Joey Wahler (Host): Today we're getting acquainted
with Dr. Noura Elsedawy. She's a Hematology Oncologist and Medical Oncologist
with Regional One Health Cancer Care, specializing in treating plasma cell
disorders and related conditions. This is One-on-One with Regional One Health,
your inside, look at how we're building healthier tomorrows for our patients
and our community. Join us as we get to know some of the individuals who help
provide life-saving, life-changing care for our community. Thanks for
listening. I'm Joey Wahler. Hi, Dr. Elsedawy. Thanks for joining us.

Noura Elsedawy, MBBCh: Hello. Thank you.

Host: So first, where are you originally from and
what first inspired your pursuit of medicine and treating blood diseases in
particular?

Noura Elsedawy, MBBCh: I am from Cairo, Egypt, and
what inspired me for treating cancer in general, was around the time when I was
finishing high school and going to med school. And we have med school right
after high school back in Egypt. So this was the time when all the mothers in
my family, so my mom, my aunts were all talking about breast cancer because
that was the time they were getting their screening.

So this was the first time I got interested in cancer and
what is that and what can I do to help them? And then when I got into my first
year of med school, we were studying pathology. I was, I got very interested in
the biology of blood and the, the science behind it and the science behind
carcinogens and carcinogenesis. That's how I ended up with cancer and blood and
blood cancers.

Host: And you mentioned that back in your native
country med school comes right after high school. That's quite a departure from
the US right?

Noura Elsedawy, MBBCh: Yes, at 16, you got to decide
what you're going to do with the rest of your life.

Host: Wow, that's not too much pressure, huh?

Noura Elsedawy, MBBCh: Time to party. No.

Host: No time to party, you said. Gotcha. So I
understand you earned your medical degree in Cairo and then later did your
internal medicine residency in Sioux Falls, South Dakota. So how about the
difference between those two areas?

Noura Elsedawy, MBBCh: Oh my God. So, a lot. I'm a
desert girl, I'm not a cold person. But Sioux Falls was a very nice, small city
and I had a few years in between, so before I went to residency, I came to the
US and I first landed in Houston, Texas, and I shadowed a lot of the doctors in
the lymphoma myeloma department and stem cell transplantation department at MD
Anderson, before I went ahead and started applying for research jobs. And then
I was granted a research fellowship, in the Kurtz Family Award and, and
research fellowship in Mayo Clinic in Rochester, Minnesota. So after Houston,
Texas, I went to Rochester, Minnesota, and I spent two years there doing my
research studies. Then I went to Sioux Falls, South Dakota. So it kept getting
colder for a while.

Host: Okay. And so you're obviously very well
traveled. What impact would you say being in those different parts of this
country, coming from another country, how has that impacted your experience as
a doctor, would you say?

Noura Elsedawy, MBBCh: I wouldn't say it impacted my experience
as a doctor, but more as, as a human being connecting to other human beings,
getting to know the US and the geography and the localities and how things are
different. My first lesson is that just because I had P Camp High in Houston,
Texas doesn't mean it's going to be good in South Dakota. So,

Host: Gotcha.

Noura Elsedawy, MBBCh: You know, things like that,
that every place has its own thing, has it's own localities and culture and
habits. It's the beauty of it all. It's the same as in my own country where
it's not a monolith, there are different places, different cultures, different
colors to people and how they deal with each other and how they go to work and
how they what fun things they do. It broadened my horizons.

Host: Sure. That's great. So speaking of work, which
you just mentioned, let's get back to that. We mentioned you treat plasma cell
disorders. So what are some of the most common ones?

Noura Elsedawy, MBBCh: So the most common one is
actually MGUS or Monoclonal Gammopathy of Undetermined Significance. And plasma
cell disorders come on a spectrum of diseases. They are basically when your
plasma cell, which is the cell that makes the antibodies in your body, becomes
older with you, and then it starts acting funny. That comes on a spectrum of
diseases.

At one end of the spectrum, it just produces some extra
proteins and you just have to watch it from one year to the next to make sure
that it stays the same, doesn't do anything to you. And at the end of the
spectrum, it produces so much extra proteins and makes so many copies of itself
that it becomes a cancer. And we call that multiple myeloma and that needs
treatment. All multiple myelomas are preceded by a state of MGUS as that
disease progresses. However, not all MGUS's will progress into myeloma or the
cancer. And then in the middle of that spectrum, there are plasma cell
disorders where you have some activity, some extra protein, it is not cancer.
The activity is not high enough to call it cancer. However, the protein is
toxic to some of the organs that we have to treat it anyway. We can't just
watch it. And the treatments are very much like how we treat the cancer itself,
or we use the same drugs just in different intensities and order. And so I will
treat all of that, all of those diseases on that spectrum.

Host: And whether it be cancer or not, if there is an
abnormality there, is this something that only would show up on a blood test or
are there symptoms that sometimes come along with it where a patient is
noticing something on their own?

Noura Elsedawy, MBBCh: So the benign state of it,
it's only a protein. The blood not doing anything. This comes along in a blood
test. You discover it incidentally, or by screening and the average percentage
of it progressing to further diseases is about 1%. And that's the average among
all risk categories, so about 1% per year.

And that one does not have any symptoms. Whereas the other
diseases do have symptoms as they cause toxicities to your organs or other
organ failures. And there are a lot of diseases on that spectrum and they have
different presentations.

