Difficult Conversations in Pediatric Oncology

Dr. Michelle Neier (2s):
One of the things I always try to stress to parents. He’s like being a kid comes first. That’s their job. Their job
is to have fun. Their job is to go to school. Their job is to see their friends. Having cancer is a side gig. If you
will, you know, that’s, that comes second. And I think we always have to remember that that without the
beauty and the happiness in life and without those wonderful moments, the rest of it doesn’t matter.
Narrator (44s):
Welcome to difficult conversations lessons I learned as an ICU physician with Dr. Anthony Orsini. Dr. Orsini
is a practicing physician and president and CEO of the Orsini way as a frequent keynote speaker and author.
Dr. Orsini has been training healthcare professionals and business leaders, how to navigate, to read the
most difficult dialogues each week. You will hear inspiring interviews with experts in their field who tell their
story and provide practical advice on how to effectively communicate whether you are a doctor faced with
giving a patient bad news, a business leader who wants to get the most out of his or her team members or
someone who just wants to learn to communicate t his is the podcast for you.
Dr. Anthony Orsini (1m 26s):
Well, welcome to another episode of difficult conversations lessons I learned as an ICU physician. This is dr.
Anthony or Sini your host today and every week moving forward. Now, if you’ve listened to this podcast
before you know that I promise my audience two things each and every week, number one, to feel inspired
and number two, to have valuable communication techniques that you can go and take home with you. The
next time you have a difficult conversation. And I am very certain that I will keep my promise today.
Dr. Anthony Orsini (1m 59s):
Today we have dr. Michelle Neier. Dr. Neier is a board certified pediatric hematologist oncologist and
integrative medicine physician. In 2005. She completed her pediatric residency at Schneider children’s
hospital at North shore university in long Island. She continued her training in New York city where she
finished her hematology oncology fellowship at Morgan Stanley children’s hospital in New York, Presbyterian
Columbia in 2008 after practicing pediatric hematology and oncology at Goryeb children’s hospital in
Morristown, New Jersey, she elected to further her training and recently completed an integrative medicine
fellowship through the university of Arizona integrative medicine department.
Dr. Anthony Orsini (2m 37s):
Dr. Neier has a strong interest in the medical humanities and especially narrative medicine. She is
passionate about teaching and as a breaking bad news instructor for the, or see any way in April, 2020, Dr.
Neier started olive tree integrative health olive tree integrative health mission is to provide quality integrative
medicine care, which honors each individual’s story. Dr. Nigher is passionate about her goal to help children
and young adults we’re dealing with chronic or life threatening medical illnesses, as well as those children
who have multiple symptoms, but do not yet have a diagnosis talk denier and olive tree integrative health
understands that disease is multifaceted and healing includes supportive her patients and the caregivers as
well.
Dr. Anthony Orsini (3m 19s):
She resides in New Jersey and in her personal time is an avid reader loves to practice yoga and spend time
with her family, and recently started knitting, but welcome Michelle. It’s so nice to have you on my new
podcast.
Dr. Michelle Neier (3m 31s):
Thanks Tony. It’s great to be here.
Dr. Anthony Orsini (3m 34s):
You know, we’ve never met in person, but we’ve been doing breaking bad news together. You’ve been an
instructor for the, or see any way for several years. And I try to get the most of the sessions, but our paths
never really crossed. We didn’t get to do the same one together, but everyone from the very beginning, so
nicely about you and said you had so much to offer the young residents. You were really passionate about
communication, just like me, and just received constant accolades about your wisdom and how well you
teach and everything that you say.
Dr. Anthony Orsini (4m 6s):
So I was really excited to finally get to interview you. When I decided to take this leap for this podcast, your
name was one of the first names that came up, because I think you’ll be easily full, be able to teach our
audience something about communication, especially in your field. One of the premises of this podcast is
that if you can have that conversation with someone about cancer or death, and pretty much the rest of the
conversations in your life will be relatively easy. So today I’m really excited for the audience to hear your
story and to really learn something about communication from you.
