Dr. Isabel Newton: Centering humanity in all aspects of healthcare
Hey, Crystal.
Crystal Page:Hello, Grant.
Grant Oliphant:How you doing?
Crystal Page:I am having an excellent day in part because our guest today is one of the Leaders in Belonging, one of our awardees.
Grant Oliphant:I love this interview. So we're going to be talking here with Isabelle Newton, a one of our 5 recipients of the inaugural Leaders in Belonging prize, a cancer researcher, a practicing doctor, somebody who's on a mission to educate people about alternatives to invasive surgical procedures, really an an exceptional individual.
Crystal Page:And in addition to the studying of liver cancer, I have to say when we did our award ceremony, she brought her 3 kids and her spouse. So the fact that she can do all these amazing things and then somehow is a gracious mother and this amazingly kind and humble human. I just can't wait to hear the conversation and what you take away from that.
Grant Oliphant:Yeah. And I well and I think that's such an important point that this is an interview with a whole human being who, who brings her whole self to her work and to her conversation, and what an interesting person she is. I think it is, a wonderful part of our Leaders in Belonging prize that a medical researcher and clinician was included in this in this set of, inaugural recipients, and it makes so much sense. If we think about a part of life where people often end up being excluded or not giving access or being othered in strange ways. Medicine is just one of those places and so is medical research, And doctor Isabel Newton is in so many ways modeling the antidote to that.
Grant Oliphant:So let's talk to her.
Crystal Page:Let's do it.
Grant Oliphant:Doctor Isabel Newton, thank you so much for being here with us.
Isabel Newton:Thank you, Grant. It's certainly a pleasure.
Grant Oliphant:Yeah. It is a it's a huge pleasure for me. You and I met really by phone only a few months ago when I called you to let you know that you'd won one of our Leaders in Belonging prizes. And I I remember I think you were on vacation somewhere, and you were trying to wrap your head around what I was telling you. You've had a lot of time since then to sort of process it.
Grant Oliphant:And we're gonna touch on the Leaders in Belonging a little bit later, but I'm I'm curious to know what that award meant to you and why why you thought it felt appropriate and and good for you.
Isabel Newton:You are absolutely right. I was shocked, and I don't know if that shock has really dissipated. I'm still surprised to be among the 5 that you selected. I'm in awe of what they are doing in the community and the impact that they have had. And so to be among them is, humbling to say the least and awe inspiring as well.
Isabel Newton:I derive a lot of inspiration from the work that they're doing. And I think when you when you told me that, it was at a point where, you know, we had done so much striving in the darkness, both through the nonprofit work that we do and through our research. And it was the first glimmer of light. And it's not simply that, you know, to be recognized because that feels good. But for me, it was a moment where I was no longer feeling like, you know, my compatriots and I were doing good work in the darkness alone, but that it had been seen and there was some light brought to it, and with that light comes opportunity.
Isabel Newton:And so for me, it was an opportunity to connect within my community in a substantive way with other people doing good things to broaden and deepen the impact of these works and to make sure that this striving amounts to something impactful and important for everyone in our community.
Grant Oliphant:I so appreciate that answer, and I am what strikes me in it is the image of striving in the darkness, because I think most people would assume you're a celebrated researcher at a celebrated institution, that you have access to people and resources, that it wouldn't feel like striving in the darkness necessarily. That might surprise people. And yet, you were telling me this before we started even that in research, it often feels like that. Can you say a little bit more about why that is?
Isabel Newton:Well, research in its nature is it it's something you don't do if you are weak of heart, because there's more failure in it, more, periods of feeling lost and disoriented than there are the wins. And you're not really chasing the wins like you would somebody who's addicted to winning, like going to a lottery or to, you know, gambling or anything like that. It's more this, like, insatiable passion to find out what the truth is, and you keep striving, keep yearning towards something. And I think that's what, is common of everyone who pursues science in a fundamental way. But when you add on top of that the fact that, I'm a clinician in a field that's relatively new, So I'm an interventional radiologist.
Isabel Newton:And for most of your listeners, that means nothing, and they are not alone because most people don't know what interventional radiology is. It was invented in the mid sixties, and it is a field where we use radiology pictures to do procedures deep inside the body through pinholes in the skin. And that means people go home. They can be whole.
Isabel Newton:They can return to their lives faster. And we do things all over the body from bleeding to infection to cancer treatment, which is what I do.
Isabel Newton:And so when you overlay the fact that you have this relatively anonymous field of medicine, and I'm trying to do research in it to convince the bodies that, make decisions about funding, that this is the right way to go, and we're on the cusp of the cutting edge, and they haven't many times heard of what we're doing or really appreciate its value in terms of, synergizing with existing and emerging therapies, it becomes a very difficult thing to, get headway in. And so the way that our funding agencies are structured, they don't really wanna take big risks for big potential gains.
Isabel Newton:So a lot of that striving in the darkness was related to that as well.
Grant Oliphant:Where do you think that interest in minimally invasive procedures came from? You know, why was that important to you?
Isabel Newton:So I, I have a a PhD in neuroscience, and I knew I was gonna be a scientist before I ever knew I was going to be a clinician, you know, a doctor. And that came from being really little and always being curious and wanting to know more about the the world around me, my own body, the universe, all of those things. And when I went to college, I knew I was gonna do research, but I did not realize how difficult it is for researchers to maintain a a constant flow of funding and all of those other uncertainties that surround it. You could be doing an amazing experiment and then your entire experiment gets contaminated by something outside of your control and you start over. It takes a lot of, strength and focus and gumption really to pursue a career in research.
