two differentthings.
And so we're honest with thepatient.
But part of being honest is tonot say hey, the clinical trial
(10:13):
that shows the best treatmentfor your disease, which is the
treatment we're going to do,which we call the standard of
care, shows that patients fiveyear overall survival, meaning
the amount of patients who arealive five years later, whether
it was from a cancer or carwreck or whatever it may be is
this number, say, 75%?
But that's just the knownknowns.
(10:34):
So, like Nassim Nicholas Talebwould say, there are also
unknown unknowns.
And there are known unknowns,and the unknown unknown I guess
it's a known unknown is thatthere has been continued
advancements in each diseasesite and the cure rate of every
cancer over time, and that willlikely continue, and maybe even
(10:59):
during the course of yourtreatment, and that itself may
prolong your life life.
And it's an exciting timebecause you have this not only
new systemic therapies that youuse with your patients, but
there's like new classes ofsystemic therapies, so like
whole new families of systemictherapies.
(11:20):
Immune therapies were kind ofthe big thing maybe 10 years ago
and continue to be a big deal,but that's been an exciting time
to be a.
An exciting but difficult timeto be a medical oncologist,
because the amount of drugs youneed to know it has expanded
exponentially.
Speaker 2 (11:36):
You know, and I definitely agree with that, I
think that, like for a while,you know, the way we treat
cancers hadn't changed for 30 to40 years, and then now, really
over the last five to 10 years,we're starting to see a lot of
new drugs come to the market anda lot of new research coming to
the forefront, which is reallyexciting.
And I think that you know, asdoctors, we never like to say
(12:00):
we're wrong, but I do say thatthe thing that I'm happiest that
I'm wrong about is sometimeswhen I meet patients and they
always ask you know so, hey, doc, how long do I have?
What does this look like?
And I find that I'm becomingmore and more wrong when I give
them the answer based on thehistorical numbers that we've
seen over the last 20, 30 years.
Right, a lot of the survivaldata we have is based off this
(12:21):
national SEER database and someof those outcomes that we see
there are now being eclipsed bythe new data.
So when I tell someone, oh hey,on average people have nine
months to live with thisdiagnosis, these patients are
now pushing two, three years.
And then it used to be thatthese were the outliers and now
we're moving more toward wherethis is the median.
(12:41):
This is what we see on averagethat people are living longer
and longer.
Not necessarily just becausethe cancer care is better, but
our supportive care medicinesare a lot better.
People are able to toleratetreatments a lot better and the
hospital care is a lot betterwhen people do get into problems
, you know yeah so, you know, Ithink that there's a lot of
things that we do here at stluke's that uh make, uh, you
know, kind of just kind of moveus inches at a time but move us
(13:04):
along toward getting people tohave better outcomes and longer
periods of cancer-free remission, like we do tumor board all the
time, where you know, youmyself, the other medical
oncologists, the surgeons arethere, the radiologists are
there, the pathologists arethere and, you know, we have 20
doctors in a room and justtalking and kind of thinking
about the case and looking at itunder a new light, and I think
that it gives patientsopportunities to to have uh
(13:28):
different opinions about theirtreatment and their care and it
might open, you know, the doorto something that even I hadn't
thought of alone.
Speaker 1 (13:36):
Yeah, it's been good.
Yeah, I agree.
And specifically with oncology,one of the things I really like
is that we have doctors atdifferent stages in their career
and I think having thatdiversity of age can be very
beneficial, just becausedifferent people kind of have
different viewpoints based offdifferent experiences.
(13:57):
And it's it's tumor board isnice and we get you know, I feel
like it's very cordial and weget along well and take each
other's recommendations, youknow, um um, into account and,
and I agree, I think it it'sbrick by brick, inch by inch,
every bit of it, um, whether itbe the supportive care with the
nurses in the infusion area orin the hospital, all of it
(14:20):
ultimately amounts to betteroutcomes.
And it's nice to be in a statewhere we're not a steady state
but things are continuallyimproving and my hope and
expectation is that, as timegoes on, that continues to
happen.
Speaker 2 (14:34):
Yeah, very much so, and I think that you made a good
point.
You know, in our group we have,I think, six people who are
still practicing medicaloncologists and I would say half
of us in our group we have, Ithink you know, six people who
are still practicing medicaloncologists and I would say half
of us are in our 30s to 40s andthe other half of us are in our
70s.
You know, I think I sit next toDr Van Amburg and he's 77, still
going strong, still sharp, andyou know, while I bring, I think
(14:56):
, optimism and maybe the newcutting edge treatments, he
definitely brings a lot ofexperience to the table.