Dr. Anthony Orsini (4m 42s):
So thank you for coming on. I know you’re very busy these days
Dr. Michelle Neier (4m 45s):
I am, but I really appreciate the compliment. It’s a big honor to be here. I think what you’ve done is amazing
and what you’re doing is incredible, and it means a lot to participate in this.
Dr. Anthony Orsini (4m 59s):
You know, I have a, a personal story that I’ve shared on a previous episode about why I became passionate
about communication. It really started when I witnessed a physician, tell someone that their baby died in a
very cold manner and it profoundly changed me. And that was when I was a fellow in neonatology way back
when. And so everyone seems to have a story and I want to, if you don’t mind sharing with the audience
here, yours, I’d like to know why you chose hematology, oncology, and maybe a story about what really
moved you either with a patient or what made you so passionate about teaching communication to the
young doctors.
Dr. Michelle Neier (5m 38s):
So I think in hindsight, the seeds of hem-onc were back, even in childhood, I mentioned to you that I’ve been
an avid reader and as a child, there was a book I read about a girl with leukemia. And I think I must’ve read
that story over and over and over a dozen times. And it just always stuck with me. I started pediatric
residency and thought for sure, I was going to do general pediatrics.
Dr. Michelle Neier (6m 9s):
I just wanted to do good preventive care and sure enough, the best laid plans always change. So I was a
resident and I met a young girl. I still remember her and think of her fondly. She had a solid tumor. She was
probably about seven or eight when I met her. And she used to walk around her and her mother walked
around with a pin that said cancer socks. And I just thought it was amazing that this young kid could speak
so loudly to what was going on in her life and just be so clear about it.
Dr. Michelle Neier (6m 50s):
But yet at the same time, be so positive and so motivated. She started a jewelry shop, I guess you could call
it. And she was selling jewelry to raise money, to support cancer research. And I still have the necklace. She
sold me. She was just always happy and inspiring and amazing. Despite walking around with like pain that
clearly said cancer sucks. She wanted to change things. She wanted to make it better. And I think that
changed things for me a bit. It just moved me in a way that general pediatrics didn’t, it felt a little bit more like
a calling, something like I needed to do.
Dr. Michelle Neier (7m 30s):
And I think it just rolled from there quite quickly, actually.
Dr. Anthony Orsini (7m 35s):
Yeah, that’s a, that’s a really interesting hematology. Oncology always move me. It’s different, but it’s a lot
like neonatology and that there’s emotional highs and emotional lows. You’ve been given so many accolades
on how you communicate and how you speak to your patients. And it really shows when you give your
valuable lessons to these young residents, but there’s someone in during your training, either as a resident
or a fellow, or maybe earlier on that you looked at because there were people in my past, I told you about
the horrible story when the doctor did it.
Dr. Anthony Orsini (8m 10s):
So coldly, but you know, that doctor was extremely compassionate. That doctor he’s the opening story in my
book, he was one of the most compassionate people that I’ve ever known. And yet when he delivered the
news, he did it so quickly, I think because he was so uncomfortable to do it, but I’ve also had some really
good role models. Some of them in neonatology, some of them in palliative care, and I watched him speak
and give bad news or have those difficult conversations. And in the back of my mind, I’m thinking, wow,
that’s a golden tongue.
Dr. Michelle Neier (8m 42s):
Like I love that phrase. I’m going to steal that. And most of the stuff that I use today, I’ll be honest, has it
been stolen? So is there someone that you remember that you said, wow, I want to, I want to speak like that.
Without doubt, I Had two amazing mentors when I was a fellow Julia Glade bender and Linda Granovetter,
and I really credit the way I deal with patients and communicate with patients to them.
Dr. Michelle Neier (9m 14s):
They are two of the smartest, most incredible physicians, women I have ever met. And I, I look back and I
don’t, while there were so many things in so many words and so many phrases that they used with patients,
I don’t think it was about the words so much as about their presence. And, you know, I used to teach Julia
when we’d be in the work room, she was all over the place and doing a million things and distracted.
Dr. Michelle Neier (9m 46s):
But when she got in that room with the patient, she was there, nothing else mattered. She wasn’t in a rush to
leave. She was truly in that moment with them. And I remember she had a young patient who was critically
ill, was dying. And Julia just sat by the bedside without mother and talk to her and held her hand and listened
to her and really absorbed what that mother’s fears were and got her to a different place, a different place of
never acceptance, but of understanding and the same thing with Linda.
