Kami Maddocks, MD, a Professor of Clinical Internal Medicine in the Division of Hematology at The Ohio State University in Columbus, reflects on her small-town upbringing and learning to love triathlons.
When did you know you wanted to be a doctor?
As long as I can remember. As a little kid in kindergarten, I told everyone that I wanted to be a doctor. I loved science and math, and as I went through school, that interest just grew.
Where do you think that desire came from?
I don’t have any doctors in my family. My mom is a nurse, mostly working as a cardiovascular nurse in the local hospital and had to take calls when I was younger. I didn’t like when she had to leave but I think knowing that she was leaving to help people is partially what sparked my interest in medicine.
Where did you grow up?
I grew up in Mitchell, South Dakota. Mitchell was a small town, with a population of about 13,000 people. South Dakota is a very friendly state. There were many families who lived on farms or rural areas, but we lived in town. My younger brother and I were very close and we spent a lot of time playing outside, swimming in the neighborhood pool pretty much every day in the summers or playing in the snow and building snow forts in the winters.
Walk us through your career path. How did you decide to focus in hematology, and lymphoma specifically?
Initially, when I was younger, I thought I wanted to be an OB-GYN and deliver babies, which is very far from what I ended up doing.
I became interested in oncology during my very first month of medical school at the University of South Dakota Sanford School of Medicine, where I also did my undergraduate degree. I was listening to a biochemistry lecture on oncogenes and tumor suppressor genes—basically how cancer can develop—and was so scientifically fascinated. When I came home, I told my roommate and best friend, “Oh my gosh, this is so interesting. I think I want to be some sort of oncologist, but I bet everybody wants to do that.” She said to me, “No, I don’t think so. I think you are crazy, that would be so hard!” She actually ended up becoming an OB-GYN.
In the second year of medical school, we started clinical rotations with different physicians of our choice and I rotated in the clinic of Michael Keppen, MD, a medical oncologist. He was a great clinician and during my time in that rotation, I saw how critical his relationships with patients were. Yes, he was their doctor managing their cancer, but he had also formed personal relationships with them. I felt like I wanted to do the same thing and started to think more seriously about oncology—whether that was medical oncology, radiation oncology, or surgical oncology.
Later, in my fourth year of medical school, I completed a 4-week rotation at Mayo Clinic in Rochester, Minnesota, and worked with Randolph Marks, MD, a lung cancer specialist. Like Dr. Keppen at the University of South Dakota, Dr. Marks was invested in the lives of his patients—not just their disease—and had physician-patient relationships that I wanted to emulate.
Of course, I then thought that lung cancer might be for me, but when I did my internal medicine residency at Mayo Clinic, I had the opportunity to work with Tait Shanafelt, MD, who focused on caring for patients with chronic lymphocytic leukemia (CLL). My interests at that time alternated between lung cancer and CLL/lymphoma. I eventually worked on a few research projects with Dr. Shanafelt leading to a publication and a presentation at the American Society of Hematology (ASH) annual meeting, which solidified my interest in hematology as a career focus.
Then, I came to Ohio State University Wexner Medical Center for my fellowship, working with 2 individuals who became my mentors: Kristie Blum, MD, and John Byrd, MD. My final decision to focus in CLL and lymphoma was a result of training with great mentors and learning about the patient population. Lymphoma affects people of all ages; as a lymphoma specialist, you see the full spectrum of patient situations and ages. The biology and research aspects of lymphoma also fascinate me.
How has lymphoma research and care changed since you started your career, and where do you see it going?
The most exciting thing right now in lymphoma research and lymphoma treatment is the expansion of immunotherapy, the therapies that we have available and those that are likely to become available in the next 4 to 5 years. Chimeric antigen receptor (CAR) T-cell therapy has dramatically changed the treatment outcomes for patients with relapsed and refractory lymphomas, including large cell lymphoma, mantle cell lymphoma, and follicular lymphoma.
Newer products being investigated—both to improve upon outcomes and to reduce the toxicity profiles of currently available treatments—such as allogeneic CAR T-cell products and other immunotherapies including the bispecific antibodies are exciting advances as we learn how to best harness the body’s own immune system to target the cancer.
How we continue to use these agents, bringing them to earlier lines of treatment and limiting patients’ exposure to chemotherapy, is one of the important questions moving forward.
What do you think makes a good mentor?