Isabel Newton:And at the time, my family was going through bankruptcy, and so I knew also, you know, how am I going to support myself? I'm coming out. So I started to explore other, avenues, and I realized I could get an MD and a PhD together, and I would fund myself. And that way, my backup plan would be medicine.
Grant Oliphant:So you were your own entrepreneurial plan?
Isabel Newton:In a way, yes. And, also, I'm a classic person who wants to leave all the doors open, and I'm always very curious. And so by doing this, I had, more opportunities to pursue interests. And in the process, I found out I loved medicine. And above all things, I really loved procedural medicine, like surgery, which is what most people understand to be procedural medicine.
Isabel Newton:I didn't realize that interventional radiology even existed, and so I sort of backed into it through radiology, which I had been convinced to do by the husband of my, my boss when I got my PhD, my PI. He was a radiologist, and he said, you'll love radiology. You'll have a lot of time, you know, to do research and all kinds of stuff. And when I started radiology, I actually, had a rotation on interventional radiology, and I was immediately hooked. And for somebody like me who, loves the combination of hands on, of fixing a problem, of creativity, of innovation, and of finding a way, it's just this incredibly fulfilling and stimulating, field within medicine, and one that I am excited to do every single day.
Grant Oliphant:Yeah. I wanna pick up on on your backstory before we move forward with the rest of this. So your family was going through bankruptcy, you had to support yourself, you decided to go to medical school as well as being a researcher. You already knew you wanted to go down this path, difficult path of being a researcher, which by the way for those of us who like to cheat by going to the synopsis of a movie and figuring out what the ending is, is probably not a good career choice for us.
Grant Oliphant:So you you had to make some hard choices in life. What was it that made you interested in medicine and research and health in general? Was there something about in your background that led you to be curious?
Isabel Newton:It's funny that you asked that because, there are people I think who strive to find their passion, and then there are people like me who strive to choose among their passions, and I become passionate about most anything I'm really, you know, into. And I love art. I love poetry and, literature. I do I can
Grant Oliphant:Can I put you on your spot on the spot and ask who your favorite poet is?
Isabel Newton:Well, it's funny because, my mother, is a literary critic, so I grew up with a lot of different poets. And lately, or just recently, I was looking at the poetry again of Federico Garcia Lorca, and my mom is a specialist in, in his poetry. But there's a lot of different poems and poetry that I that I love, and it kind of spans the gamut and has had an interesting resurgence in my career now as we have integrated the humanities in some of the works that that I'm doing now.
Grant Oliphant:Okay. So we're gonna come back to that.
Isabel Newton:We'll get to that. But
Grant Oliphant:yeah. So how- you had choose among your passions.
Isabel Newton:So when I was in college, there was a literary critic there, Elaine Showalter, and I knew about her when I was a high school student because we, had to do a critical reading of a text that we chose, and I chose The Awakening, by Kate Chopin. She was one of the literary critics that I quoted, and I became a fan of hers, which is kind of, in retrospect, rather nerdy of me, but I hunted her down in college and I, signed up for her class And they assigned me to a small group that didn't include her, and I came up with some reason to be put into her small group. And so I was able to study with her. And after small group one day, I asked her, I said, how did you know that you wanted to do English? Because I'm so interested in this, but I'm also so interested in science And she quipped, well, because her husband's name is English Showalter.
Isabel Newton:She goes, if you find a man named molecular biology, you will know.
Isabel Newton:And I thought that was really funny, but then what I realized is, science is not something I can do as a hobby . But I might be able to satisfy a lot of my my, artistic and literary, interests on the side. So I really wanted to do the thing that was going to be most impactful. I've always been driven by a desire to leave the world better than how I found it and and contribute as much as possible, and that's that was what what showed me is, you know, I'd be able to do so.
Grant Oliphant:A lot of women in the have have talked about how difficult it is to be a woman in the sciences and in research in particular, And we've had on this program, Svasti Haricharan, who's looked at the challenges that women face in getting a fair share of resources and access for their research. That pivotal moment where you were asking the question about which of these paths should I take, the more conventional decision would have been to go with English. And you chose science anyway. What was it in you do you think that made you make that harder choice?
Isabel Newton:So now I'm a mother of 3 children, and so I look at, you know, how they interact with their peers and whatnot. And I thought my daughter was gonna be kind of how I was, which was utterly oblivious. I did not know you were supposed to be embarrassed about answering questions or that you were supposed to dress a certain way or, or any of that until kinda too late. I was already set in my ways. And in some ways, my daughter is much more aware of the fashions and whatnot, which, you know, means she always looks better than I would have ever looked at her age.
Isabel Newton:But part of me wishes she had that obliviousness because it became my superpower. And later on, you know, I just took risks and did things thinking, I'm just I'll figure it out when I get there because I always did, and I always have. And so I didn't really worry about these things. And, also, you know, I'm approaching 50, and so I fall in this group of women where there were really strong, amazing women who paved, paths before us and did so, you know, having to be tough and like men and sometimes harsher than men. Some of my mentors were like, don't apologize to them.
Isabel Newton:You know, you be strong and all this kind of stuff. And then there are women after us who are fully women unapologetically, you know, and aren't afraid of appearing weak or being dismissed in the same way that we did. And so those of us who kind of fall in between, we try to be invisible. So we really just try to blend in and, be, you know, not different from the men. You know, my field of interventional radiology when I joined, it was 7% women.
