‘Active listening makes the difference and is sometimes more difficult than removing a tumor’

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When Marike Broekman gets up in the morning, she thinks: ‘I can mean something to other people through my work and I am going to learn new things. That’s a really nice thing to be able to do.’

It is Tuesday morning and she has found some time between operations at the Haaglanden Medical Center to make a video call and answer a few questions. ‘I may be called because of an emergency situation.’ Since August he has been a professor of translational neuro-oncology at the Leiden University Medical Center (translational is about the link between the laboratory and the patients).

Horrible messages

Every Wednesday she has consultation hours: then she has to tell people that they have a brain tumor that in many cases cannot be cured. About 1,100 people in the Netherlands receive this diagnosis every year. Fifteen months later, after major brain surgery and often radiation and chemotherapy, half are still alive.

Remarkably, some of her patients subsequently felt sorry for her, she wrote in her inaugural lecture: ‘What horrible messages you have to give, doctor; How do you keep this up?’

She responds: ‘I have such lovely people at the outpatient clinic. We have very special conversations. You quickly come up with questions like: what makes life worth living for someone? People often cry and then we make a few jokes. All emotions come through. And then you suddenly get such a sweet question that you think: guys, you don’t have to worry about that at all.’ Her patients are exactly the reason she perseveres: ‘That I can do this for people: have that conversation nicely, start the guidance well.’

Put your shoulders to the wheel

The collaboration with her colleagues is another reason she likes this work: ‘You really work together in teams to improve patient outcomes. To all be able to put our shoulders to the wheel: in the morning the tumor is still there and at the end of the day it is gone.’

Science and practice

Broekman is actually very broadly interested. In high school she liked many subjects. She studied medicine and law at the same time and completed both studies. She did her final year of medical school at Harvard University in the US. She loved the lab research, especially in combination with working in the clinic. ‘Many of my qualities come into their own here.’

In her department at the HMC she is the only doctor who also conducts research in the lab and in her department at the LUMC she is the only researcher who also works with patients. ‘As a researcher you know better why you are doing it.’ Her students often find it interesting to hear that you can combine science with practice.

Still a lot to gain

Of course, she would rather tell her patients: we can cure you. ‘That’s why I do so much research.’ In recent years she has investigated how tumors in the brain change immune cells and thus support the tumor. She and her colleagues discovered that by blocking a specific molecule that is involved, the tumors grow less well.

But how to put this important discovery into practice? To this end, she is now investigating, with a team, how the barrier between the brain and the bloodstream can be temporarily abandoned, so that medicines can be injected and the tumors grow less quickly.

Broekman is optimistic: she believes that her profession will become a lot less gloomy. ‘We still know so little about the brain and specifically about these tumors. There is so much to gain.’

But, she emphasizes: improving the prospects for patients also requires genuine attention and the realization that the best care is different for everyone. This requires more than the technical skills of a doctor, she writes in her inaugural lecture. ‘It is precisely the ability to listen actively and empathy that makes the difference. This is sometimes more difficult than operating on a deep tumor.’

Culture change

A good working culture is also desperately needed: being able to communicate and collaborate well with colleagues and daring to ask questions if you don’t understand something. ‘I was trained by someone who would throw things in the operating room if things didn’t go well. People are now leaving the profession because they don’t like the culture. There needs to be a culture change.’ Because only then will a ‘learning environment’ be created – the title of her inaugural lecture.

Broekman is also vice-chairman of the Medical Sciences Council of the KNAW, has other additional positions and has three children. Where does she find the time? ‘I always think in possibilities.’

Marieke Broekman will deliver her inaugural lecture on April 5. Unfortunately there are no more places available. You can follow the inaugural lecture via a live stream.

Source: Universiteitleidingen.nl.

The article is in Dutch

Tags: Active listening difference difficult removing tumor

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