Dr. Michelle Neier (10m 30s):
I have clear memories of sitting in Linda’s office with a patient that I know Linda and I think of often and will
never, ever, ever forget. And I just remember Linda looking at those parents, not as a physician, but as a
human and really feeling their pain and absorbing their pain. And I think that alone changes the conversation
because I think, well, so many people remember the words and they remember little things that we say.
Dr. Michelle Neier (11m 9s):
They also just remember us being together. And I think that goes a long way. You know, I don’t think most of
us are in medicine. Yes. We enjoy the science and we enjoy, you know, learning about biology and all of the
other things, but we’re really in medicine because we want to help people. It’s not about being a doctor. It’s
about taking care of each other. And so when I saw LinkedIn and Julia work, that’s what they were about.
Dr. Michelle Neier (11m 40s):
That’s what they are about. And that always stuck with me. And it changed me.
Dr. Anthony Orsini (11m 46s):
That’s an excellent point. The word presence is a word that keeps coming up during this podcast. And I don’t
know if you’re familiar with a book called I’m here, but we had a few weeks ago, a guest, his name is Marcus
angle. And Mark his angle has an incredible story. If you haven’t heard the podcast, please go back and
listen to it. But Marcus was in a car accident when he was 17 years old, he was hit by a drunk driver, went
blind instantly. I had a facial fractures and ended up being in the hospital for almost two years.
Dr. Anthony Orsini (12m 21s):
And Marcus has the story that when he was in the trauma Bay, they’re putting in chest tubes or trying to
intubate someone who literally barely has a face. They had to do a cricoid split. And Marcus only remembers
that he was blind. He couldn’t see there’s all this stuff going on. And one woman grabbed his hand and said,
Marcus I’m here. And he didn’t find out who that woman was for another 20 years, but it changed his life
forever.
Dr. Anthony Orsini (12m 50s):
And that’s the exact word that he uses presence. And I agree with that. Totally. But it’s about being there.
And I think that if we can learn one thing from this episode of podcast, it is that is that physicians are all
compassionate people. I truly believe that that’s why we went into medicine, but no one wants to be the
bearer of bad news. And we’re all uncomfortable doing it to a certain extent. And I think when we’re
uncomfortable doing that, we tend to rush through it and want to get in and get out.
Dr. Anthony Orsini (13m 23s):
Now, Michelle, I’ve done a lot of breaking bad news programs. And sometimes when we do the videotape
filming with professional actors, the young doctor, and we’ve even done, senior doctors will just come out
and say, my name is dr. Orsini, you have cancer. And I’ll say, when we do the video review, I’ll say to the
doctor, why were you so abrupt? And he, or she will say, well, that’s what I was taught. I was told, get it over
with and get out of there.
Dr. Anthony Orsini (13m 54s):
And so we’re fighting decades of bad teaching. And I’m so glad that you had mentors that made you who
you are today. And I think together, along with other people, hopefully we can change that, but the word
presence, what a great word. And I think that’s probably going to be number one on the top of things that you
need to do when you’re having difficult conversations, just be present. It doesn’t have to be a medicine,
right? Someone could be a friend who lost a loved one. Someone had just got a divorce, other things, other
difficult conversations in our lives.
Dr. Anthony Orsini (14m 28s):
We have some guests that are going to speak about getting fired from their workplace. You know, there’s a
lot of bad things that happened to people. It doesn’t have to be health-related, but as a friend, people say,
what should I say? Well, maybe all you should do is just say, you’re sorry. And sit there. And that’s probably
the best advice. So thank you for that. That’s great. I want to ask you about the particular challenges of the,
as they say, tweener or a teenager, they tend to handle things differently, right? So teenagers, although they
might understand cancer, maybe they’re in denial or maybe they’re a little on the young side to understand
that.
Dr. Anthony Orsini (15m 7s):
I mean, that’s telling a five year old is a whole different skillset. What about that? 12 year old, 13 year old?
