Smile, Be Happy, and Work Hard

Evan B. Shereck, MD, MEd, knew she wanted to be a pediatric oncologist even before she knew exactly what that was. Looking back, she’s not sure exactly how or why she made that decision. “One day in high school, I announced to my family, ‘I’m going to be a doctor. And I think I’m going to be a pediatric oncologist,’ ” she said. “I had no idea what it meant, or what they did. Somehow, it just came to me.”

Years later, she did a general during her third year in medical school and chose to do a pediatrics rotation on the inpatient ward. “Once I got there, I said, ‘Oh, my God, now that I know what this is, I really want to do this.’ It just . . . really, everything clicked.’"

Today, the North Jersey native is a professor of pediatrics and the director of the pediatric hematology/ oncology fellowship program at Oregon Health & Science University (OHSU). Shereck knew early in her career that she wanted to work with fellows, and her interest in improving medical education led her to earn an MEd at the University of Cincinnati. After joining OHSU, she became associate fellowship director and worked with the then-director to eventually take over the program. “He was excited. It wasn’t like a coup,” she hastened to add.

Shereck spoke to Oncology Fellows about working with families experiencing incredible stress, the importance of wellness for both physicians and their partners, and making medical learning fun.

Oncology Fellows: Why does pediatric oncology appeal to you?

I love that you have to remember everything you ever learned in medical school—it wasn’t just a single organ, it was the entire person. Maybe you’re worried about cancer, which could be in any organ, but you’re also worried about the side effects of chemo that could affect any organ. Plus, we have to be concerned about nutrition and infections. Then you have to [know a little about] psychology because you work with families—children and parents, and sometimes aunts, uncles, and grandparents—through the hardest thing they’re ever going to go through in their lives. It appeals to the different aspects of my brain that I have to work on the entire patient and the entire family at once.

I also love [exploring] what is happening on a cellular level, thinking about the science of what is going on in the different diseases and how chemotherapy affects these diseases. That really intrigues me as a scientist.

I love the continuity of the patients. We see them on the inpatient ward, but also every week in the clinic. You really get to know the patients, their siblings, their parents, their grandparents. It’s more than just medicine; you feel like you’re part of the family. All of that made me realize this is where I belong. This is the field for me.

How did you become interested in medical education?

I was never thrilled by lectures. About 15 to 20 minutes into the lecture, I’m starting to daydream. I always thought there has to be a better way. This is really interesting information, but it was just so dry. When you’re on rounds, you’re talking and there’s a patient there. It is exciting. You stay enthused. You’re not daydreaming anymore.

When I was a camp counselor, we would do some educational activities and we made them fun. We made them games. I thought, why can’t I bring that summer camp atmosphere into the lecture hall? People will remember it, they’ll want to be there, they’ll want to be a part of things, and hopefully they’ll learn it better.

Is it possible to make medical education fun?

We do blood bingo, believe it or not. I show cells of the blood, and they have to figure out which blood cell it is, then look on their bingo board and see if they have that blood cell written down. They have to get through a lot of different blood cells. So, yes, there are ways to gamify hemtology/oncology.

What do you tell fellows about taking care of their own health and well-being?

Our program has always had an emphasis on wellness and well-being. Our fellows have a lovely support group where they meet with a social worker after hours and o site, and they can peer mentor each other.

Our social worker covers all the topics that the fellows need to know. They learn about work-life balance, time management, organization, dealing with grief, stressful situations, [and] difficult conversations. We even have 1 or 2 sessions a year where significant others are invited to attend, which is really important. As we all know, [physicians] work really hard and we can become a bit obsessed with this career. Sometimes it can be a little difficult for our signficant others, so it's really important for them to get to talk about their difficulties, and it's really nice for the group to hear from each other.

I also try to be a role model. It’s really important that they see that we prioritize wellness. I will say at 5 o’clock, “I am going home, and I’m going to have dinner with my family.” Because [it] is important to me that I have dinner with my husband and kids every night. It’s really important for attendings to be intentional and say the things that they’re doing, and not try to sneak out of the hospital.

Did this emphasis on wellness exist a few years ago?

I never heard about wellness at all when I was a fellow. It was all about working hard and making it look like you were working hard. People would walk around stomping their feet and looking miserable because that meant you must be working hard. Now, thank God, things have changed. We’re allowed to smile and be happy. That doesn’t mean we’re not working hard; it just means we’re taking care of ourselves.

What do you want fellows to take away from your program?

I want them to know that they are individuals. There’s no one right way to be a pediatric hematologist/oncologist, and they need to find a way that is right for them. I want each person to think about what they want and how they’re going to contribute to the field as an individual. Then, of course, [I] want them to realize how they [are] going to work on their wellness and make sure that they are happy. I don't want them burning out and quitting this field after a few years.