SCABB Blog



Meet this month’s Trendsetter – Alice Chen

BB trendsetter alice chen

Q:  Tell us a little bit about your practice and current position.    

A:  I am in a pathology group, Gulf Coast Pathology Associates, which provides Transfusion Medicine Consultative Services that are somewhat beyond the usual. The beginning of our service can be traced back to the 1970’s at the Texas Heart Institute in the Texas Medical Center, during the era of famed cardiac surgery pioneers such as Dr. Denton Cooley. As these early cases were quite a strain on blood resources, the Blood Banker of the time, Dr. John Milam, was frequently called to the CV OR to assist with massive transfusion. As Transfusion Medicine Physicians, our understanding and application of coagulation testing, blood components, and in the modern era, hemostatic agents, is beyond that of other specialties’. We choose to be directly involved in bedside care of the patients, and the Service is very much appreciated by our colleagues. Dr. Art Bracey can be credited with increasing the visibility of the service in later decades, and as new technologies arose in heart transplantation, artificial hearts, ventricular assist devices, extracorporeal membrane oxygenation, and other cardiovascular support, our Service grew rapidly. Other institutions within the Texas Medical Center are now performing these procedures, and in the last few years I have been involved in establishing this same Service at UT-Memorial Hermann.

Q:  What is a typical day like for you?                                                                                                     

A:  On call, our Service is a bit of a blend between Medicine and Surgery, built on a core of Pathology. We usually round on our ICU patients first thing in the morning, prioritizing ones we know have had bleeding issues. We perform histories and physicals on new patients, write progress notes on established patients, order coagulation testing, evaluate the results with our understanding of the limitations of the testing, and then order blood products and hemostatic agents as we deem needed. By later morning, the ORs are busy, and we will be consulted on cases with ongoing or high risk of bleeding, such as redo-sternotomies, complicated surgical plans, or recent anticoagulant and/or antiplatelet effect. We stay in the OR during the most critical portions. OR cases or rounding often extend into the afternoon and not uncommonly evening, and a little teaching usually happens with residents or fellows in the afternoon. Probably once a week there will be a late night / early morning case, typically a heart transplant. Fortunately, we have a team of Blood Bankers taking this call, so we take turns and give each other a chance to recuperate!   

Q:  What do you enjoy most about what you do?

A:  I very much enjoy being able to apply knowledge in our field to care of a patient in front of me. I think most Blood Bankers appreciate direct patient care to some extent, and our Service fosters this to a greater extent. I also know that this exposure as a Transfusion Medicine Consultant gives me a better understanding of what our clinician colleagues experience, whether the issue is difficulties with blood ordering in the electronic system, or inefficiencies in resulting or viewing of reference labs, or confusion with nursing staff over protocols. This allows me to serve as a better intermediary between the clinicians and the Blood Bank, improving trust and communication, which benefits all, including the patients.

Q:  What are three events that helped to shape your life/career?              

A:  My career, as I suspect with most, has been greatly influenced by outstanding mentors. I was an MD / PhD student in the Genetics Department at Baylor College of Medicine, and I had started in a lab studying yeast genetics. However, I then met Dr. John Belmont, a member of the department who was studying hematopoiesis at the time, and was struck by how a brilliant physician-scientist could also be a nice guy. Being nice is one of my life goals, by the way. I switched to Dr. Belmont’s lab, completing a thesis searching for genes involved in murine hematopoiesis, and this started my path into blood.

My fellowship in Blood Banking was also at Baylor College of Medicine, and I was the first to go through several months of rotations at St. Luke’s, under the direction of Dr. Art Bracey. Until working with Dr. Bracey, I had not seen how closely a Blood Banker could be integrated into the daily care of these critically ill patients. I had again found the unique combination in a mentor of both brilliant and nice, and one easily sees the effect of this as Dr. Bracey is simultaneously respected and adored by the hospital staff, whether lab, nursing, or clinical. My current clinical work is modeled after the services Dr. Bracey developed.

One other event that had a tremendous impact on me actually happened before the other two. After graduating from college at Rice University, I was award a Thomas J. Watson Fellowship, a national grant for independent international study. My project was the study of Endangered Parrot Species in the Eastern Caribbean, Australia, and Indonesia, and I traveled alone for a year to these locations. The Fellowship does not permit coming back to the States during the year, nor enrolling in any educational institution, so I experienced real life in parts of the rest of the world. As a result, I value seeing issues from different viewpoints, thinking on a larger scale, and coming up with ideas outside the box. I am also now an avid world traveler!  

 

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