In this edition, Tom DeLoughery, MD, talks about the approachability of hematologists, blending his interests in science and the outdoors through wilderness medicine, and the origins of his "famous handouts."
Where did you grow up and what was your childhood like?
I grew up in a town called Terre Haute, Indiana, near the Illinois border and on the banks of the Wabash River. Terre Haute is home to Indiana State University (Larry Bird's alma mater) and the birthplace of Theodore Dreiser and Eugene V. Debs. That's about all it's known for!
My wife accuses me of not remembering much about my childhood, but I remember that I had a pretty good one! I often broke things while playing, like my ankle or my glasses about a thousand times. From a very early age, I was an avid reader. My family encouraged reading, so many of my memories are of going to the library and reading books.
What were your favorite books to read?
I loved Winnie-the-Pooh books and, even as a very young child, I loved children's versions of science and history books. Isaac Asimov, who is known as a science fiction writer, published several books on the solar system and other topics to make the sciences approachable. These books were a very good introduction to all sorts of sciences.
Did you always want to pursue science as a career?
I did. Growing up, I always knew I was going to end up in the sciences, but I never specifically said, "Gee, one day I'm going to be a doctor."
I betrayed the family path by not going into accounting. My father is an accountant because his father was an accountant. After a short stint as a librarian, my mother went into bookkeeping. My older brother was also an accountant.
But science always fascinated me. I was interested in and curious about the world around me. I still am – I love to learn new things.
Walk us through your career. When did you decide you wanted to go to medical school?
I attended Indiana State University – at the same time as Larry Bird, by the way, as evidenced by a very grainy photo I have of the two of us. I took all kinds of science courses as an undergraduate but decided early on that studying medicine would be the most practical and logical path. I went on to medical school at Indiana University School of Medicine.
At that time, the University had regional campuses, so I actually completed my first year in my hometown of Terre Haute. I had a summer job working in the lab of Frederick J. Walker, PhD, a coagulation researcher who first explained the role of protein S in coagulation. That's when I caught the hematology bug. I was always one of the few people on the wards who understood the coagulation cascade!
Then, as a senior medical student, I drove across the country to the University of Washington in Seattle to do three months of senior electives. It was probably around this time that I seriously considered being a hematologist. I used to joke that, while I was driving across the Utah desert on the way back home, a giant red cell appeared to me and told me to go into hematology. The simple truth is that, while I had many other interests, my fascination with hematology outlasted all of them.
I completed my residency at Oregon Health & Science University, which has a strong hematology program. Luckily, I had the opportunity to work in the clinic of Scott Goodnight Jr., MD, a coagulation expert and true professional. Working in that milieu, alongside great hematologists like Dr. Goodnight, Grover Bagby, MD, and others, helped shape my future. I have been at Oregon ever since.
How did you learn to be a mentor to others?
Something that has struck me throughout my career is how approachable and welcoming other hematologists – even very senior hematologists, both inside and outside of my institution – have been in offering advice, allowing me to be part of meetings, and generally helping with career development. I could name at least 20 people who have shared their time and wisdom with me. It is something I have always been grateful for, and something that I hope to emulate now as a more senior hematologist.
When I approach mentoring, I try to remember the effect that a senior person's words and advice had on me early in my career, and what effect my words will have now. I take great pride in our classical hematology program and try to be accessible to our trainees. The running joke is that, as a graduation present, every graduate gets my cell phone number so they can text me if they ever run into issues. That comes up often in hematology, where there are plenty of clinical problems without textbook answers. It helps to talk through these issues with someone.
I consider teaching and helping learners succeed to be part of my life's mission. It's fun to see people learn things and it helps me stay fresh, too.
Speaking of teaching, can you tell us the story behind your "famous handouts"?
When I joined the faculty at Oregon, I doubted my teaching skills and I believed that the only way I was going to become a better teacher was by teaching a lot. To gain that experience, I signed up for the residency program's lecture series and gave talks on iron deficiency, anemia, and blood clotting. Before each lecture, I made a handout on my old computer, maybe an Intel 280, printed them out, and passed them around. I tried to make them very practical.