Good mentors are invested in their mentees, their mentees’ work, and their mentees’ outcomes. Mentors are interested in helping mentees succeed not for any personal gain, but to improve research and improve patients’ lives.
At every step in my career, I’ve had great mentors—both in terms of senior mentorship and peer mentorship. Dr. Shanafelt and Dr. Marks were critical to shaping my early career path and I continued to have strong mentorship through Dr. Blum and Dr. Byrd. With each, I envied their involvement with research as well as their relationships with the patients they were treating.
External mentorship, like that I have received from John Leonard, MD, has also played an important role in furthering my career opportunities.
Peer support has been vital for me. These relationships are key because, as a trainee and early junior faculty, going to someone much more senior than you to say that you are struggling and need help can be difficult. Instead, it can feel more comfortable, and beneficial, to be able to go to someone who is on a similar level or has recently gone through some of these challenges.
Having gone through training programs, I met several people who were in similar situations as I was. In particular, Peter Martin, MD, one of my colleagues, and I have served as peer mentors for each other, collaborating on projects and offering advice as we each moved through stages of our careers. I have worked with peer mentors on opening each other’s clinical trials, collaborating on retrospective research, writing review articles, and other projects.
Working in a collegial environment also helps support the development of mentoring relationships. Institutional support is key, but I think that mentorship with an individual outside of your institution can be important as well. It can be helpful to hear an unbiased opinion from someone who is not involved in the day-to-day politics of your institution.
Do you have any advice for early-career professionals who might be struggling to find their focus?
The best advice is to find what you are passionate about and pursue it. If you are going to work and research and see patients with a certain disease, make sure you love and enjoy what you do. It’s better for you and better for the patients.
I think success as a clinical researcher is unique because the patients are what drive the questions you’re asking. How can we improve their lives? What treatments work better? Those are the questions that drive what we do every day. If you are doing what you love and what interests you, brainstorming how to answer those questions becomes much easier.
What would you do for a living if you weren’t a doctor? Is there anything else you’ve considered?
Given my love of math, I think I could have been a certified public accountant. I took an accounting class in high school and loved it; my teacher tried to talk me into going into accounting, but I already had my mind set on becoming a doctor. In my last year as an undergraduate at the University of South Dakota, I had completed all my math, science, and honors credits and was already accepted to medical school, so I decided to take accounting classes for fun, naturally.
Again, the professor tried to convince me to go into accounting, so I had to break the news to him that I was planning to go to medical school and had no intention of redoing another 4 years to be an accountant. If I ever want to switch careers, at least I have a viable option.
How do you spend your time outside of work, and with whom?
My significant other and I have 4 Cavalier King Charles Spaniels. We had 2 (Rubi and Libbi) and then rescued 2 sisters (Izzy and Zoey) this past year. So, most of our time is spent with the dogs—walking them, cuddling with them, playing with them. In my other free time, I enjoy reading, biking, and running. I’ve completed 2 Half Ironman triathlons, which consist of a 1.2-mile swim, a 56-mile bike ride, and a 13.1-mile run.
When did you become interested in competing in triathlons?
I always enjoyed running but I wasn’t a big cyclist until I participated in Pelotonia, a cycling event to raise money for cancer research at the Ohio State University Comprehensive Cancer Center – James. I bought a bike to prepare and got hooked. I have since done 4 century rides, which are 100-mile rides, as well as two 180-mile bike rides that were held over 2 days.
After I took up riding, I learned that the Leukemia & Lymphoma Society was planning to hold several fundraising events, including a triathlon. I was a good swimmer growing up, so I thought I might as well take up swimming again since I had already gotten into running and biking.
I ended up running a few shorter-distance triathlon events and decided to train for the Half Ironman race. The first one was held on a very windy day, which was fine, but did not make for the best experience. I wanted to try again, properly training for it and seeing if I could improve. So, that’s how I ended up completing 2 Half Ironman triathlons.
I’m not sure when I would be able to run a third one—the training is extremely intense and time-consuming. The several monthslong training schedule dictates that one does some sort of running, biking, or swimming activity for 13 of 14 days, and, on half of those days, doing 2 events on the same day. During training, I would set my alarm for 4 a.m. to get up early to swim, go to work in the clinic all day, and then try to run in the evening. The weekends were spent doing either a long day of 1 component—such as a really long bike ride or run—or a “mini” triathlon—biking, swimming, and running on the same day. So, for a while, my life was basically wake up, train, work, train, eat, work, train, eat, and catch a little bit of sleep.