Host: Now you've been involved in establishing a new
oncology service at Regional One Health. So what's that been like?

Noura Elsedawy, MBBCh: It's been very exciting, very
frustrating, very rewarding at the same time. But it gives me a lot of hope and
excitement because Regional One did not have that service before we started.
And now we have a full floor with a lot of patients that did not have that
service before. We not only serve some of the patients of Memphis, we also
serve people in East Arkansas and in North Mississippi. So having that
available for those patients gives me great pride.

Host: I'm sure. And so for cancer patients and their
families that are often scared and overwhelmed, how would you say you approach
providing the support and compassion they need?

Noura Elsedawy, MBBCh: It's a very delicate balance.
Because you have to give hope, but also you cannot. It's a very fine line
between hope and wishful thinking. And I try to be very honest with my patients
from the get-go, but at the same time, give them the hope of what can actually
be achieved and put that in balance. You also have to extend grace to the
patients and their families having all the emotions of grieving. That comes in
many colors. It doesn't have to be just grieving death. It's grieving the
diagnosis of cancer, the loss of life quality, having to see me and coming to
the hospital or being admitted multiple times and losing that time of your
life, that precious time between clinics and hospitals and doing procedures.
You need to expand your horizons and have grace and acceptance and to manage
all of that.

Host: Well, you mentioned it's a difficult balance
between wanting to provide optimism and hope while at the same time being
honest and realistic. Similarly, how difficult is the balance between being
compassionate and empathetic, and yet you're dealing with this, unlike the
patient and their family on an ongoing basis. You see this all the time. How do
you kind of separate personal feelings from professional duties, if you will,
when you're trying to lend that support?

Noura Elsedawy, MBBCh: It's hard to separate and you
learn not to let it affect your thinking. You have to be on your feet all the
time. You become a master griever. I'm able to remember my patients with good
memories and the good moments. The kind moments that we had together. A lot of
people think that you separate, you push it out. You really don't. You just
have to function within that. You have to develop the wisdom to realize that
this is the way it is, this is the way of life. This is the natural progression
of things. And get comfort in knowing that you did your best for your patients,
and they did their best trying too.

Host: Well, I would imagine hearing all that, that it
can be quite an emotional rollercoaster doing what you do. So let me ask you
this, what about your free time outside of work? What do you do to unwind and
enjoy yourself and be involved in other things?

Noura Elsedawy, MBBCh: So it's starting to be
beautiful here in, in Memphis. And I revel in the sun. I will get out and
garden even if it's for 30 minutes, after 5:30 when I get back. I also, I used
to paint, but I am, I somehow, I lost interest in it. So I picked up a new
instrument to learn. I'm learning the OUD and I'm enjoying being very bad at
it.

And this is as popular as the guitar, but for the Arab part
of the world, it looks like a guitar, but with a big belly, it's like half an
almond shaped. And it makes the most beautiful sounds to me because that's the
sound that I grew up with. So I'm trying to learn that with Skype.

Host: And how do we spell that?

Noura Elsedawy, MBBCh: OUD.

Host: And that's an instrument back in Eygpt?

Noura Elsedawy, MBBCh: It's in the Arab countries. So
North Africa, the Levantine area, so Iraq, Syria, Jordan, Lebanon, Egypt. From
Egypt to Morocco, you know, all the North African. So in the Arab speaking
countries, which is North Africa and Western Asia.

Host: Oh, that's great. And so when you're doing
that, does it make you feel more in touch with your heritage?

Noura Elsedawy, MBBCh: Right now I'm extremely bad at
it. I'm just trying to find the chords.

Host: You'll worry about getting in touch with
heritage later, and you said you're taking online courses in this, yes?

Noura Elsedawy, MBBCh: Yes.

Host: Is there anything we can't take online courses
for nowadays? No, that's tremendous. And so finally, in, in summary, Doctor,
what would you say is most rewarding about your job? We talked about some of
the difficult parts, but of course there are many times when you're giving a
positive diagnosis and you're helping people to get out of a medical jam, if
you will, simply put. So what's most rewarding for you about that at Regional
One Health Cancer Care?

Noura Elsedawy, MBBCh: The most rewarding thing is
the human connection that I develop with my patients, because no matter what,
if it's good news or it's bad news, you develop this very vulnerable, very
true, relationship with your patient and their families. It's a very precious
thing, the doctor-patient relationship. It's a very precious category of human
interaction because a person is basically entrusting you with their most
vulnerable moments. And you have to stay true to that and you have to give and
exchange some sort of vulnerability as well for that to be comfortable. And
that is the most rewarding thing for me.

Host: Well, it certainly sounds as though the
patients at Regional One Health Cancer Care are very fortunate to have you.
Folks, it's been great getting acquainted with Dr. Noura Elsedawy. Doctor,
great to meet you and thanks so much again.

Noura Elsedawy, MBBCh: Thank you.

Host: And folks for an appointment with Dr. Elsedawy,
please call 901-515-HOPE. Again, that's 901-515-HOPE. And to learn more about
Regional One Health Cancer Care, please visit
regionalonehealth.org/cancer-care/. Now, if you found this podcast helpful,
please do share it on your social media and thanks for making One-on-One with
Regional One Health, part of your journey to better health. Join us next time
as we introduce you to another member of the Regional One Health Family, hoping
your health is good health.

I'm Joey Wahler.