St. Jude Children's Research Hospital w/ Dr. Justin Baker

June 6th is National Cancer Survivors Day, and there is no better way to celebrate than to feature St. Jude Hospital, which leads the world in improving the survival rate from childhood cancer. This episode dives into the rich history of St. Jude, their mission and some keys to their success. Like any organization, it is the people that make it go; that carry out the mission and goals. Justin Baker, MD gives an interview that shows you the passion and dedication of the staff, and you will finish listening and want to support this great hospital in any way possible! It was an interview full of hope, compassion, purpose and inspiration.

Guest:
Justin N. Baker, MD

• Member, St. Jude Faculty
• Chief, Division of Quality of Life and Palliative Care
• Attending Physician, Quality of Life Service
• Director, Hematology/Oncology Fellowship Program

Links for St. Jude:
St. Jude Children's Research Hospital homepage: Here
St. Jude - Ways to Get Involved: Here
St. Jude Instagram Page: Here
St. Jude LinkedIn Page: Here

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Transcript

Naveh Eldar  0:17  
Welcome to the landscape, a podcast to shed light on the people programs and businesses that are changing the landscape for individuals with any type of disability. I'm your host Naveh Eldar. national cancer survivors day in the United States is June sixth in celebration of that day. Today's guest is Dr. Justin Baker, the director of pediatric hematology oncology Fellowship Program at St. Jude Children's Research Hospital. No Research Hospital in the world has done more to improve the survival rate from childhood cancer than St. Jude's. You will learn about their amazing history, mission and practices during this episode, as well as get a glimpse at the passion and dedication of the hospital staff. If you are new to the landscape, make sure to subscribe and share with friends. Before we get started, I'd like to thank Michael from St. Jude's Media Relations team for helping make this episode possible. Now, today's conversation starts with our guest introducing himself and explaining his role as chief of the Division of quality of life in palliative care, a field that was personally very new to me.

Justin Baker, MD  1:37  
Well, first, thank you so much for having me. My name is Justin Baker. I'm the director of our quality of life and Palliative Care Initiative here at St. Jude Children's Research Hospital in Memphis, Tennessee. And I'm often asked what Palliative care is. And the reality is, Palliative care is all about quality of life. In fact, so much so that instead of saying we have a palliative care team, we say our team is called the quality of life for all team. And I'm sitting here right now surrounded by koala bears because it's que o l a quality of life for all like a koala. And so our koala team, as we introduce ourselves to families, we talk about us as being a group of people who can help them accomplish whatever it is they want to accomplish for that particular day. How can we help you have the best day possible? And how can we support you in a whole variety of issues. And so we have training and communication, symptom management, certainly an end of life care. But really we're, we target suffering as our main main disease process. Sometimes it's easiest to think about me as an oncologist where the enemy is cancer. As a palliative care, Doctor, the enemy is suffering. And so that I think is helpful to kind of think about palliative care as the experts in treating the disease of suffering.

Naveh Eldar  3:04  
It's such a unique area of study, what what drew you to it? When did you decide to even go into it?

Justin Baker, MD  3:11  
Yeah, it's really fascinating. I think that it's quite common that people ask me, how do you do what you do. And I really think that I've been placed on this earth just to do this. I can't imagine myself doing anything different. I have always wanted to do pediatrics since literally the time I can remember as a young child crawling up into my pediatricians lap, maybe when I was five, or six. And I didn't have anyone in medicine in my family. But even when I was 12, I wrote a term paper on the topic of holistic medicine, which is really fascinating. Because again, without any background in medicine, or anyone in medicine, that's quite surprising to me to look back on that. And so as I became more and more aware of the different areas of medicine, I was drawn, drawn to all of them because I was really drawn to suffering and how, as just a human connection as human human, I could provide care in a compassionate way. And that's really one of my favorite word's compassion. And it means actually literally to suffer with poverty to suffer and come together with. So as I walked through all these different trainings, and through medical school and residency, I came to realize that it was that aspect of medicine was most interesting to me, which is suffering and, and being with families in times of suffering so that I could hopefully make that day just a little bit brighter. And that's where I really found my calling is what I really found that I was supposed to be doing. It's where I find my, my true north.

