Dr. Robert Witherspoon often wonders what inspires a stage actor to deliver a compelling performance each night, despite a never-changing plot.
But in the case of his own long-running medical career, he has never needed to look further than the patient in his office for the motivation that has sustained his nearly three decades of commitment to cancer care.
"People might imagine that there are repetitive aspects to being a transplant physician," said Witherspoon, director of Fred Hutchinson's bone-marrow and stem-cell outpatient transplant clinic at the Seattle Cancer Care Alliance. "But the person who is receiving your care is always different. It's the patients that draw me in. Each one is a new catalyst for inspiration."
Witherspoon's commitment to patients and his team-oriented approach to care drew recognition last month from his colleagues, who nominated him as this year's recipient of the Clinical Research Division's Ali Johany prize for excellence in patient care.
Dr. Fred Appelbaum, division director, presented Witherspoon with the honor during Feb. 25 grand rounds.
"Picking a recipient for this award is terribly difficult since essentially all of our faculty provide outstanding care and do it in a manner that makes me proud to work at the center, and Bob is, of course, no exception," he said.
"What perhaps distinguishes Bob is how well he works with the entire care-giving team, including our fellows, physicians assistants, nurses and support staff. Providing cutting-edge care for complex, sometimes very ill patients in a research environment is not an easy task, and it takes many individuals, each with his or her own set of skills, to accomplish this. One of Bob's great skills is bringing these individuals together to accomplish the task at hand."
Dr. Marc Stewart, Alliance medical director, described Witherspoon as an "outstanding, compassionate clinician with a very positive approach toward patients as well as his co-workers and colleagues." Witherspoon expressed gratitude for the award, and for the opportunity to work with superb colleagues.
"I have such strong, highly skilled, highly performing colleagues," he said, citing nurses, social workers, pharmacists and other support staff who comprise the transplant team. "Caring for cancer patients effectively means confronting the human experience, and a doctor simply can't do that alone. But together, with our first-rate team, it just clicks."
Utmost compassion, respect
Longtime colleagues Louise Schilter-Harms, nurse manager of the Alliance's adult inpatient transplant unit at 8NE of University of Washington Medical Center, and Aleana Waite, the Alliance's director of quality/risk management and patient family services, commended Witherspoon's skill at treating patients and their families with the utmost compassion and respect.
"Bob is dedicated to working with patients and their families as partners, in addition to his skill at working with the entire interdisciplinary professional staff," Waite said. "He's always willing to take the time to educate, to help patients understand their illness or treatment or to explain a new procedure to a colleague."
Schilter-Harms recalled an example of Witherspoon's compassion that touched her own family.
"Years ago, a cousin of mine who had cancer wasn't responding to treatment and was quickly going downhill," she said. "She was being treated somewhere else, but when she was in town, Bob agreed to provide a second opinion. He stood at her bedside with such an empathetic and caring manner and told her she wasn't going to live. His gentle honesty and respect was a great gift to her and her family."
Not every seriously ill patient will overcome his or her disease. But Witherspoon said his role, and that of his physician colleagues, is to relieve what is often a patient's greatest fear: uncertainty. The best strategy, he said, is to fight fear with knowledge.
"My job is to provide patients with an authoritative view of their options, which helps to relieve some doubt," he said.
"The patient gets a clear idea of what the possibilities are. There's a spirit in there, and it's our job as the spokesperson for the patient-care team to focus that spirit on something concrete, on what is possible. That helps to give patients hope."
Witherspoon first joined the transplant team when the procedure was a highly experimental treatment for blood cancers under development by Dr. E. Donnall Thomas and colleagues. After completing a hematology/oncology fellowship during 1973 and 1974, Witherspoon returned to Thomas' group as a permanent member in 1976, shortly after the official opening of the center in its First Hill facility. It was then that he became acquainted with the deep satisfaction of a career that combines patient care with research.
"As a clinical researcher, you know there is always the prospect of improving things for the patient through research," he said.
"The example set early on by Don Thomas, Rainer Storb and colleagues has been that you have to view the goal of curing patients from a broad perspective, not just your window of experience. By focusing on our advances in patient care overall, you are sustained by knowing that there are those who can be cured."
Witherspoon's focus on the big picture extends beyond his perspective on cure rates for leukemia. As director of the outpatient-transplant clinic, he leads implementation of new administrative policies and procedures.
No bureaucratic nightmare
Waite said some might view the role as a bureaucratic nightmare, but not Witherspoon.
"We're a heavily regulated industry, with new rules and regulations mandated all the time," she said. "Bob not only has a very cheerful attitude toward dealing with these, he also understands why the regulations exist, which is ultimately, to ensure the best care for patients.
"He can tease out what we're trying to do and come up with practical solutions for how to do it, and if the strategy doesn't work, he sits back down at the table with our team until we come up with something that does."
While he is grateful for his colleagues' appreciation, Witherspoon said his greatest reward is the satisfaction he reaps from treating those with cancer.
"When a patient is critically ill, it's the biggest event in the world to them," he said. "You have to respect that the doctor and the patient-care team are not the most important thing in the family's eyes at that time, but it's up to us to provide them with reassurance that their loved one is receiving the best possible care.
"If that means I must stay at the clinic until 10 p.m., I know that I have done something very important for that person."
Ali Johany award recognizes excellence in transplant care
The annual Ali Johany prize honors a Fred Hutchinson physician who has provided exemplary clinical medical care and compassion on behalf of the center's hematopoietic stem-cell transplantation patients and their families.
Individuals are nominated for the award by Dr. Fred Appelbaum, Clinical Research Division director; Dr. Marc Stewart, medical director of the Seattle Cancer Care Alliance; Louise Schilter-Harms, nurse manager of the Alliance inpatient transplant unit at 8NE of the University of Washington Medical Center; and Aleana Waite, director of quality/risk management and patient family services at the Alliance.
Nominators base their selection on feedback solicited from faculty and patient-care colleagues. Award recipients receive a gift of $10,000 from a $150,000 fund donated by former center patient Dr. Ali Johany of Saudi Arabia.
Dr. Jim Wade, former medical director in Clinical Research Division who departed last year, was instrumental in the award's creation.
Last year, Drs. Leona Holmberg and David Madtes of the Clinical Research Division were the first to receive the award.