The Doctor Factor

They are two women engaged in the universal banter of motherhood. "I brought wedding pictures," says Karen Ulisney, pulling out her photo album. "Kristina got married to a great guy. She's so happy." Claudine Isaacs leans forward and smiles. "How old was she when we met?" Isaacs asks. "Sixteen. And Matt was 6," says Ulisney. Isaacs laughs. Ulisney beams. "He's five-ten now. He's such a handsome young man," says Ulisney, flipping to a photo of mother and son walking arm in arm. "You look just a little bit happy," says Isaacs. "I didn't think I'd make it to the wedding," says Ulisney, tearing up. "That was a milestone."

These are not old friends catching up at a coffee shop. The setting, instead, is an exam room at Georgetown University's Lombardi Comprehensive Cancer Center. Ulisney, 51, is a 10-year breast-cancer survivor in for her annual checkup. Isaacs, her oncologist, is at the cutting edge of compassion. Yes, the doctor performs a physical exam. And she and Ulisney discuss her patient's medications and concerns. (Should she have genetic testing? Does she need a breast MRI?) But their interactions transcend the clinical. The two women are partners in an odyssey that combines medicine with the human spirit.

The science of cancer has made great strides in recent years. Researchers are identifying the unique molecular characteristics of tumors and developing new targeted drugs to attack them. But no technological advance can measure fear or heal the psyche. In the inhumane world of cancer—the terrifying lingo ("malignant neoplasm," "adenocarcinoma"), the burn of radiation, the dread of recurrence—patients want not just excellent care but caring experts. And oncologists are hearing the call. "Part of this humanistic approach is the increasing awareness that there's another person in front of you who's suffering," says Dr. Teresa Gilewski, of Memorial Sloan-Kettering Cancer Center in New York. "The question is, what can you do to help?" Practicing world-class medicine and humane treatment aren't mutually exclusive, says Dr. Lidia Schapira, an oncologist at Massachusetts General Hospital Cancer Center. "They're part of the same definition of a good cancer doctor."

Ulisney had no choice the first time she put on her paper gown. Cancer invaded her breast tissue, but there is more to a patient than her disease. Isaacs, director of Georgetown's Clinical Breast Cancer Program, knows this, and it defines the way she practices medicine. She gently touches patients' arms when she senses they need comfort, she pauses during conversations to allow for a fear that might otherwise be stifled. Isaacs can recite the molecular blueprints of her patients' tumors, but what she remembers after her appointments are over is not the cancer. "It's who they are, what they do, how many kids they have," says Isaacs. "We're afforded an intimacy into people's lives. Hopefully, we can help them through a tough time."

Talk to cancer patients who love their doctors—and, yes, the word "love" comes up frequently—and key themes begin to emerge: hope, trust, respect. Brendan Lohan found all of this in his relationship with Dr. Robert Mayer of Boston's Dana-Farber Cancer Institute. In 1999, Lohan, then 39 and the father of two young children, was diagnosed with advanced colon cancer. Lohan and his wife, Mary Jane McKenna, knew his prognosis was grim. But Mayer made it clear that talking numbers would be unproductive. "He basically said, 'Statistics don't matter when it comes to the individual'," says Lohan, now 48. "That gave me even more desire to fight."

What Mayer did want to focus on, he says, was "developing the very best, most reasonable, rational and tolerable treatment plan." Along the way, he calmed Lohan's anxiety by assessing his disease in real time, rather than fast-forwarding to an unknown future. At first, Lohan was intimidated by Mayer's stature, but they quickly developed a warm rapport marked by simple non-jargony explanations about cancer one minute and chatter about soccer games the next. Over the past decade, Lohan, a carpenter born in Ireland, McKenna, a lawyer, and Mayer, a leading authority on colon cancer, have become fellow warriors. Patients want "somebody who knows them, who they have gone to battle with and come back in one piece," says Mayer. "People whom they trust."