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Pulling Back the Curtain: Sarah O’Brien, MD

March 2, 2023

March 2023

In this edition, Sarah O’Brien, MD, discusses why she chose the subspeciality of pediatric hematology, some of her passion projects, and the meaning of work-life integration. 

Leah Lawrence

Leah Lawrence is a freelance health writer and editor based in Delaware. 

Sarah O’Brien, MD

Sarah O’Brien, MD, is a pediatric hematologist at Nationwide Children’s Hospital, the Abigail Wexner investigator in the Center for Child Health Equity and Outcomes Research at Nationwide Children’s Research Institute, and associate professor of pediatrics at The Ohio State University College of Medicine. 

 

 

Tell us about your childhood and how you became interested in medicine.

My parents both had a big influence on me. I grew up in Pittsburgh, where my father was a sports writer and an author. A big part of my childhood was watching him write and report on events. That definitely influenced my love of reporting, which is a big part of being a scientist.

I have a black-and-white photo on my desk at work of my father and me at a track meet. He has his notebook and is writing, and as a 5- or 6-year-old, I have mine and I am writing notes. That really translates to what I do today.

My mother was a stay-at-home mom for most of my childhood, but when I was in high school, she rejoined the work force as an oncology social worker. That impacted my interests as well.

Once you decided on medicine, what first piqued your interest in hematology?

Growing up, I always wanted to be a math teacher. Even once I decided that I was going to medical school, I knew I wanted to do something in pediatrics. They tell you on your first day of medical school that you will change your mind about your specialty, but I was not one of those people. Once I entered my pediatrics residency, the next choice was deciding if I wanted to care for well children or sick children. Taking care of children with a chronic disease was what really interested me.

As a resident you spend so much time on the inpatient floor. I loved taking care of the children with cancer and getting to know those families. That long-term relationship appealed to me. At first, I thought I would become a leukemia doctor, but I also knew that I wanted research to be a big part of my career.

So little was known about bleeding disorders and thrombosis in children and there seemed to be so many scientific questions. I could easily see how one person could make a difference and add to the science, so that is what put me on the classical hematology path.

It seems like you have spent most of your professional career in the upper Ohio River Valley. What do you like about living there?

I’ve never really thought about that. Moving to Columbus, Ohio, was appealing because it allowed me to remain close to my parents who live in Pittsburgh. I’ve always been happy living in the Midwest. I love to visit the East Coast and the West Coast, but I am always happy to come back here. I live 10 minutes from work, 10 minutes from the airport, and our children can all walk to school. That is a dream location no matter what part of the country you live in!

Dr. O’Brien and family share their The Ohio State University pride. O-H-I-O!
Dr. O’Brien and family share their The Ohio State University pride.
O-H-I-O!

If you had to share one fun fact about yourself, what would it be?

Because my father was a sports writer, I got to have a lot of unique experiences growing up. I met Julius Irving (“Dr. J”) in a locker room, and he went to the soda machine and bought me a soda while my dad was interviewing him. I got to go to the Pittsburgh Steelers training camp in the summers and eat in the cafeteria with the football players. I got to meet Charles Barkley in an elevator. I was able to have a lot of neat experiences. And clearly, the access sports writers had to professional athletes in the 1970s and ’80s was a lot different than it is today!

What do you consider to be some of your biggest professional accomplishments?

As medicine becomes more specialized, I am proud of having managed to stay involved in the science of several different areas of hematology, from bleeding disorders to thrombosis to sickle cell disease (SCD). I have been involved in the clinical trials bringing direct oral anticoagulants to pediatrics. I am proud that I was able to get independent investigator funding from the National Institutes of Health (NIH) to study topics in reproductive health and hematology, which is such an underserved area.

You chaired a session at the 2022 ASH Annual Meeting about maternal morbidity and mortality. What prompted your interest in this topic?

I have been at Nationwide Children’s for 16 years. Within my first few years, my nurse clinician, Linda Grooms, RN, approached me. She had come back from a conference where she heard about a multidisciplinary clinic that had hematology and gynecology in the same clinic. She thought it was an interesting idea and wanted to work together to develop a similar program at Nationwide. That was one of the most impactful conversations of my career.

Clinically, I knew a lot of the girls I was seeing for heavy menstrual bleeding were being referred to adolescent medicine and then gynecology or vice versa, which meant it was taking forever to start treatment. We started our Young Women’s Hematology Clinic back in 2009. I run that clinic with an adolescent medicine specialist, Fareeda Haamid, DO. So many girls have said that just knowing the clinic exists makes a difference because they realize that they are not the only person going through these issues. The whole team of medical providers are there specifically to help figure out why they are having heavy periods and how to treat them. Having an opportunity to work in that clinic and meet these young women has made me passionate about making this a research focus as well.

Over the years, I have recognized how many touch points there are between hematology and women’s health. Reproductive bleeding is one touch point, but questions also come up when young women with risk factors for or a family history of thrombosis are choosing contraception. We help guide them to the safest choices. Facing these clinical problems made me recognize how much more research is needed. For example, right now, our team is using Medicaid data to learn about contraception-​related thrombosis in patients with SCD.