Isabel Newton:So the bathrooms are always, you know, free at the conventions. Like, you didn't have to wait in line, but you were often mistaken for, you know, a a rep from a company or something like that. And it's funny what you say because when I was asked, to give a talk on women in interventional radiology and in medicine, my first response was, what is there to say? And then when I started to really delve into it, I started to understand things that we had ignored, suppressed, or or intentionally just sidelined. And I asked other women from different generations about the same thing, and I realized there's been a lot of code switching, a lot of, just, you know, sort of not standing out too much.
Isabel Newton:And I've had a couple of instances with, funding and things like that where I felt like if I pushed too hard to advocate what for what I knew was right, I was going to be seen as being overly aggressive
Grant Oliphant:A push woman, yeah.
Isabel Newton:Pushy, yeah, all of those things, the b word. You know? And so I just it was very unsettling, you know, and and it's crazy making because it's undermining you. You know what you see and what you're experiencing, and yet you're being made to to feel like you're not seeing an experience.
Grant Oliphant:Do you still experience that today?
Isabel Newton:I that instance, which when I which I'm alluding to is the worst one. Mhmm. I do at sometimes feel these these kind of subterranean things, but something magical happens as a woman approaches 50, and it's where you just stop caring so much. And, also, you have, earned enough gravitas for the power of these other, influences to kind of start to, to dissipate. I wouldn't say that, it's not there, but I still am a product of my generation, so I still make myself invisible.
Isabel Newton:I still code switch. I still do the things where I make myself be the nice guy even though I'm very frank, you know, and that's not necessarily how I would be, but I've learned politically how to navigate some murky waters.
Grant Oliphant:And code switching in this case for you manifests as not appearing to be too pushy, not being too aggressive. Is that right?
Isabel Newton:It goes in both directions. It's, you know, not being pushy, but also acting like a guy. You know? It, you know, using the language of men, not being sensitive to, you know, even cursing and things like that. Like, it's just you go with the flow.
Grant Oliphant:And what's your advice to young women today who ask you, hey. How do I get to where you are?
Isabel Newton:That's you know, my number one advice to my mentees is don't try to be the person you think they want you to be. You will be unhappy. It is a surefire way to end up a place that you don't want to be, and it's basically a prescription for burnout. But the other side of it is if we are looking for more diverse members of teams, we want them to come with the uniqueness that they bring, not the sameness that they think that we want.
Isabel Newton:Even if we think that there's a certain type that would excel in a role that we're looking for. When I was program director, of our residency program in interventional radiology, I was always looking for the people who came from the atypical roads because innovation really derives from different perspectives, and that was important to me and has borne out.
Grant Oliphant:I just have to say how how fantastic I think that is because I think so often in mentor mentee relationships, the the thing the mentee is looking for is sort of the magic formula. It's what's the what's the the secret key that gets me into every room. Tell me how to behave. Tell me what I have to do. What your advice is is how to be more uniquely themselves, and translate that into whatever environment that they need to be in, which is great advice for life by the way, but apparently also great advice for future researchers because they'll bring a unique perspective into the room.
Isabel Newton:Absolutely.
Grant Oliphant:I'm curious where well, we can talk about where that wisdom came from, but I'm I'm curious for your view of being a mentor. Did you have a particularly spectacular mentor who helped you see that?
Isabel Newton:I did, and I think it's not just one mentor. So, when you're a woman, especially one pursuing both, you know, research based kinda and clinician and and interventional radiology, I call it a Frankenmentor. You end up aggregating, you know, people across different parts of your life who have a significant impact, and they go beyond being a mentor to being a sponsor. And sometimes and these are people, like Judy Brenzo Bechtold, who was my mentor for my PhD, who modeled, grace, but also just a an unwavering dedication to research into the truth, not the story you want to tell, to people who have plucked me and put me in situations where I may not have had any business being or maybe I didn't feel like I did, like Steve Rose, my mentor for interventional radiology, and Anne Roberts, also my IR mentor, who, supported me in doing some of these things that looked very outlandish at the beginning. You know, I'm telling them, hey.
Isabel Newton:We're gonna go film a docuseries, and they're like, go for it. Or I'm do you know, I'm trying to integrate molecular biology into interventional radiology, and they I'm gonna put you up on a stage to talk about this to our field. And these are things that catalyzed a lot of important opportunities for me, and I think that mentors across the the spectrum have this opportunity to kind of pick somebody up and move them far ahead on the on the board game of life. And sometimes it doesn't take much effort on their part, and that's the kind of mentor I'm trying to be. And I even pick up mentees from strange places, like, at one point, we had a a service where, they would drive us around campus before they built the bridge between the VA and UCSD.
Isabel Newton:And so one of the young women who picked me up to take me over to the campus, was this woman that, was in science early in science, and we started talking. And I just noticed in her this fire, and she remains my mentee to today.
Grant Oliphant:To this day.
Isabel Newton:Yes. And she's, pursuing her PhD, and it's just truly remarkable what she's done. But we just do these very kind of infrequent but impactful touch points. We're, you know, navigating difficult situations and talking about common ways that we've we've gone through things. And what I've noticed is my best mentees also become my mentors in a way.
Isabel Newton:I learn a lot about opportunities and to to better myself and also to integrate, values into the work that I do.