Are there any special advice that you can give to someone who has to speak to a 12 year old about cancer?
Dr. Michelle Neier (15m 18s):
So I think one of the biggest mistakes that we make in medicine, whether it’s an oncology or any other fields,
or even frankly in parenting, is that we underestimate our children. I think we underestimate our children,
whether they’re five years old or 25 years old. And we tend to think that they can’t understand or handle the
information we’re afraid of telling them things.
Dr. Michelle Neier (15m 53s):
You know, I’ve had friends say, well, I don’t want to tell my 12 year old daughter they ask because she’ll be
afraid because she won’t be able to handle it because she’ll freak out to a certain extent. They’re right. The
kids might freak out. You know, they might get hysterical, they might cry, but that’s normal and that’s
appropriate. And that’s okay, that’s a human emotion. But the point is that kids can also heal. And part of the
process of getting them to the other side is allowing them to have those emotions, allowing them to be
scared, to be angry sometimes to be in denial.
Dr. Michelle Neier (16m 35s):
I think it just depends on the kid. I’ve seen 12 year old kids who say, okay, I have leukemia. Let me get back
to my video games now. And I’ve seen other 12 year old kids who say, Oh, I have leukemia. Well, what type
and what type of chemotherapy are you giving me? And how long will I be in the hospital? And what are the
names of all my organizations? It’s so variable. I, I think more than the tweens, the younger adults are the
ones that I’ve really struggled with.
Dr. Michelle Neier (17m 12s):
I think tweens are still used to being taken care of. They’re used to being with their parents. They’re used to
being fed information. I think the young adults, the 19, 20, 23 year olds are the ones that for me have been
the most challenging, but also the most rewarding population. You know, their lives are interrupted at such a
crucial stage when they’re leaving the nest, when they’re becoming independent.
Dr. Michelle Neier (17m 49s):
And then in many ways, least in oncology or when someone’s diagnosed with a chronic illness, we take
away that independence. We completely interrupt and arrest their development at a certain stage. So I think
that’s the population probably more than the tweens that I’ve struggled with. I think the tweens these days
are so knowledgeable. They’re so connected. We very quickly develop amazing support systems.
Dr. Michelle Neier (18m 19s):
We have a young girl in our community who was recently diagnosed with leukemia and she very quickly
came out on social media and announced our friends. This is what’s going on. I’m going to lose my hair, but
it’s going to be okay. And so I think the way they communicate has changed, but I think maybe that helps
them. I think they’re able to find resources that even 10 years ago, weren’t available to them.
Dr. Anthony Orsini (18m 45s):
My niece, who was an ex premature baby. And then she got through that and then 17 years later finds out
she has lymphoma and they had to do reconstruction on her neck. And she went through chemotherapy and
I interviewed her. She became a instructor for breaking bad news. I got her because she was in nursing
school. And now I’m so proud. She’s an oncology nurse and Cincinnati, but she came to a breaking bad
news program as a student instructor.
Dr. Anthony Orsini (19m 19s):
And I said, you have such a wealth of knowledge because you speak from a personal point of view. And I
asked her during a impromptu interview, I’m trying to get her on this podcast because I’m telling you you’d be
blown away. And I’m so proud of her. I still cry when I, when I think of her. But I asked her about her
hematologist oncologist who took care of her at chop. And I said, what do you remember about her?
Because she was 17. And she said, what I remember most about my oncologist is that she said, I am not
going to forget that you’re 17 and that you have things to do.
Dr. Anthony Orsini (19m 54s):
And so we’re going to make sure you go to your prom. And if you need to skip a session or skip a
chemotherapy, we’re going to do that. And you’re going to live your life. And you’re going to get through this.
And you could hear my voice cracking because I’m so proud of her. She got through it. She went to her prom
with no hair. Her boyfriend also shaved his head and she had an great outlook on life. And now she moved
to Cincinnati because believe it or not, where she went to nursing school, she tried to get several jobs as an
oncology nurse.