Naveh Eldar  4:41  
And so and I have to say I'm gonna throw it out there is you know, I work with one of your media relations team, Michael, and he said that you were like one of the nicest guys he's ever met like anywhere, all right. And so it really fits into like what you're saying right now. I've just, you know, being drawn to this even from when you were younger. So what drew you to St. Jude? What brought you there?

Justin Baker, MD  5:04  
So St. Jude is really known as this beacon of hope, a place where we try to help those that are in most desperate need. And at the time that I was looking at training programs, there was no specific training in hospice and palliative medicine, not only at St. Jude, but really in the whole field. And so the closest thing is hematology oncology. And the best place to be trained in hematology oncology was St. Jude Children's Research Hospital. And when I came here, I quickly found out the people were studying this field of palliative medicine, even though there wasn't clinical training, there were research opportunities. And so I quickly dove into those research opportunities as kind of opening my mind to new ways of thinking about suffering, addressing suffering, learning about suffering, and kind of brought that on as additional training. And then once you come to St. Jude, it's such a special place. I mean, the mission is so amazing. And it really is working with those in the most difficult of situations, and helping them walk through these really difficult times. And every single person on this campus is here for for the kids, for their families. And it's it's now been almost 20 years, and it's really difficult to ever think about leaving.

Naveh Eldar  6:22  
And so that's a perfect segue to my next question, which is, Can you can you give us a little history, everybody knows the name, St. Jude, it's, it's probably the most recognized name for a hospital in the country, if not the world, but give us a little history of the hospital itself.

Justin Baker, MD  6:35  
Yeah, so it's such an amazing place. I think that there are many places in the world that would say they really have a mission of advancing cures. And that is absolutely what St. Jude is about. But the beauty of what Danny Thomas did when he established his hospital, as he said, it's going to be the best place to receive patient care, we're going to do the very best research possible. And we're going to do that all for people for free, regardless of their background, regardless of their ability to pay, regardless of their race, their creed, their ethnicity, anything, we're going to pay for it. And we're going to give all the knowledge that we generate out to the rest of the world for free as well. And so it is just such a beautiful kind of mission that he established back there in the late 50s. The hospital opened in 1962. And in 1962, if you can imagine, almost every child with cancer died, there was a stated 4% cure rate. But you know, you wonder how it was even 4% because there were really no modalities to treat kids with cancer. And it took a really brave pioneer people are very early clinical researchers and heads of the hospital that helped advance those cure rates. And slowly across time, we reached 50% for the most common type of cancer acute lymphoblastic leukemia. And now today, we're well above 90%, almost 95% cure rates for that particular type of cancer. So it's it's just been an incredible story. And St. Jude itself was really built here in Memphis, because of the disparities that existed here. And it is specifically in Memphis. And in the kind of middle part of the country, there really were no pioneering hospitals being built. And so when when Danny Thomas was speaking with the board of directors and trying to figure out where should we build this thing, they said, Boy in Memphis is the exact right spot. And it's worked out so beautifully, you know, met the St. Jude has been on the cutting edge of so many issues related to medicine, but also related to desegregation of the hospital. It's never been it's been a fully integrated hospital from day one, which being here in the Mid South is just an incredible statement. And it's been a place that has been a beacon of hope for for employees for a very long time. Now we have a entirely new millennial movement that has come in here and, and younger and younger people are wanting to work here because it's such a special mission in such a cutting edge place that is doing so much to advance such a critical cause. The survival rate of childhood cancer is at 80% at St. Jude, which is well above world averages, national averages. So

Naveh Eldar  9:24  
I don't know if you can put it in layman's terms, some of the things you've done to reach those numbers.