Grant Oliphant:I, I so appreciate your approach to this, it was part of the consideration that the committee had as we were thinking about your candidacy for becoming a leader in belonging, and by the way, you didn't know, you didn't know that you were being considered for this, but it came up that you were an eager and willing mentor who would work with people. Before we leave this gender subject, and I and I didn't really expect to go as deep as we have on this, but it's it's important, and I really appreciate your candor. What do you what do you wish men in research would understand that about about what it's like to be a woman in research that perhaps they still don't get?
Isabel Newton:You know, I don't know if it's gendered in that way because I think perpetrators of misogyny, are of both genders.
Grant Oliphant:Interesting.
Isabel Newton:I think it's more of a way that we think in our society and perspectives that have been normalized. So when I give talks of this subject, one thing that I say is when you talk about, in improving latitude in terms of family planning, that shouldn't be gendered either. There are very dedicated parents of any gender. Right? And and being a parent or being a caregiver, whether it's to a child or to a spouse or to a parent, that is not at all related to what gender you are.
Isabel Newton:So when we talk about giving, you know, parental leave or giving family leave, they always like to center that around women as if the burden falls all on women, and I think that's unfair to to men and to other genders, nonbinary, whatever you are. So that was one thing that that I would note. The other thing that I think is important if you are in a position, you know, and I won't name specifically what this would look like, but if you are not minoritized in some way, it might be difficult to understand what it's like to be from a minoritized group, which many times just to not ruffle feathers or make waves, you're trying to make yourself invisible. And what it must feel like if you are one of those people who has to raise a valid concern Or who makes a mistake or who is legitimately angry or who's just having a bad day.
Isabel Newton:You know, how how easy is it for you to be someone where everyone around you is assuming you're going to go ahead and do the best and and be successful? Whereas these people are out, they have to prove themselves, so you can't have a bad day. You can't look unprofessional, or have hair that doesn't look like everyone else's. So I think that's the wider message is broaden your idea of what success looks like. Don't have this very rigid, sense of what somebody who belongs looks like.
Isabel Newton:And I think that if you do that, your experience of the teams that you're on and the groups that you belong to are is gonna be a lot richer.
Grant Oliphant:Yeah. Suddenly, I mean, what you're describing is a formula for welcoming all the unique perspectives that you were describing earlier, and allowing more perspectives into the room, and therefore, more and better opinions in theory. So as we think about your unique perspective, let's switch now for a moment to what it's like to be both a doctor and a researcher.
Isabel Newton:Mhmm.
Grant Oliphant:How has being a physician, influenced your understanding of research and vice versa?
Isabel Newton:That's such a good question, and and when you're learning to be both, it's extremely difficult, because they're almost at odds with each other. On the research side, you're taught to question everything and to be skeptical about everything, and on the medicine side, you're taught to learn, to memorize, to implement, and to be decisive because you have to be. And so what you learn to do is to switch back and forth, and, it's something where, you know, it's a great opportunity to be able to to be that sort of liaison, that bridge, but it's very difficult to do so. But I'll say that, now that I have learned to really walk both sides, and I can switch many times within a day now, whereas in the in the past, it'd be this very difficult, alright. Now we're going from research to medicine.
Isabel Newton:Okay. Now we're going from medicine back to research. But what it does is it, deepens the sense of urgency and, and value of what we're doing. So for instance, I treat liver cancer, and that means I get to meet and know and love people who are suffering from and facing liver cancer for a long time. And that feeds the urgency to make it better because it's really not acceptable, the options that we have for patients now.
Isabel Newton:And so it personalizes it. You know, in the laboratory, you are you're trying to pursue an idea or the science, which is incredibly fulfilling, you know, the idea of something or mechanisms, like for those of us who really love that kind of stuff, but that doesn't address the part that makes us human, and that's what being a clinician really brings to me.
Grant Oliphant:I really appreciate that answer and the way in which you talk about melding these worlds. You launched something called the interventional initiative. Can you tell us a little bit about what that is?
Isabel Newton:Right. So in 2015, my cofounder, Susan Jackson, and I recognized the fact that minimally invasive image guided procedures are relatively unknown to the public and to people who would benefit from them. And the way that we came to that realization is we had actually been filming a documentary. We thought it'd be one documentary about, we thought it was gonna be the start of, interventional radiology. What it became was a few patients' interactions and experience with interventional radiology procedures and the clinicians providing it.
Isabel Newton:And we realized this is not enough just to make a one off documentary to educate the public. We need to have some kind of longitudinal way where we address this problem because at its heart, it's an access problem. If you don't know something exists, you can't access it when you need it. And so we began the interventional initiative, in 2015 to educate and engage the public about the value of minimally invasive image guided procedures. And since then, it has grown and evolved quite a bit, but it's always focused on this idea of improving access to care through minimally invasive procedures.
Grant Oliphant:The name of the docuseries was Without a Scalpel.
Isabel Newton:That's right.
Grant Oliphant:Is that right? And I very catchy title by the way that I think most of us would wanna learn more about, but I'm curious as you talk about minimally invasive procedures, clearly, that's a a good in its own right in medicine. Why is it also an equity issue?
Isabel Newton:So first of all, health care is an equity issue at its at its very core. This morning, we had a stunning grand rounds by my mentor slash mentee, Peter Abraham, who's published extensively on this, and we published together about health equity and radiology and the impact of of the pandemic. But more fundamentally, when you're talking about some of these very cutting edge procedures, there's not access to them in sort of an even way across our country. So rural areas suffer from lower access to minimally invasive procedures, and then the same goes for the world. There are areas of the world where there is lower access to care simply because they are very cutting edge procedures that rely on technology and advanced training to, practitioners to be able to perform them.