I also serve as the hematology point person for our Teen and Pregnant clinic at Nationwide. Many of those young women struggle with iron-deficiency anemia – as do many young women who are not pregnant.

What do you hope to accomplish going forward?

Most of our research has focused on young women who have already been referred to a hematologist. My next step is getting this research into a primary care setting, which is where most patients initially present with concerns about heavy menstrual bleeding.

My current R01 award from the NIH will compare methods to identify heavy menstrual bleeding in the primary care setting. That might be a short questionnaire about bleeding symptoms, point-of-care ferritin tests to test for iron levels, or a combination of the two. That is my big shift. We are moving from depending on somebody else to refer these patients to hematology to pushing our reach forward so we can touch all patients not referred to hematology.

I am also excited about ASH’s new maternal health initiative. This initiative touches so many areas of hematology and so many patients who already have existing hematology conditions. Reproductive care is a huge need in our patients, including women with SCD and in patients with a history of thrombosis who face unique reproductive issues. This initiative will tackle things like how we can better diagnose and treat iron deficiency in women, particularly pregnant women. How can we help prevent post-partum hemorrhage? This initiative is also unique for ASH because it is attempting to reach out to women who may not be established hematology patients yet.

How do you maintain a work-life balance?

Many of us in academia view it as a work-life integration more than a work-life balance because we are so blessed to do work that we love. This work doesn’t fit neatly into a 9-to-5 box.

We have four children: an 18-year-old daughter, a 14-year-old daughter, and 8-year-old twins, a son and a daughter. I feel blessed to be able to be a mom of four and have a busy clinical and research practice.

 

Dr. O’Brien on vacation in Wilmington, NC, with husband Mathew Eapen and children (from left to right), Jeffrey (age 7), Margaret (age 18), Susannah (age 14), and Madeline (age 7).
Dr. O’Brien on vacation in Wilmington, NC, with husband Mathew
Eapen and children (from left to right), Jeffrey (age 7), Margaret (age 18),
Susannah (age 14), and Madeline (age 7).

What I have learned is that there is not one right way to be a mother. My kids all think I am a great mom even though I am not a traditional mom. It has been interesting and fun to have kids with a wide range of ages. One of my favorite stories is sitting at the table with my youngest daughter, Madeline. She said something about me missing her first Halloween parade. My older daughter piped in, “You are never going to see mom at a Halloween parade,” but it was said with warmth and love. She was explaining, “That is not our mom.” Ironically, I did attend the Halloween parade this year! I think that is one of the benefits that came out of the COVID-19 pandemic, a better recognition that work and life cannot be separated. While working in academia may mean that doing some work on the nights and weekends is my norm, it can also mean that if the Halloween parade falls on an afternoon that doesn’t impact clinical or administrative responsibilities, then it’s OK to put the parade on the agenda for the day.

It is so important for all moms to give themselves grace whether they have chosen to be a stay-at-home, work-from-home, or academic mom. We all just do the best we can, and our kids know that.

When I have time, I love to read, particularly mysteries. I also love to travel and tour new places and I especially enjoy traveling with my husband. I am great at itineraries but horrible at directions. Mathew is a great navigator and has a more adventurous spirit than I, so we make a good pair. I am at my happiest at a historical landmark or museum, wearing headphones and listening to an overly detailed audio guide.

Dr. O’Brien poses with her husband, Mathew Eapen, and the Shanghai skyline at ASH Highlights of Asia 2013.
Dr. O’Brien poses with her husband, Mathew Eapen, and the Shanghai
skyline at ASH Highlights of Asia 2013.

How has your involvement with ASH impacted your career?

I participated in one of the first classes of the ASH Clinical Research Training Institute (CRTI) in 2005. That was likely one of the most informative experiences of my career.

In one aspect, it introduced me to mentors who I still engage with today. It also gave me community. It is hard to balance patient care, clinical research, and all the administrative responsibilities. The people I met through my involvement with that program as a faculty member, and later as a co-director, are my community in terms of colleagues living my same life. That is still important today.

We even have a text chat group made up of old CRTI friends. Those are things that help lift you up, for example, when you get a grant rejected. You know that you have colleagues that understand those moments and will lift you up during them.

Dr. O’Brien attends ASH-a-Palooza 2018 with “Blood Buddies” Dr. Cindy Neunert and Dr. Jenny Despotovic.
Dr. O’Brien attends ASH-a-Palooza 2018 with “Blood Buddies” Dr.
Cindy Neunert and Dr. Jenny Despotovic.

What advice do you have for young professionals wanting to start a family?

I have heard this advice from many people: In medicine, there is not a perfect time to have a baby, so it is always a good time to have a baby. My first daughter was born after I had just finished my first busy clinical year of fellowship. There was a natural break between taking time off to be with her and coming back and starting my research years.

I have had a child as a trainee, as a new faculty member, and as a seasoned faculty member. It doesn’t get easier if you wait because you have more responsibilities, more committee involvement, and more leadership involvement. And in line with the concept of work-life integration, I also think it is helpful for trainees and young faculty to seek out one or two mentors who may not exactly match your clinical and research interests but align with your personal interests, whether that is having children, an athletic pursuit, or being an active community volunteer.


Leah Lawrence is a freelance health writer and editor based in Delaware.

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