Right, he kind of knows, youknow, how hard to push and how
hard not to, and I think thatwisdom there is definitely
something that you can only gainover years and years of direct
patient care and just kind ofseeing these things in real life
.
Also, you know, even at 77,he's still a pro using the
(15:19):
computer.
So I can't complain at allabout using our medical record
system or anything, and so he's,you know, he's an encouragement
to what I could, you know, seemyself doing one day.
But definitely having a big mixin both experience, age and
knowledge definitely helps ourgroup a lot.
Speaker 1 (15:36):
You know, the other thing I like about St Luke's
Oncology is that we're all busy.
We're all not only busy, butvery busy, and that means that
if you see a lot of patients,it's just like anything else in
life it's reps, and so patientsaren't reps, but it's more
experience.
And so if you say you're afootball player and you run a
play and practice five timesversus 100 times, you are going
(16:00):
to understand the nuance of thatplay a lot better, and so
anytime you do something a lot,you figure out how not to do it,
and you figure out you know whyyou need to do it this way
instead of that way.
And I think being busy makesyou a better doctor too, just
getting in more reps, moreexperience, and so and I know
(16:20):
you're you're a busy doctor, drRana and Dr Soken, and so but I
think that makes people bettertoo.
Speaker 2 (16:27):
I think so and I agree with that.
You know, people always ask,people always say, like you know
, you should choose the doctorsthat your doctors choose.
Right, because, and in the sameway, like the guy who did the
surgery on my leg, he is anankle guy so he does lots of
ankle surgeries.
I was his third ankle surgeryof the day, right and so, and
then I guess it's that sentimentwhere you know, if you kind of
see a lot of different diseasesand you see them often you kind
(16:48):
of understand the nuances of howto treat things and it makes
you as a practitioner morecomfortable with any kind of
issues whenever they come up.
Speaker 1 (16:57):
Yeah, same with tattoo artists too.
If you're going to get a tattoo, um, you don't want them like,
right, as they get the needlehumming, to say, hey, this is my
first one, hopefully it goeswell.
Right, you want somebody who's,like you know, done a couple of
thousand maybe a couple more.
Yeah, for sure, for sure, Mike.
Um you're, um, you've told mebefore that your uh work ethic
(17:18):
to some comes from yourexperience with your parents and
seeing how hard they work.
Can you talk about that alittle bit?
Speaker 2 (17:25):
Yeah, so my parents, they were immigrants.
My dad was born in Japan and mymom was born in Vietnam, and so
coming to the United States, Ithink, was definitely a
difficult transition for them,but I could definitely see that
when they came here, almosteverything they did was to help
(17:47):
us succeed and help us make itin our lifetime.
You know my mom when she washere she worked at Pizza Hut for
a while, and my dad, he was ajanitor, and so kind of seeing
them come up from humblebeginnings and even though they
didn't have the sameopportunities I had, they worked
hard to make sure that I couldpursue not only primary
(18:08):
education but secondaryeducation and to make sure that
that was something that I foundimportant in my life.
I definitely learned from themthat you just need to kind of
have a goal in mind but alsoevery day work hard and make
sure that that's something thatis always in the forefront of
(18:31):
your mind, and it definitelykind of motivates me to know
that my successes are not my ownnecessarily, but they come from
generations of my own familyand other people around me
working hard to kind of put mein a good place where I have the
opportunity to come and learnthings that I would never have
imagined and help people in waysthat I would only dream of
(18:52):
before.
Speaker 1 (18:53):
That's beautiful.
And when I think of my ownchildren, you know, I think it's
a much better life to try tolive your life for something
bigger than yourself, and youhave.
You can look internally, andyou can only do that for so long
before you.
You know, for most people ittends to get kind of ugly, but
(19:14):
you have the whole universe thatyou can focus on instead of
yourself, and that's actually amuch better way to go.
Are there problems?
You know problems out there forsure, but living your life to
sacrifice yourself for yourfamily is, as I'm kind of
learning over time is, um, youknow, probably a better way to
go, um, to try to live for ideasor things that are bigger than
(19:37):
you.
Um, and so when I think aboutyour parents' life, you know
they've, you know, worked hardwith for you and your siblings
to do well, and you know thesame with my parents as well.
And I used to be kind of likethe wide receiver on a football
team who would like, when hewould catch a touchdown, he
(19:57):
would like pound his chest andsay, look how great I am.