Isabel Newton:And so what we did last May, is a group of us from the interventional initiative joined up with a sister organization called Road to IR, and Road to IR is very cool because they started a training program in Sub Saharan Africa, at Muhimbili National Hospital in Dar es Salaam, and they recognize if we can train clinicians there, if we can train radiologists there to do minimally invasive procedures, we can improve this access issue. And so we join them as volunteers, but also as storytellers because that's what we do is is really, put a name to what they are accomplishing, and we filmed. So 1 week, we just volunteered, and the second week, we filmed for what is becoming episode 5 of without a scalpel, and it's called same care everywhere.
Grant Oliphant:I you know, as I'm as I as I listen to you talk about that, I am I'm struck by how often in conversations about any kind of access or belonging or equity issue, the argument is thrown up that this is about marginalized groups, this is about a particular subset of the population. What I hear you saying is this is actually about better care for everyone. Mhmm. Is that how you talk about it?
Isabel Newton:Yeah. Our mantra is same care everywhere. And when we say that
Grant Oliphant:I mean, that's what I mean, that that that phrase struck me as, you know, to use a terrible analogy is, like, the the concept of Starbucks when they started was that you'd get the same cup of coffee anywhere in the world.
Grant Oliphant:Why wouldn't you expect the same of your health care that you can get the same quality of care no matter where you go? So say more about that.
Isabel Newton:Well, I think, you know, if you're just gonna look at underserved areas, I think in the past, the idea is let's just send donations. Let's you know, even if they're expired donations, you know, whatever we can send is better than nothing. And that thinking is really changing too. Like, why would you send these people any less quality, materials than what you would give to your own family, and so there's a real change and a focus towards, providing the same quality of care with the same quality of materials and elevating all of us because none of us are well unless all of us are well, and it takes a while to get there, but that should be the goal from the outset, outset, not just good enough. And so when we went to Muhimbili National Hospital, we showed up with 7 suitcases of donated materials, and they were all brand new, but they were donated materials, and even as we were giving it to them, we said, you know, this is not sustainable, And I met with the, director of the hospital. He said, we wanna purchase things. We wanna be able to have sustainable access to these consumable materials so that we can develop, our practice. We can stop sending patients to they were sending patients to India and to, China where we can become the hub where people come for treatment, and we can support our own communities. And so I have, through the interventional initiative, actually, become involved with a group where we're kind of trying to address those issues of how do you provide sustainable access to materials to, places in the world that have not had them.
Isabel Newton:You're basically paving new roads is what you're doing. And so that's an exciting other sort of offshoot of our our goals through the interventional initiative is that we're seeing, this importance of improving access, not simply being something that is North America or even places where there's well developed healthcare, but beyond. And and that includes, as I say, also rural America because those are places where you have sometimes relative deserts of, cutting edge.
Grant Oliphant:It's a hugely underserved population actually in the United States.
Isabel Newton:And the health outcomes are worse. I'm curious how you view all of this. So you're a you're a medical clinician, you're practicing medicine and and caring for people. You're doing research in this minimally invasive procedure area, Also studying liver cancer. And you're you're trying to figure out how to ensure access for people in rural America and around the world, which is kind of a social mission. Do you view these as three distinct areas of your life, or do they all somehow knit together in your own mind?
Isabel Newton:Yeah. When people when I tell people what I do, it feels, like I'm all over the place and chaotic, because you feel like it's not
Grant Oliphant:It doesn't feel chaotic. It does feel like a lot.
Isabel Newton:A lot. Yes.
Isabel Newton:It is a lot. But they they all sort of feed the same purpose and the same goal. And the goal is, I love I love patients. I want people to be well.
Isabel Newton:And how do we how do we come at that problem from different areas? And so, you know, the research, make sure that we have better procedures to offer, the interventional initiative, make sure that people understand their options so they can connect with them when they need to. Also through the interventional initiative, we are focusing on, shared decision making through patient decision aids and a curriculum to teach, our clinicians how to talk to patients in a compassionate way that, drives their values and and what they want to do. And then there's also wellness. So there's another realm that we haven't even talked about, but I have I served as wellness director and, am quite attuned to, the issues, surrounding burnout and wellness and making sure that all of us who are doing this work don't want to leave the work before we're done, you know, before we're ready to retire.
Isabel Newton:So I think it is a lot. I've always been someone who likes It's
Grant Oliphant:Not a criticism, by the way. It's just admiration, I think, more than anything.
Isabel Newton:But I think there there's there's something to be said. You know? You can fill your plate too much even if it's full of stuff you love to eat. You know?
Isabel Newton:It can still be too much to to handle, and I am, I am guilty of that at times. But anytime a little spot on my plate opens up, I just put something right back in it. So it's, it's definitely a passion.
Grant Oliphant:Why is it important to get patients' voices more into the conversation?
Isabel Newton:It's important on so many levels. What is important to patients, their values, their goals, that impacts their outcomes, and we have research that shows that. So patients who are educated and make informed decisions, they actually do better than patients who just sort of are buffeted around or do whatever their team tells them to do, but also, anyone who's ever been on the patient side, it's this terrifying thing where even if you have people telling you, yeah, you know, you're it's what you wanna do or whatever, there's a tendency for most people to kind of assume the role of a lamb. Like, I'm just going to just tell me what to do, doc, you know, and I always try to encourage my patients to become, I tell them at the VA, the captain of their own ship. I say, I'm here to advise you.