Justin Baker, MD  9:30  
Yeah, so right now one of the things that St. Jude does that is quite unique and allows for us to optimize patient care is we have a housing structure that really, I don't want to say it takes socioeconomic status out of the picture because that's still a major stressor. But we actually put people in our own housing and support them with meals with transportation, nobody pays any co pays even so it's it's a situation where we try to create the best place for medicine delivery possible. We certainly contemplate and Bill insurances, etc. But it doesn't matter if the insurance covers it or not, doesn't matter if a family has insurance or not, physicians and clinical teams are able to do what they think is the very best for the that patient. And that really helps. And so there are a variety of issues that I think help us provide truly cutting edge cancer directed delivery of care. And we also work with hematology patients, neurologic patients and patients with infectious diseases. And we can provide that care in this really optimized arena, where people are getting their medicines for free for housing, and food is for free. And they can really focus on the treatment of that disease. We also have a really well integrated psychosocial support system. And the psychosocial teams, including our team that are quality and the palliative care team are integrated right from the beginning of these really devastating diseases. And so those additional supports also helped tremendously for these patients and families.

Naveh Eldar  11:07  
You already mentioned it that you share a lot of your research and information and best practices with everybody who wants it, right? how receptive are other hospitals or other countries have taking this information and trying to duplicate? You know, the way that you support people? And I asked this because I had a previous guest who's in the health field, who specifically talked about the lack of mental health supports for people who are actively asking for them. And then here you are, you build it in from day one. So I was just curious to how receptive are other places to you?

Justin Baker, MD  11:42  
Yeah, one thing I'd encourage your listeners to look into is kind of the story of the history of pediatric oncology. Many areas of medicine are unfortunately competitive one with another institutions and, and trying to compete for dollars or compete for patients and families where pediatric oncology is a beautiful story of collaboration, where all of us are cheering for each other as there are new successes that come about where, you know, institutions that might in other areas be viewed as competition by pediatric oncology really unites people. And here we have this huge group across the United States called the Children's Oncology Group. And then across the world, you know, St. Jude is partnered with the World Health Organization to promote pediatric oncology recognition and how important it is in global health. The reality is, we really are all cheering for each other. And we want to see these cure rates advance. And we know the best way to advance them is by working together because, thankfully, pediatric oncology and pediatric cancer is a relatively rare diagnosis. And because of that relative rareness, you have to put a whole bunch of people and a whole bunch of institutions together to do some of these trials to see is the new proposed treatment regimen better than the historical one? Can we keep marching that forward. And it's an incredible story of success that really bears out in that acute lymphoblastic leukemia that I shared with you, it was 4% than 50%, then 60 and 70 8090. And now 95. And that came through iterative trials across the United States and across the world, and across now, the span of six decades. And so it's been an incredible story of success that only comes about because of the tremendous collaboration that everybody is a part of across the pediatric oncology landscape.

Naveh Eldar  13:38  
Now we talking about these trials. And I know because I was reading about you that you have personally looked into ethical considerations surrounding the enrollment of children into phase one clinical trials. So the first question is, can you explain what is a phase one clinical trial?

Justin Baker, MD  13:57  
That's a great question. So phase one clinical trials are really trials to see, okay, this is worked in a setting that is either a very controlled animal setting or potentially very beneficial in an adult similar cancer. And then we have to try to figure out what is the potential right dose to use in a pediatric larger trial. So it's where we take a small trial, and we continue to increase dosing or delivery change delivery mechanisms, to see how is it that we should deliver this medicine in a larger scale trial. And so interestingly, sometimes these trials have a little bit of benefit for the participants themselves. But that's not either one of the main outcome goals, the main outcome goal is to figure out what's the right dose to use moving forward. And so you're certainly hoping that there's some response, and that's really the ethical consideration is Do people really understand what the role of these trials are? Are these trials something that young children Yo should really even be put on, I'm of the strong belief that participation in these trials, advances the fields. And that that is a really important thing for us to consider. It is however, very difficult to contemplate as a parent, and certainly as a child, that perhaps this won't help you, but maybe it will help advance the field. And, you know, in studying this, the thing that I have really found is, families are going to enroll on these trials if they are available. And so what that means to me is, we have to be really dedicated to make sure that these trials are created in the most ethical way possible, because once they're offered to the family, the family is almost always going to say yes, and so we have a responsibility to make sure that we are optimizing the potential benefits and minimizing the potential risks, because there really is a chance that this particular child will not individually benefit from this trial. So we've really got to be thoughtful as we as we create these trials. And we work very closely with the ethics committees with research ethics committees, with something called IR B's, which are called institutional review boards, and also with ongoing scientific monitoring systems. And so there's a robust system in kind of all of the pediatric oncology centers that are really large and conducting research to make sure that is the safest possible.

