ASTCT asked Nandita Khera, MD, MPH questions about what it is like to be a woman in the transplantation and cellular therapy field in celebration of Women's History Month, March 2023.
What inspired you to enter BMT and Cellular Therapy field?
It was a series of experiences that led me to choose BMT for my career. During my first year of medical school in India, I helped a neighbor of mine whose 5-year-old daughter had been diagnosed with rhabdomyosarcoma of the hand. Exposure to this little girl’s cancer journey made me decide early on that I wanted to be an oncologist. When I came to the U.S. after medical school, I had the opportunity to work with Dr Rakesh Sindhi, a liver transplant surgeon at Children’s Hospital of Pittsburgh in the area of ‘immunosuppression and rejection in liver transplantation’. This is when I decided to go into BMT to combine these two interests of oncology and immunology. Spending a month at an inpatient BMT unit at Fred Hutch during my medicine residency as a visiting physician strengthened my resolve of doing this for my life. I was fortunate enough to get into the fellowship program there to learn from the giants in the field who carry forward the legacy of Dr. E. Donnall Thomas. The ability to work with a multi-disciplinary team, taking care of very sick patients by utilizing one’s knowledge of a variety of medical specialties and belonging to a close, tightly knit community of highly committed people is what inspires me to this day to be a BMT physician.
How do you inspire others?
I have been very fortunate in having strong mentors throughout my career whose style I try to emulate when it comes to inspiring others and paying it forward. Taking a page from their mentorship guide is how I try to inspire others. I feel that having a positive and enthusiastic outlook always, striving to achieve excellence myself to lead by example and making sure that everyone’s value and contributions are recognized has helped me inspire the next generation of trainees that I have worked with. These attributes are also very helpful to me in inspiring the highly committed multidisciplinary team members of our BMT program and other teams that I lead in my other roles in the department.
Even though I am still new at being a mentor, the success of my mentees or trainees that I work with brings me great joy. Two years ago, I was approached by a medical student who clearly had the talent and drive to embark on an academic career but wasn’t quite sure of the area he wanted to focus on. He worked with me in the area of health services research in hematology/oncology (which he was able to present as oral abstracts and publish manuscripts) and this excited him so much that he is now doing a Masters in Public Health at Harvard and plans to be an oncologist focusing on health services.
Which living person do you admire most?
My mother. She is my first strong role model in life. She has inspired me to strive for the very best always despite the challenges in life. She is the one who has instilled the values of hard work, respect for others and integrity and taught me that hard times can be overcome by strong faith and continued determination. She was my dad’s caregiver through his prostate cancer journey. The last days when my dad was in home hospice were hard, as she was completely by herself during the pandemic as both myself and my brother couldn’t travel to help them. Despite the physically and emotionally draining times, I never once heard her complain about the situation or feel sorry for herself. Instead, she continued to provide emotional support to us. She truly exemplifies the caregivers and loved ones of all the patients I see, who often put their own needs aside to focus on their love one's needs.
What does it mean to be a woman in this field?
I am proud to belong to this field of BMT and cellular therapy with exceptionally strong women leaders who are role models for all of us who strive for excellence while trying to balance personal and professional life. Working with some of them has made me want to offer time, advice and support to other female physicians and trainees to ensure their success. I do feel the diverse perspective that women bring to medicine leads to better health care delivery. There have been challenges on the way as a woman doctor that I think are not uncommon in medicine. Incidents causing frustration and emotional distress when a patient decided to switch their care from me to an older male colleague just because ‘I am a woman and dont have enough grey hair’ are rare but do happen. I just take those in my stride and do my best to provide compassionate care to all my patients despite their biases and prejudices.
What is your greatest achievement?
My greatest achievement is being able to reach a point in life where I have had the honor of touching hundreds of lives and create wonderful relationships including with my patients and their families, my colleagues and my students. I am grateful for the chance to not only share the joys and celebrations with my patients who do well but also the sorrows of those who don’t. A letter from a patient’s daughter thanking me for helping her mom stay alive to see her grandbaby is as much of an achievement for me as is the message from another patient’s wife considering me worthy to share her grief after he died. Outside the clinical field, helping mentees define their goals and supporting them to achieve those has been a very satisfying experience too.
This has by no means, been a simple linear path. There have been roadblocks, but I am proud of myself to have overcome them to reach that position in life where I can now help and guide others in their journey. I have many people to thank for my own journey including my parents who constantly encouraged me to set and reach for the highest goals, my husband who continues to push me for ‘never settling for status quo’ and many teachers and mentors who guided me through my career.
Who are your heroes in real life?
My patients and their loved ones are real life heroes. I conducted a patient and caregiver panel after a lecture on ‘Cancer Survivorship’ where one of the AYA patients told me that they didn’t consider themselves to be heroes and that they were just ‘ordinary people’ who were unfortunate to get the cancer diagnosis and were trying their best to cope. Despite that comment, I still feel that the cancer patients and their caregivers are ‘heroes in real life’ because they show strength in a difficult situation where they have very little control. I recently attended a memorial service of a 33-year-old patient with AML who died from relapsed disease after her haploidentical transplant. The number of people at her service and the breadth of the sentiments shared about her made me realize that she had achieved in her 33 years what some people may not be able to even if they lived for 100 years. Our patients truly embody Dr. Barnard’s quote: 'The business of living is the celebration of being alive’ and that is why they are heroes both in life and death.