My colleague Bill Hersh, MD, who was one of the first people to focus on medical informatics, saw them and said, "Tom, I'm going to put your handouts on the World Wide Web." My response will date me, but I said, "Gee Bill, I've never heard of that. Go ahead and do it." So, "Thomas DeLoughery M.D.'s Famous Handouts" was born. The site took off from there. It was one of the first medical resources on the internet. I update the website every now and then because it remains a widely used resource.
Tell us about your family.
My wife is a retired geriatrician. She is active in volunteering at schools and the library, plays flute in the community band, and routinely beats me at cribbage.
My daughter is an intern in internal medicine here at Oregon, which is a lot of fun, although I think she cheats by asking me hematology-related questions. I see her around quite often, but if we're doing something professional, we try to ignore each other. My clinic building is down the hill from the university, and when time allows, we walk back up the hill together. It's been nice to spend time with her, especially as the pandemic has kept so many other people distanced.
My daughter is also an avid reader. We're both Shakespeare fans. This is going to sound pretentious, but a few years ago, because my daughter had a bit of a classical education, I read The Iliad so we could discuss it together.
What else do you like to do in your free time?
One of my pandemic projects has been to learn to bake. I've been baking banana bread, sourdough pizza crust, cookies, brownies … a bit of everything, but mainly treats that I share with my family and people at work.
I've been a runner since college. When I travel, I find it fascinating to run through the town I'm in, because I get to see it from a different aspect. It's especially interesting when I travel overseas.
Running has always kept me outside, and I love being outdoors in general. My cross-country drive to Washington was my first time visiting Yellowstone National Park and I have now been through the Greater Yellowstone Ecosystem at least 15 times. My wife and I even honeymooned nearby in Grand Teton National Park. We have always enjoyed visiting the area and seeing the animals, the amazing geology, and the breathtaking scenery. I also routinely go to Alaska, another area with magnificent scenery.
My trips to these areas sparked my interest in photography. Years ago, when I visited Denali National Park for the first time, I had a little point-and-shoot camera. I thought, "These pictures look okay, but I think I could do better." Photography developed (pun intended) as a complementary hobby to my love of the outdoors – it gives me an excuse to hike and spend time in the wilderness to get a great photo of the wildlife – and to justify buying new camera equipment. Even when I'm running, I always carry my phone with me to make sure I don't miss an opportunity for a great photo.
You have combined your love of medicine and the outdoors into an interest in wilderness medicine. How did that begin?
Many years ago, I gave a lecture on the coagulation cascade to a group of medical students, including the very talented Deborah Robertson, MD, who is now an emergency medicine doctor in Idaho. She heard "cascade" and asked, "I climb mountains, but what does mountain climbing have to do with coagulation?"
As I mentioned, I'm a curious person, so that question led me to read studies about snake bites, people getting sick on mountain expeditions, and how the human body responds to different conditions.
In fact, I recently gave a talk on rounds about wilderness hematology, tackling questions like, "What does the blood do at altitude?" It started as a hobby, but it has grown into part of my work, a way to apply what I've learned in academic hematology to another field.
Wilderness medicine also ties many of my nerdy scientific interests together – geology, medicine, biology … Currently, I'm working with an excellent student on a pandemic project about avalanches and avalanche safety. It's just one way of satisfying my curiosity about different aspects of the world.
What's something most people would be surprised to learn about you?
I am a huge Bob Dylan fan. In 1976, I saw his "Hard Rain" TV special, where he performed live during a rainstorm. I was hooked. After seeing that, I stole all my brother's Bob Dylan records and have been a fan ever since.
I've been to 40 Bob Dylan concerts in six countries: Canada, the Netherlands, Sweden, England, Germany, and the U.S. Bob Dylan fans have a reputation for being hardcore, so that number is still pretty low. At a concert in Berlin, I met a man who had been to 100 shows.
I literally have a 1 TB hard drive full of bootlegs, books, and every album he's ever made, and I still consider myself just an amateur fan.