Dr. Anthony Orsini (20m 27s):
But you know, there’s a long waiting list for that. I said to her, I said, Lauren, tell them that you you’ve been
through this. And so she is a pediatric oncology nurse in Cincinnati right now. I’m so proud of her, but that’s
what she remembers the most about her oncologist saying, I’m going to let you be a teenager. And I’m sure
if you,
Dr. Michelle Neier (20m 50s):
Yeah. So it sounds like you have a lot to be proud of about Lauren. She’s been through a lot. It’s pretty
amazing that again, a young person can recover the way they do and go on to do really tremendous things
with their lives. One of the things I always tell parents when I need them, whether it’s a parent of a kid with
cancer or a parent of a kid with sickle cell disease, which I saw plenty of and I think has its own challenges.
Dr. Michelle Neier (21m 26s):
But one of the things I always try to stress to parents is that being a kid comes first. That’s their job. Their job
is to have fun. Their job is to go to school. Their job is to see their friends. Having cancer is a side gig. If you
will. You know, that comes second. And I think we always have to remember that, that without the beauty
and the happiness in life and without those wonderful moments, the rest of it doesn’t matter.
Dr. Michelle Neier (22m 5s):
You know, we have to keep in mind, what are we doing this for? We’re doing this so that like you say, they
can go to their problem so that they can see their friends so that they can go to a barbecue. And I fully agree
with those people down at chop, those docs down there, do a great job. They’ve got it right. We have to
prioritize normalizing life for these kids.
Dr. Michelle Neier (22m 35s):
As much as possible life will be the same, but it will be someone always said it, Maurice town, it will be a
new normal, there’ll be a different kind of normal, but that involves all of the milestones. Whether they’re
graduations or communions or bat mitzvahs, they may not happen in the same way, but we have to find a
way to make them happen. And when they can’t happen, where they don’t happen on time, we have to really
acknowledge the sadness in that we have to, we have to again, feel their pain and relate to their pain, not
blow it off.
Dr. Michelle Neier (23m 24s):
I think that’s one of the things that we’re seeing in Corona right now. You know, they, kids are so sad about
missing things and it’s very easy to say, okay, it’s not a big deal. You’re missing something. But there is
sadness in that because for a child missing an event, missing a milestone is a big deal and it is a big
disappointment. So it’s okay to be sad for a moment. They, the work isn’t in not being sad, the work is in
healing from being sad and in getting over, being sad and recovering from that.
Dr. Michelle Neier (24m 4s):
And so when you think, whether you’re a pediatric oncologist or you’re a parent or a friend, the goal is the
same. It’s to be with somebody in their emotion and to help them process it so they can recover and get to
the other side
Dr. Anthony Orsini (24m 22s):
And not let it define you who you are. We talked about communication and in my line, there’s a lot of
emotions. There’s a lot of babies who are dying, who are very sick and they stay in my hospital. You know,
sometimes 30, 60, 90, a hundred days. These premature babies are with us. And I have a lot of emotional
times with the parents, but in between that, it’s very important for me to come up as a genuine person. When
I teach about patient experience and how to use communication, the patients and the patient’s families need
to know you as dr.
Dr. Anthony Orsini (24m 59s):
Neier who’s from New Jersey, who, you know, is a person, not just their doctor and doctors need to
remember that. That’s the person on the other side of this is going to lead me to the integrative medicine part
of what you do, but it’s important, correct? To start off the conversation by asking them how’s school what’s
going on instead of all business. And one of the problems that medicine has right now in my belief is that we
are pushed so much that we become very task oriented as physicians and nurses.
Dr. Anthony Orsini (25m 34s):
And that’s really affected the patient experience. We have 25 patients to see, we have to write notes. We
have to move on. And I discuss in my book how you can sit down, find something that’s common in
someone. Maybe you love reading. So if you find someone whose parents reading a book, when you walk in
to comment on that book and tell them about the last book that you read, especially if they’re a teenager, it
takes their mind off of it. You know, we don’t want it to be all business. It’s important, but you’re a person too
correct.
Dr. Michelle Neier (26m 4s):
I try to be a person. My kids might not always agree.
Dr. Anthony Orsini (26m 11s):
We see in my field, we see people that we feel that that’s just the parent of the baby. Who’s the 29 weeker.