Isabel Newton:Here we are all advisors, but let's work together, and it's an empowering thing. And I think that actually supports better wellness too, to not be the person to which things are done, but be the person who helps decide how I'm going to go forward, and even when you have patients who are at the end of life, and especially those patients, that kind of agency really communicates a sense of grace and also, peace to some patients to be able to say, I'm choosing the way that I go forward.
Grant Oliphant:You know, in our work, Isabelle, we've we've borrowed the concept of wellness to guide our thinking about community, and we wanna be agents of community wellness. But for you as a researcher and a physician who spends every day talking with people about this. What does wellness mean in your context?
Isabel Newton:Well, people who treat patients, have higher rates of burnout, than age matched people in the community. So, clinicians, you know, it's it's a kind of a recipe for burnout in some ways because especially those of us who deal with patients, at the end of life or patients with, chronic, disease or serious illnesses, that sense of loss keeps repeating itself, and it's very undermining to one's wellness. But other factors are at play, and that's the increased burden of, the electronic medical record, the introduction of things that are meant to, you know, make medicine better, but just make it more bureaucratic, less efficient, and, decrease the touch points, those human touch points that were so fulfilling. So all of these forces are at play, and what's happening is it is undermining, our ability to provide quality care to the patients that we're actually with in the moment. So it's rare now to find a clinician who will sit down without a computer in front of them, look you in the eye, and have a conversation with you and make you feel like they have time.
Grant Oliphant:Right.
Isabel Newton:And it's not because they're bad people. There are all kinds of pressures that are making it difficult to do that, to practice medicine in that way. And so now the, the way that people are going is, alright, order as many tests as possible so we, you know, can rule out as many things as possible because then the other end is that, oh, fear of this litigious outcome. You know, someone's gonna sue you. And I think this all goes down to the problem in the US, which is patients are consumers instead of being patients.
Isabel Newton:You know, It is a business in the United States, it's not like in other countries or even in the VA, which is the la la land where I practice. You know, we really can just do what's right for patients. I don't have to worry about can they pay or not pay, or will insurance pay for it or whatever. I can just take care of the patient. And in terms of moral injury, nothing's more injurious than on the outside when you know you could do something right for a patient, and yet they they don't won't have access to it because they cannot pay.
Grant Oliphant:Wow. That's so powerful. I, we could have a whole other program about that. And I, you know, but what I what I'm really struck by is, you may have too much on your plate, but there is a a very obvious through line in the things that you're doing, which is, at least to me, as an outsider, that you are in every aspect of your work focusing on how to put the human at the center, and have a a person's personhood be recognized whether they're a patient or you're talking about researching their disease or talking about the clinician and how they stay healthy and whole. Is that a fair way of thinking about how you view your life's mission?
Isabel Newton:Yeah.
Grant Oliphant:Is there anything that you feel particularly excited about at the moment that you're working on?
Isabel Newton:I'm really
Grant Oliphant:I mean, you're excited about it all, so I hope people get the sense of passion that you convey as you talk about this work, but I'm just curious if there is some new project in the offing that has really got you fired up at the moment.
Isabel Newton:So, the CURE prize that that our laboratory got, was to fund a new clinical trial to try to, address liver cancer.
Isabel Newton:You know, the problem is liver cancer, even with our best treatments, comes back in by some accounts, up to 85%. And in our laboratory, we've been able to show that with a unique combination of 3 different, strategies that, attack the cancer immunity cycle. We're able to trick the immune system to become our allies in treating liver cancer, and it has worked so beautifully in our animal model that, we are launching this phase one clinical trial to demonstrate safety and tolerability in humans. And if this ends up being safe, tolerable, and effective, it could change the way that we treat liver cancer of all stages, so that is really getting me excited. And the other thing is is not just liver cancer, but other cancers that are immunologically cold or silent, some breast cancers, some prostate cancers, some brain cancers.
Isabel Newton:The same approach could be employed for these, and we could offer an opportunity to sensitize more patients to some of our immunotherapies that are out there, so it's really exciting. So that's one thing, and then on the II side, the interventional initiative side, I'm really excited for episode 5 to come out. I think it's gonna be our best one yet. The imagery is so stunning, and the the themes that we're exploring there are very compelling, and so to see it all come together, the genius of our editor, Oscar Butcher, is just, you know, just so exciting. He's been working with us the whole time across all of the episodes.
Isabel Newton:So that too is is very exciting, and we're hoping to have it out by this summer.
Grant Oliphant:Thank you for sharing that. I think I should probably ask you quickly about so the the Cure Prize is from Cure Bound?
Isabel Newton:Yes.
Grant Oliphant:A really amazing San Diego institution Right. Is focused on, intersectional work to address cures to cancer. Mhmm. So congratulations on that. And then you recently got another recognition as well for the lab.
Grant Oliphant:Is that right?
Isabel Newton:My collaborator, Nick Webster, so he and I do all of our research together. He was the PI on a sister grant, which is the targeted grant, just a half a $1,000,000 grant through Cure Bound for, looking at prolonged nightly fasting in patients with liver cancer to see if it's safe and, and tolerable. And the idea is in our animal models, we have noticed, that fasting decreases, cancer growth. So if we can combine that with some of the other things that we're doing, we could really decrease the rate of recurrence and empower patients to do something for their own health. So we saw that also in breast cancer.
Grant Oliphant:Is that right?
Isabel Newton:Yep.
Grant Oliphant:And prolonged so the so is this what we all think of in terms of intermittent fasting, or is this more?