And I feel like I'mtransitioning more to a running
back where I'm thinking myoffensive line and having a
little bit more gratitude aroundthe people who help you get to
where you're going or who tookthe time when they didn't
necessarily need to help youturn this way instead of that
(20:19):
way, and sometimes that's justthe grain of rice that tips the
scale.
Speaker 2 (20:24):
Yeah, I agree with that.
I think that you know, eventalking about children, right,
you know, I think that the waythat sometimes we see success in
the media is always portrayedas people who are famous or
people who are wealthy, and Ithink financial success is
something that people kind ofput a lot of weight in.
But I think that, you know,just seeing my parents and kind
of reframing what they see assuccess, you know, I think that
(20:46):
their joy doesn't necessarilycome from having two or three
cars.
It comes from seeing theirchildren successful and happy
and comfortable and they can seethat all their years of
dedication to help us get wherewe need to be has paid off.
And I think that, you know, Isee that now as a goal for
myself.
I think, you know, people havecareer goals and career
(21:07):
aspirations but, like I think,seeing the way my parents were
with me, I put a lot, I guess Itry to focus on the goals I have
for my own daughter, notnecessarily that she needs to
have a certain job or be, youknow, successful in whatever way
she wants, but, you know, tomake sure that she is well, you
know, well adjusted and happyand ends up in a place in her
(21:29):
life where she feels comfortableand and just enjoys that, you
know, and I think that that'sthat's.
That's something that maybe Idon't ever see that much
emphasize, see that emphasize onTV that often, but I think it's
something that maybe I don'tever see that much emphasize on
TV that often, but I think it'ssomething that I know my parents
have kind of shown me is a wayto bring happiness even after
I'm done working, even after I'mdone with everything here.
Speaker 1 (21:50):
Yeah, yeah, your parents are incredibly wealthy
and incredibly successful inthat regard, and I think that's
the best regard to to live lifethrough um, and and you make a
good point you know it's that isnot emphasized enough um, and,
and, and it's it's somethingthat should be, um, venerated,
(22:11):
it's something that should berespected and um, and that's
(22:32):
that's what we want, right?
Speaker 2 (22:33):
our children um children and our community to
live the longest life and thebest life, the integral
happiness curve right credit forwhen I was 18.
Speaker 1 (22:39):
For sure, but yeah, and so, and we will be imperfect
parents, for sure, but theeffort will be there, yeah.
Speaker 2 (22:53):
You know, and I think I actually look to you a lot
whenever my daughter was bornright, I think I as a new father
it was very difficult, Like Iwasn't sure, and I think your
reassurance and your advice wasjust like you know, you take it
one day at a time, right, andthen when they're young, you
just try to keep them alive andit'll be okay.
Speaker 1 (23:04):
Right.
Speaker 2 (23:05):
Everything will be all right.
And I think that idea of justkeep looking forward, you know,
keep moving forward and do thebest you can every day, I think
that's probably sage advice forfor every stage in life you know
, yeah, and we're all winging itas parents, right, it's all our
first go, so, like we're doingthe best you can, um uh, the um.
Speaker 1 (23:25):
One of Mitch Albom's books says um uh, you know your,
your children, are like crystalglasses.
You will get fingerprints onthem, but don't shatter them.
Speaker 2 (23:34):
So, yeah, I guess I'll tell you how it goes in 18
years.
You know how good my parentingis.
But uh, give me give me 35years.
Speaker 1 (23:42):
Okay, that's fair, all right, mike.
Well, mike, I um, uh, Iappreciate working with you so
much and I, um, and and and Ithink I think when I think of
you, I think of somebody who'sit's kind of weird, but you're
an extremely hard worker butalso have a very good and
(24:02):
positive attitude, and you don'talways see those two things
kind of side by side, but Ialways love talking to you.
You're a dear friend and Iappreciate working with you.
Speaker 2 (24:12):
Thank you and I would definitely like to reciprocate
that sentiment to you and thatyou know this is my first job
out of training and I've beenhere now for for four years and
you know, part of my success andpart of who I am today, I think
, is because of the peoplearound me, and you guys have
definitely helped shape theperson I've become now and shown
me kind of really what not onlywhat I need, but what patients
(24:35):
need when they come to us in adifficult time, right.
So I definitely thank you somuch for having me today, and
then I do consider you a dearfriend and I really kind of
enjoy our both personal andworking relationship and I'm
looking forward to more yearstogether.
Speaker 1 (24:52):
I couldn't agree more .
Thanks so much, Mike.
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I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com