And I discussed the importance of finding commonality with people in every day and with every single
patient, for instance, I’m down in Orlando now, but every now and then I will see a patient. And when I go to
call the mother cell phone number, it’s nine, seven, three. And that is an instant bond with that family,
because I can meet that family and say, nine 73 area code that’s where I’m and the patient’s family lights up.
Dr. Anthony Orsini (26m 48s):
He’s one of us with nothing to do with race or background or whatever. Just the fact that we both lived in
New Jersey, or I’m lucky enough to see a parrot. And during a very difficult time, over the course of 30, 60
days, maybe they might be wearing a Yankee hat, or there’s a book that I used to read and finding that bond.
And if you go back to the story of my niece, Lauren, she bonded with that doctor because her doctor came
up as a friend and a teammate we’re in this together.
Dr. Anthony Orsini (27m 22s):
And I think that’s what medicine is all about. Right?
Dr. Michelle Neier (27m 25s):
Yeah. I completely agree on so many levels. You know, I’ll tell you a brief story. When I was a fellow, one of
my very first patients at Columbia was a little girl. She was very, very, very religious Jew from upstate New
York. And I will never forget. I went down to see her in the ER. And I said to the family, Hanukkah was
coming up and I said to them, Oh, you must be so excited.
Dr. Michelle Neier (27m 58s):
How did I know it was coming up? And the mother looked at me and she said, Oh, you’re Jewish. I said, Oh
yes. And we started a whole conversation. And I told her where I lived and they lived in a very isolated
community of very religious Jews. We really, in many ways had nothing in common, but that was my way of
crossing a barrier.
Dr. Michelle Neier (28m 29s):
And it started a relationship that lasted for years long after I left Columbia, they taught me about their
community. I taught them about my community. Yes, I treated her leukemia, but it was so much more than
that. We developed a relationship. And you know, when I was a fellow and a resident, one of the messages
usually unspoken, but sometimes spoken also was that you have to maintain a professional barrier and that
you shouldn’t cross those boundaries.
Dr. Michelle Neier (29m 7s):
And I was always so afraid of crossing those boundaries. Did I cross the boundary? Did I cross the
boundary? I wasn’t sure as a young physician where that line was, but I was so fearful that if I crossed it, that
if I became too personal with families, I was risking something. And as I moved on in my career, I found the
opposite was true. That the more I gave of myself personally, and the more I crossed boundaries, and that’s
not to say, don’t be professional.
Dr. Michelle Neier (29m 42s):
I think that’s a different thing. You always have to be professional. You are a physician. You need to be a
leader, but when you let people into your lives, they let you into their hours. And I think that was what
sustained me as a physician. That was the beauty of my job. That was the heart and soul of the work.
Dr. Michelle Neier (30m 14s):
Especially with the young people, you know, the young adults. You talk about walking into the room and
asking about what’s going on. I never, I shouldn’t say never because I’m sure I did, but I’ve tried not to walk
in the room and say, are you taking your medicines? You’re getting this too much today. You’re getting that
today. I tried to walk in the room and ask an open ended question. How are you doing? What’s going on in
your life? Tell me about school.
Dr. Michelle Neier (30m 46s):
And I found that it changed our relationships. I am so blessed that I have a number of young adults in my job
who stayed in touch with me. And you were talking about your niece. It makes you cry. It makes me a little
verklempt, a little emotional to think about how those patients have really become friends. And I think by
crossing those boundaries, it allowed me to be a better physician.
Dr. Michelle Neier (31m 17s):
I’ll give you one more example. I took care of a young adult. He had leukemia and we became very close.
And when he relapsed, he didn’t want to get therapy he was so angry. And I understood that he had a hard
time. We had interrupted his life. It’s so much going on, but because I had taken the opportunity to get to
know him and his mom and his girlfriend, we were able to sit down and have one of the most emotional
conversations I’ve ever had in my career.
Dr. Michelle Neier (31m 59s):
But we listened to him. We just sat with him and he cried and he was angry and he yelled, and thank God.
He decided to go ahead. And he decided to continue with his, his therapy. And he’s doing great. Now he’s
back in school. He’s living on his own. He’s amazing. I speak to him all the time, but I do wonder if I hadn’t
crossed those boundaries.
