Oncologist Confidential: I Remember the Names of Every Patient I've Lost

Dana Najjar

January 08, 2020

In her 2 years of practicing oncology, Yana Najjar, MD, remembers the names of every patient she's lost. "I'm sure many oncologists will say the same thing," she says. "You remember all of them." 

Yana Najjar, MD, assistant professor and medical oncologist, University of Pittsburgh School of Medicine

After pursuing her undergraduate and medical degrees at the American University of Beirut, a postdoctoral fellowship at the National Cancer Institute, internal medicine residency at the Cleveland Clinic, and hematology/oncology fellowship at the University of Pittsburgh, Najjar is now a medical oncologist specializing in melanoma at the University of Pittsburgh Medical Center Hillman Cancer Center. She sees patients for one and a half days each week and spends the rest of her time on research, including a Department of Defense-funded project investigating the role of tumor metabolism in developing resistance to immunotherapy. 

The following interview of Najjar by her sister Dana Najjar, who interned for Medscape in 2019, has been condensed and edited for clarity.

Is it true that women in oncology have to work 10 times harder just to be heard?

Any female physician can tell you about all the times she's been in the room with a male nurse or a male medical student or a male trainee, and the immediate assumption is that the male in the room is the physician. That's very frustrating. Right now I'm on service as the attending with a male fellow, and I make it a point to introduce myself first because every patient is going to think the fellow is the attending. 

Can you tell me about a memorable patient interaction? 

This may very well change over many many years in my career, but right now, I remember the name of every patient I've lost over the past 2 years. I'm sure many oncologists will say the same thing. You remember all of them. The difficult thing is that you feel you have truly failed if you can't control their disease. I have to remind myself every single day that I'm there to help them as much as I can. I have to remind myself that I did not cause the disease, and I can't always make the disease go away. 

There are also wonderful successes, which is one of the things I love about clinical trials. I have a patient who I've been taking care of for years who was on the verge of going on hospice because we were really and truly out of treatment options, and he enrolled in a clinical trial and had a near complete response that is now going at a year and a half. Seeing him walk into clinic every month is so enormously rewarding. 

How do you cope with losing patients?

It's something you have to learn how to live with. In the beginning when I was just starting out, in my fellowship and as an attending, I struggled with that and I had to find outlets. And I don't think it's a coincidence that once I became an oncologist I started doing things like hiking Machu Picchu and going to the Galapagos. I love to travel, and I try as much as I can to unplug when I'm away. While I'm not very good at this, I try to clear my mind between leaving work and getting home so I'm not constantly thinking about the cases I've seen that day. 

Do you still take it home with you?

Sometimes I wake up in the middle of the night to get a glass of water, and I start thinking about a specific patient scenario and asking myself if I made the best decision for this person. At any given time, and I think any oncologist will attest to this, you have a list of patients in your mind about whom you're the most worried. It's this running list of whose disease is not going well, who has relapsed, who are you really worried about.

What's the most unusual item in your office? 

"I like the idea that there's a universe
in which a frog is putting on lipstick."

— Dr Yana Najjar


Well, my favorite thing in my office is a picture of my son. But I also have a picture of a frog sitting in front of a vanity putting on lipstick that I bought at an art fair, and I think it's just delightful. I have it sitting it right next to me because I spend hours every day writing, and out of the corner of my right eye I can see this frog putting on lipstick and it makes me very happy. I like the idea that there's a universe in which a frog is putting on lipstick. I also have a shelf full of thank you cards from my patients and their families, and when I've had a hard day I go back and read them.

Dana Najjar is a journalist in New York City. She interned at Medscape in 2019.

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