Isabel Newton:It is, and, you know, it's funny. Fasting has become this faddish thing, but it's not new. Actually, part of my thesis, in the brain was on caloric restriction and its impact on a part of the brain that is involved in learning and memory. So I've been in this space, this metabolic space for a while. Nick Webster has been as well, so we're a very natural fit.
Isabel Newton:And, what we have seen is we call it prolonged nightly fasting because, of course, unless you wake up to eat in the middle of the night, you don't eat during the night. Right? When you stop eating and stop taking in calories, there's a period of time, and so, there's data that shows that at least 12 hours and up to 16 hours, depending on how you do it, there are various ways, has, differential impacts on the body, on the liver metabolism, on cancer development, and all that kind of stuff. So in this study that Nick Webster is leading, it's called prolonged nightly fastings. It's just prolong that fast that you normally would do, and instead of breaking it at 6 AM, don't break it till 10 or 11 or or 12.
Isabel Newton:And there's some questions because liver cancer patients, there's this idea that they need to be eating all the time
Isabel Newton:Up until the minute they go to bed, so that they don't have wasting because they lose protein sometimes. So we have to test that to see if it is indeed safe, and it seems like it will be safe based on all of our studies, but if so, it could be something that could really change the microenvironment in the liver. And right now, the microenvironment of liver cancer patients or patients with scarring in the liver, which we call cirrhosis, is is really one that promotes cancer development. So if we can change the tides and do something to make that environment less tumorigenic, then we'll have fewer patients who are suffering from this deadly disease.
Grant Oliphant:Well, so many important and interesting questions, and the reason I brought up the additional recognition was earlier we had talked about, you know, at the top we'd spoken about striving in the dark, and it sounds like you're encountering more and more light. I know, speaking on behalf of the Prebys Foundation and the Leaders in Belonging Committee, we're delighted to have been able to shed some light on the work that you're doing. It's extraordinary, and I really appreciate what you're doing to center people's humanity in everything that that you're doing. And through the research and your medicine, I think you're really making an incredible mark for belonging in San Diego. Thank you.
Isabel Newton:Thank you so much. I appreciate this.
Grant Oliphant:Pleasure being with you.
Isabel Newton:It's been so nice. Thanks.
Crystal Page:Wow. So much to take away from that interview.
Grant Oliphant:What an extraordinary human being, And I, you know, I do think that this piece we ended up with at the end, Crystal, of of how in everything she's doing, which is so many different things, she is putting, people at the center and their humanity at the center. It's really an extraordinary model. I got a poem for you. Alright. So I I did some quick research, when when she walked out of the studio before you and I recorded this, on Federico Garcia Yorka, who she mentioned early on as being one of her favorite poets.
Grant Oliphant:So he wrote a poem called Ditty of First Desire, which goes in English, in the green morning I wanted to be a heart, a heart, and in the ripe evening I wanted to be a nightingale, a nightingale. Soul turned orange colored, soul turned the color of love. In the vivid morning, I wanted to be myself, a heart, and at the evening's end, I wanted to be my voice a nightingale. Soul turn orange colored, soul turn the color of love. It's a poem about having to make deep hard choices in life, whether to be your true self or the heart or the nightingale.
Grant Oliphant:I think she told us the story of how she lived that choice, having to choose between her love for the arts and humanities and having to choose her love for medicine and science. She thinks she chose science. I think she chose both.
Crystal Page:Oh, one, I should have known you were gonna go straight for the poetry.
Grant Oliphant:Of course. Yeah.
Crystal Page:Should have known. But, yeah, she is so poetic in the way she tells the story of the work and of the people, but I think you're right. I making the decision to choose the science because she knew she needed to be in a lab or doing these things, but then she says on the side, but you're right. She wraps the humanities, which is the reason for things like STEAM instead of STEM now. She wraps the humanities into her work, and I think that allows her to see the human struggle.
Crystal Page:And those things drive her work in this noninvasive intervention. Right?
Grant Oliphant:Yeah. And I well, I, you know, I think one of the takeaways for me from that was, how completely she sees the challenges that she engages in. It's not just about solving a puzzle. It's about solving a puzzle for people. And and she has real because of the medicine that she does, she has real people in mind.
Grant Oliphant:And I that comes across in everything that she talks about. You know, the fact that that she is through the, interventional initiative trying to expand understanding of noninvasive procedures and their availability to people everywhere, and the ability and right of patients to ask for a different type of care so that access is expanded for them no matter who they are or where they're from. Her idea now of same care everywhere, that you should be entitled to the same standard of care wherever you are in the world. And I, you know, I meant I made that terrible analogy with Starbucks, but the but the reason is very simple. You know?
Grant Oliphant:We think that's okay or logical for there to be a sort of standard cup of coffee you can get anywhere. Why shouldn't at a minimum that be what we expect of medicine, that, that there be the standard level of care, and she's just opening up the doors of better medicine and better care and better research for everyone.
Crystal Page:Well, in noninvasive care, it seems so practical. The idea that you don't have to be completely opened up, get your surgery, and then she said you recover faster. The quality of life for someone who has that experience versus having one of those big complicated surgeries that often has complications has to be life changing, especially if you're someone struggling to make ends meet. So the idea of saying care everywhere, I just feel like that should be the banner of quality health care.
Grant Oliphant:It should be. And as long as the banner is also about quality, which for her, it clearly is.
Crystal Page:Absolutely.