Dr. Michelle Neier (32m 29s):
Would we have been able to have that conversation? Would we have been able to be that open with each
other? And I don’t know, I just don’t know the answer to that, but I’m grateful that we were, and I think that’s
the benefit of opening yourself up to people and to learn about who they are, not as a patient, but as a
person,
Dr. Anthony Orsini (32m 56s):
I would make two comments on that. First of all, you’re exactly right. The patient and the patient’s family. And
right now doctor is crying. So I just want everyone to know that. And the reason I want them to know that is
that that’s what medicine’s all about, right? Those bonds that we made through the years, and, and I got
emotional about my niece and you get emotional about your patients. I still receive Christmas cards. I think
we’re going on now. There’s one family, 14 years that I receive a Christmas card from a premature baby who
died.
Dr. Anthony Orsini (33m 31s):
And to me, that is one of the things I’m most proud of. Not that she died, but that, that family holds me in
their heart. Even in the tragedy, they could have been very angry. You didn’t see my baby, but we really
bonded. And to get a Christmas card from her 14 years later, it’s just one of the things I’m most proud of. So
another great teaching point here is that it’s okay to cross those boundaries. In fact, I think it’s preferable the
patients and the families will always know that you’re the doctor.
Dr. Anthony Orsini (34m 6s):
And I think that some of us make mistakes into thinking that if I crossed the boundaries, don’t forget that I’m
the doctor and that’s not true. They’ll respect you even more in my book, it’s all in the delivery. I go over the
five principles of patient experience. And number one is called, it’s hard to fire your best friend. And the point
of that whole section is find the commonality, build the rapport, cross the lines a little bit, and you will be their
best friend and who doesn’t need a best friend, especially during these critical conversations, right?
Dr. Anthony Orsini (34m 40s):
I mean, that’s, that’s what they need. They need a friend. They need, they know you’re the expert in the
room. They respect you. And they’ll respect you more when they realize that you are a real person.
Sometimes just going into a room and saying, my five-year-old just wouldn’t go to school today makes you a
real person, you know, you bond because they say, well, this is a real person. This is not just a doctor who
thinks that I’m leukemia or just calling me by my disease. So another great teaching point for the audience
before we go, Michelle, I want to talk about your integrative medicine.
Dr. Anthony Orsini (35m 12s):
So you made that change. And I, I kind of know, just from speaking to you, why you did that, but I want you
to talk about why you decided to, you had a very successful practice treating hematology, oncology patients,
but decided that I want to be even better and go back to school for integrative medicine. So tell me about
that transition and how that happened.
Dr. Michelle Neier (35m 33s):
Sure. So it was a slow journey in my personal life. I had struggled with some chronic pain issues, some GI
issues. And to be honest, wasn’t quite finding the answers that I was looking for in traditional medicine. And
so I started asking questions on a personal level. I am very blessed. I found some amazing practitioners.
Dr. Michelle Neier (36m 6s):
I really think of them as healers in my life. Physical therapists, massage therapists, acupuncture is yoga
instructors, amazing people with a whole different skillset than I had learned about in medical school and in
my training. And at the same time that I was on that personal journey professionally, I found that I was
opening myself up a little more.
Dr. Michelle Neier (36m 37s):
And as I did that, I was being confronted with different questions, questions. I didn’t know the answers to
questions like my kid is getting chemotherapy and I don’t think I should give them sugar anymore. What’s the
right thing to do, or my kid has nausea, but I don’t want to medicate them all the time. What else can I do
questions that I didn’t know how to answer? And so I started looking for the answers and my personal and
professional paths, I think really came together in that way.
Dr. Michelle Neier (37m 17s):
And as I started looking, I found that integrative medicine is the framework to answer those questions. So I
think people think of integrative medicine as being kind of hokey witchcrafty, weirdness. That’s not at all what
it is. And that’s what I love about it. It is really a framework for in fact, many of the things we’ve talked about
in my training, one of the things we’ve talked the most about is forming relationships, how to communicate
with people.
