Swayam Sadanandan

Pediatric Hematologist Oncologist

Talk a bit about what pediatric hematology-oncology is and what kind of patients you deal with.

A pediatrician is someone who takes care of children by definition, even though we take care of children and young adults from birth to 21 years of age. And as a hematologist-oncologist I have specialized in the field of blood disorders and cancers in children. So I take care of a large spectrum of diseases that involve primarily the blood organs, blood-forming organs and cancers of various organs in children.

Growing up did you know you wanted to do this?

Not really. I wasn’t one of those children who walked around pretending to be a doctor. I just happened to enter medical school at a time in India where education was a lot of streamlining very early in the course of your education so if you were a good science student you went to science and if you were good in arts you went into liberal arts. And those were the days you just needed to do well in school and the competition was purely academic. And that’s how I got into medical school. So up to the point I got into medical school it wasn’t one of those big dreams to be a doctor or anything. But once I entered the medical school I thought it was one of the best things that happened to me.

Why did you decide to come to the U.S.?

I’m not sure why I decided to come. Everyone was coming at that time. I actually was not dreaming to come to the west, but they needed doctors at that time here and we just needed to pass an exam, which we did, and we got the visa to come here. But living in the U.S. I think particularly helps you a little bit more in your own personal growth. And also in professional ways I have been able to do a lot of things that, you know, I’m happy to be here and to be able to do the kinds of things that I have.

Talk about developing this Hematology-Oncology program.

Coming from Manhattan first in that training then Queens where I worked for 10 years and then coming to Brooklyn I was amazed in the difference in the services that were available or provided in Brooklyn at that time. There was practically a non-existing program in pediatric hematology-oncology program in this hospital. But within two years I was able to get the staff that I needed. I have a partner in hematology, a hematology-oncologist, I have a nurse and a secretary of her own and little cubbyhole office space where we could work from. And it kept growing.If you don’t fight in a hospital you don’t get anything. There’s such scarce resources. A lot of people who start a program will lay down the rules I need X, Y and Z before I start and I did it the other way. So yes it was a little tougher. I did not have the support staff I needed initially but then I have to show them that I have the patients, and then I did get the people I needed to work with.

What are some of the main frustrations with the program you’ve faced?

The frustrations is that the present-day medical practice has become somewhat difficult. There’s enormous pressure from HMOs as to what we can and cannot do. We lose a lot of time getting authorizations to do whatever we have to do. The other frustration is that most of the hospitals seem to be having financial difficulty and so did ours. So because of that there are problems with having either certain subspecialty services not being available on the premise or surgical services not available that we would like to have. So there are some frustrations in a professional sense that we don’t have all the support systems that we need. The last one is that we live in a world of fierce competition and there are the bigger centers claiming that they are the only ones that can do what they do and that the rest of them are incapable. So that’s not a healthy competition, it’s more of an unhealthy competition, but it hasn’t really affected us. We don’t go out and sell ourselves, and if patients come and they are happy they stay with us, and we are very open with the patients.

What are some major misconceptions on the part of people entering the medical field?

Most of the doctors don’t make a lot of money anymore. So it’s not a big money-making business. Yes, there are some doctors who make it rich and there are some private surgeons and practitioners who make money and who could probably make money. But it is not, it is not one of the professions you want to go into and study for twenty years thinking you’re going to come out rich and prosperous. Plus it is an area where a lot of hard work is needed. But I guess it’s needed in any area if you’re to be successful, so it’s a commitment. Some people do it as a job, they work 9 to 5 and they go home. But if you really want to do well, it is not a job, it’s really not a job. So that’s something that you need to be prepared for.

How much of working with your patients is establishing relationships?

100% of it. I don’t think there’s a patient who walks in through that door whether it be for a one-time consult or for a long-term relationship for a long-term problem, I don’t think there’s anything I don’t know about them as a family, as a patient, by the time they leave the office. And it has made a huge difference because each individual patient is a person by name with a history, and so for me that’s 100% of the component.

So you never thought you would be here.

No, I just walked into things without thinking what I’m going to do, I just do it. This is the style I like and all the staff members they know that, so they will not be telling a patient that you cannot talk to the doctor because she is not available, so I have a million interruptions in my day but they know I would rather hear from the patient than not, and if anybody is upset they are they know they can reach me at any time and talk to me.