Grant Oliphant:I'm curious what you thought of one of the themes that left out from our conversation for me as well is how she has clearly lived the mantra she teaches her mentees about being uniquely yourself. How did that resonate for you?
Crystal Page:You know, I happen to work at a place that talks about bringing our whole selves to work. I'm like, are you sure? But I do think she's right because what happens if you aren't unapologetically yourself or if you don't bring yourself to things, you're not speaking up. You're not bringing your best ideas, but even more so when you can bring the entirety of yourself, you're bringing your experience, your lens. It makes for better science is what I took away.
Crystal Page:It makes for better science, better human connection. Like, the fact that the person who takes her in the shuttle from the VA to UCSD or who used to, she started mentoring that person because they were in the shuttle everywhere. Right? And so relationships are built not just based on shared identity, but really knowing each other.
Grant Oliphant:Mhmm.
Crystal Page:So I think it lands with me. I think it's a challenge, though, especially also being a woman. I have been in spaces where it's easier to keep your mouth shut or it's easier not to offer a different way of thinking because it may not be received. Actually, when she said the piece about going to conventions, initially, women were 7% of the attendees. That's probably why I was giggling was, thinking about the bathroom lines being clear.
Crystal Page:Sounds amazing. But that means how many opportunities are lost, ideas from women, ideas from people who may be caregivers who have more of a female experience. There's all these things that are lost when not everyone's at the table. So I think it resonated, but also lots more to think about.
Grant Oliphant:Yeah. Her I thought her discussion of that, which was incredibly candid and completely devoid of any self pity was, was exceptionally powerful. You know, she talked about how, as a woman researcher of her generation, which she's young to me, but she, is feeling her wisdom at the same time. She, clearly has had to negotiate, being in a world where at times she has felt like she's invisible, or needs to stay invisible, or needs not to rock the boat, or needs to code switch so that she doesn't offend people in the room who might be offended or she might not be perceived a certain way. I think that probably resonates with anybody who's ever been the, the minority in the room and had to navigate, how to adapt to a dominant culture in that room.
Grant Oliphant:What I also found powerful was how she is part of she sees herself as part of a generational shift in changing that. You know, she paid tribute to the women who went before her. She also paid tribute to the women who have come after her, who are much more comfortable now in these spaces, and very interesting perspective from her about being in that sort of pivot generation where it's a transition from the one to the other.
Crystal Page:And I think that's the world that we're in now. Right? We're in this transition. Having worked for several, folks in government, women in government, you see that transition. We had these these fierce women who are probably 60 plus now and then there's this transition of wanting to be invisible.
Crystal Page:But I will tell you having been in a room with doctor Newton, she just keeps opening doors and spaces and invites you in and makes you feel like a peer. I don't know half of what she knows, but, you know, she, makes you feel like a peer. And she talks about this the value of that mentorship. Right? How do we make sure that the knowledge and the experience and the doors that she's open stay open for other people and then they open other doors for other folks?
Crystal Page:And so I think that there's a sense of community or a vision of, making improving upon what the past generation has given us that I have great gratitude for.
Grant Oliphant:And once again, I think we were treated to a master class on why what you just said is important, not just on the face of it, not just for the sake of the researchers or scientists involved, but because it actually produces better research and better medicine and better care for more people everywhere regardless of who they are. You know, this is a this is a piece that gets so lost in the current iterations of conversation around how we include others, and how we create a culture of belonging, but if we create a culture of true belonging in medicine and healthcare and health research, what we are going to have is better better medicine and better health care and better health research for everyone.
Crystal Page:And to go back to what you said on that and what she said about minoritized groups. Right? There is this whole piece of feeling comfortable enough to be in a space and and do things like raise valid concerns. Right?
Grant Oliphant:Right.
Crystal Page:And so I just thought there was a value when you asked her about, you know, what do men need to know in this space, and she turned it around to here's what everyone needs to know. Yeah.
Grant Oliphant:I thought that was brilliant.
Isabel Newton:Yeah. It
Crystal Page:she's just like the queen of speaking as far as I'm concerned. So good. But yeah. What did you take away from that that moment in time?
Grant Oliphant:Well, first of all, I just found that very powerful and what she is willing to do, which the best people often are when they're when they're thinking about these issues is, well, she's willing to challenge us all. That there are behaviors and ways of thinking that we all can expand our minds around to make, for better outcomes. And that's that's essentially what she was doing. Listen, I think, I think doctor Isabel Newton this was a, a fantastic interview, and here's my final takeaway about her. She started off by talking about striving in the darkness, and that is, you know, for people like me who like to know the answers before the show is done, that I just don't know that I could be a researcher the way she is, and I'm so grateful for the striving that she and her colleagues do, because they are lighting the way for all of us, and as simple as that.
Crystal Page:I think that's the the place to end it. Alright. Thank you, Grant.
Grant Oliphant:Thank you, Crystal. This is a production of the Prebys Foundation, hosted by Grant Oliphant and co hosted by Crystal Page. The program is co produced by Crystal Page and Adam Greenfield, and it's engineered by Adam Greenfield. Production assistance is provided by Tess Karesky. And our new theme song is by mister Lyrical Groove, a local San Diego artist.
Grant Oliphant:Download episodes at your favorite podcatcher or visit us at stop and talk podcast.org. If you like this show, and we really hope you do, the best way to support it is to share, subscribe, and review our podcast. Thank you for your support, your ideas, and most of all, for listening. This program has been recorded at The Voice of San Diego Podcast Studio.
