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My Kind of Medicine: Real Lives of Practicing Internists: Saad Z. Usmani, MD, FACP
Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning. --Albert Einstein
Cancer-one of the most emotionally-charged words in the English language-is a frightening diagnosis and a debilitating disease. A biological villain robbing its host of healthy cells, it disrupts the lives of patients and their caregivers, consuming their thoughts and resources as they embark on a surreal journey fraught with uncertainty and anxiety. This is the terrain that hematologist/oncologist/clinical researcher Dr. Saad Usmani, FACP, travels everyday with his patients.
"Few other diseases carry the stigma that cancer does," says Dr. Usmani. "As an oncologist, the relationship I have with patients is very unique. My job is to provide my patients with a hopeful outlook as well as realistic expectations. I must educate and communicate, and in the end, if therapies do not work, I must walk with them all the way, even that last mile."
Dr. Usmani is Director of the Plasma Cell Disorder program and the Director of Clinical Research in Hematologic Malignancies at Levine Cancer Institute /Carolinas Healthcare System. He is a specialist in Hematology, Medical Oncology and Bone Marrow Transplantation and holds an academic appointment as Clinical Associate Professor of Medicine at the UNC-Chapel Hill School of Medicine. As a clinician, he is hopeful and enthusiastic about the advancements in the field of clinical research and clinical trials.
"Clinical trials are an extremely important part of cancer care and vital for moving the field forward," says Dr. Usmani. "We are providing patients with options when no other options exist." According to Dr. Usmani, only 3% of cancer patients in the U.S. are enrolled in clinical trials. "We don't have good mechanisms to make these trials accessible," he says, "that's the piece we really need to work on and that's why I came to Levine Cancer Institute (LCI)."
Prior to joining LCI, Dr. Usmani was an Assistant Professor of Medicine at the University of Arkansas for Medical Sciences in Little Rock, AR where he served as the Director of Developmental Therapeutics at the Myeloma Institute for Research & Therapy. His clinical and translational research focused on plasma cell disorders, specifically high-risk multiple myeloma. He is among 100 clinicians and researchers in the field of oncology from around the country who were recruited by LCI President (and ACP Fellow) Derek Raghavan, MD, PhD, FACP, FRACP. Dr. Raghavan's vision is simple: improve access to clinical trials and world-class experts by removing the financial and logistical barriers that often disproportionately impact underserved patients.
According to Dr. Usmani, LCI's motto, "where you live shouldn't determine how you're treated," is being achieved through the creation of a consortium of linked cancer centers across North and South Carolina. "By developing an integrated network," he explains, "we can make clinical trials available to far more patients." Carolinas Healthcare System is the largest not-for-profit healthcare system outside of the Veterans Administration. It encompasses close to 50 hospitals and 900 health care facilities throughout the Carolinas, and has a single EHR system. "What's happening at LCI," says Dr. Usmani, "parallels ACP's focus on patient-centered care, access to care, high clinical standards, and bringing value to care."
Dr. Usmani was encouraged to join ACP while doing his internal medicine residency at Sinai-Grace Hospital/Wayne State University in Detroit. "ACP's Michigan chapter is very active," he says, "I learned research methodology and how to write and present abstracts by participating in the state and regional competitions, and I'm extremely thankful for the mentoring I received." Dr. Usmani believes it's important for medical students to understand what ACP has to offer. "At the grass roots level, ACP members are coaching students, helping them become better physicians, better communicators and effective leaders."
Trading cricket whites for medicine's white coat
The oldest of five children, Dr. Usmani was born in Lahore, Pakistan, a large and vibrant metropolitan city, to parents he fondly describes as "over-achievers who pushed me and my siblings toward academic excellence." "In Pakistan," says Dr. Usmani, "smart students are pushed toward mathematics or science and by the end of 10th grade they are selecting careers." Dr. Usmani excelled in biology, but he also loved playing cricket. When he was accepted to Allama Iqbal Medical College in Lahore, he was torn between wanting to play cricket or study medicine. Laughing, he acknowledges, "a little bit of gentle persuasion from my parents sealed the deal as to what I should be doing with my life."
Fortunately, Dr. Usmani was well suited for a career in medicine. "I enjoyed figuring out why a biological phenomenon happens. Also, I'm a very social person and I liked the human interaction of medicine."
Dr. Usmani's interest in hematologic malignancies and clinical research began when he was a medical student. "Of all disease pathology, cancer intrigued me," he says, "specifically the hematologic malignancies, because that is the organ system where you can study the development of normal cells from stem cell level to maturation in real time." "A bone marrow biopsy shows cellular evolution," he explains, "No other organ system can provide that kind of imagery."
Dr. Usmani recalls when a drug therapy was discovered for chronic myelogenous leukemia (CML). "The natural history of the disease had been five years," he says, "so it was very exciting to see that overnight, a drug turned a death sentence into a chronic illness and revolutionized how we think about cancer." Excited by developments in the field of clinical research, Dr. Usmani chose to leave Pakistan to pursue further educational opportunities in the United States.
After finishing his residency at Wayne State University, he completed a fellowship in Hematology & Oncology at the University of Connecticut Health Center in Farmington, Connecticut, and later became a transplant-trained physician. "Stem cell transplantation is a highly subspecialized field and very important to hematologists," says Dr. Usmani, "but it is not new-in fact, it is almost four decades old; but in the past 15 years we have learned to make these therapies safer and more effective for patients."
In addition to being an ACP Fellow, Dr. Usmani is a member of the International Myeloma Working Group, the SWOG Myeloma Committee, the Bone Marrow Transplant- Clinical Trials Network Myeloma Committee, the American Society of Hematology, the American Society of Clinical Oncology and the American Society of Bone Marrow Transplantation. He serves on the ASCO Scientific Committee on Lymphoma and Plasma Cell Disorders, the ASH Committee on Plasma Cell Neoplasia, and the editorial review board of numerous medical journals.
Dr. Usmani is married to Dr. Zainab Shahid, who did her fellowship in infectious diseases and subspecialized in transplant infectious diseases. The couple and their three children, ages two, seven, and ten enjoy traveling to Pakistan to visit grandparents and other relatives, but they love living in Charlotte, North Carolina where they can do weekend excursions to the beach or the mountains. Dr. Usmani still enjoys playing in occasional cricket matches, likes watching sports and movies, and shares his 10-year-old daughter's passion for Harry Potter and the Hunger Games series.
A jovial, "glass half-full" physician, whose job it is to provide "a hopeful outlook and realistic expectations," Dr. Usmani's mission is to ensure that patients have the resources they need to fight the fight and reclaim their right to hope.
Hope-one of the most spiritually-charged words in the English language-is fear's greatest adversary. For cancer patients and their families it is a reprieve from despair, a place of possibilities where they can breathe and dare to dream again. This is the terrain that hematologist/oncologist/clinical researcher Dr. Saad Usmani, FACP, travels everyday with his patients.