Dr. Michelle Neier (37m 54s):
That’s really the basis and the foundation of integrative medicine. The idea is to harness the body’s ability to
heal. So it’s not a replacement for traditional medicine. It’s a way to enhance traditional medicine the way to
enhance ourselves, to focus on the mind body and the spirit. And so for me, I think it was a very natural
progression into this type of medicine and for a number of reasons, it was the time it was the time to leave
my job.
Dr. Michelle Neier (38m 37s):
It was the time to take on new challenges, different challenges to learn different skills. And so everything just
kind of collided and came together at the right time. So here I am, it was without a doubt, the most difficult
decision I’ve ever made in my life. I love pediatric hematology, oncology more than anything.
Dr. Michelle Neier (39m 7s):
I am so grateful to all of the patients and their families that I’ve met, but it was time personally for a change.
And this felt like the right one,
Dr. Anthony Orsini (39m 19s):
One of our previous guests, Kathy Caprino who had a life changing moment when she changed from being a
big financial person to coach for women. I think her quote was, you know, when you’re not sure what to do
the universe steps in, and it sounds like that’s what happened to you, that everything came together and I
can see in your face, this is audio only, but for the audience I could see in your face, how you laid up when
you speak about integrative medicine. So it sounds like you’ve found your calling and you’re happy with it.
Dr. Michelle Neier (39m 51s):
Yeah. My second calling.
Dr. Anthony Orsini (39m 55s):
So you open the olive tree and that just opened up in April.
Dr. Michelle Neier (39m 59s):
Yeah. So a couple of months ago, I decided why not in the middle of a pandemic, I’ll start in your business.
So I opened that. I opened up olive tree to telehealth patients only, and my, now that things have calmed
down my physical office space in Springfield, New Jersey should be ready in about a month is a really, really
excited. It’s a beautiful, quiet, sunny space.
Dr. Michelle Neier (40m 30s):
And I really want it to be a place where people feel safe, where they feel safe to express themselves, to ask
questions, to talk about what they need so often and, you know, by necessity. So often many medical offices
are crowded. They’re busy, they’re sterile.
Dr. Michelle Neier (41m 1s):
We walk in, we have, you know, two minutes with the physician to ask all of our questions. I really want this
to be a different kind of experience. I want people to be able to sit in a comfortable chair, have a cup of tea
and to take a breath. You know, I always joked one of our amazing massage therapist at Mars town used to
say to me, Michelle, breathe, just breathe, just breathe. And I would joke around with her and say, Oh God,
leave me alone with the breath already. But she’s right. You know, I want people to just take a minute for
themselves so that we can really have a meaningful and productive conversation about how to improve their
lives, how to make things better, how to get to a better place.
Dr. Michelle Neier (41m 45s):
So I’m very excited. I’m very hopeful. I am looking forward to this next stage, this next journey.
Dr. Anthony Orsini (41m 54s):
That’s fantastic. As a osteopathic physician, that integrative medicine component has been kind of pushed
into me since I was, you know, first entered medical school. And so I think it’s so important. It’s something
that’s up and coming. I think more and more people are realizing that medicine is not about just giving
medicine, that there’s a whole body approach and you have to treat the mind, the body and the spirit. And so
I love the way you smile when you talk about that. And I’m so blessed that you agreed to come on this
podcast, we accomplished our goal of inspiring and teaching, and I knew we would.
Dr. Anthony Orsini (42m 33s):
So I want to thank you so much for coming on. It’s been really great. Thank you, Tony. And it’s just really an
honor. If you want to find out more information, you can contact me at <inaudible> dot com. If you enjoyed
this episode or any of the other episodes, please go ahead and hit subscribe, leave a review. It’s very, very
important. And anytime you want to refer someone to the podcast as a guest, please let me know again,
thank you to the audience and I will see you again next Tuesday, Michelle.
Dr. Anthony Orsini (43m 3s):
Thanks again. I really appreciate it. Take care Michelle.
Narrator (43m 7s):
If you enjoyed this podcast, please hit the subscribe button and leave a comment and review. If you would
like to contact Dr. Orsini and his team, or to suggest guests for future podcast, visit us at The OrsiniWay.Com