Naveh Eldar  16:26  
Because even though you tell them, there's a chance, and maybe the point of the study isn't even to you know, advance your your disease or help you get better in their hair. That's exactly what it might do. It's like that hope that yeah, this is gonna cure me though. Maybe, right? Yeah. So

Justin Baker, MD  16:45  
yeah, it's very interesting. We've tried to put a new number to that. And, you know, a large study that we were a part of people, it's, it's actually even, it's a fascinating thing that happens. Because when you think of somebody else, you might be able to get closer to the actual reality. Like, let's say that a researcher has even explained to a family that maybe there's a 10%, or less chance that it will help your child. Well, it seems that the parents then if they talk about somebody else's child, they they get close, they might say 20% or less might benefit from this. But when they talk about the chance for their child, they talk about it being closer to 50% or higher. And so there's just a almost an, you know, cognitive inability to contemplate how horrific of a situation is happening with their child's progressive cancer. And I've seen it time and time again. And we've looked at this in the context of parents who know that their child has incurable disease, those parents still continue to hope for a miraculous cure. And that miraculous cure is not necessarily through God, it might be through medicine, it might be through something else. And they hold out the hope for this, this cure that is impossible, while all at the same time recognizing that it is very likely that their child will die. And we used to think of this as a pendulum as kind of going back and forth. But we actually now know that they hold both of these hopes at the same time. And we just published on this this year, looking at kind of these dual hopes of parents whose children have incurable cancer and how they continue to hope that their child will be cured while also recognizing that their child is very likely to die. Do you have

Naveh Eldar  18:29  
staff to help them try to process that?

Justin Baker, MD  18:32  
Yeah, it's a great question. So as parents try to work through these very difficult, almost cognitive gymnastics of grasping something that is so horrific, and the weight of it all, yes, each child and family here at St. Jude, and at most pediatric oncology institutions have psychology that works very closely with them. They work with a group called child life specialists, which are developmental specialists, age specific specialists who can help children kind of understand and grasp what's happening. They work with chaplains, they also work with our team who are really specialists and kind of providing anticipatory guidance of those next steps. They work with, obviously, nursing in their primary doctor, all of us have additional training and trying to walk with families through this. But interestingly, we here have added a layer that actually most institutions don't have, that is newly bereaved parents or parents whose children have incurable cancer will be paired with past bereaved parents of a similar diagnosis where their child died, let's say one parent is their child is dying of a brain tumor, we will pair them with a parent whose child already died of a brain tumor. And that seems to be really effective as we pair them together so that one parent can talk to them about the things that help them walk through this for even just the availability of somebody who actually understands like not just says they understand I've unfortunately walked through this with 1000 different parents or more, but I've never walked through it myself. And so to have another parent who has walked through this, it's just been invaluable for families.

Naveh Eldar  20:14  
And so, you know, this podcast is around disability issues, and I'm gonna be honest with you. I've been working in the disability field for decades, mostly in either severe and persistent mental illness or intellectual developmental disability. And so, you know, we kind of live in silos when we work, right? Like, I'm very, very, super familiar with what I do. I was not aware or never thought about the fact that cancer could be a disability. So I wanted to know if you could address you know, what are the short term and long term disabilities that can be caused by cancer.

Justin Baker, MD  20:49  
It's so interesting to think about cancer as causing disability or even being part of a disability situation and the patient and family. But you're exactly right. It is such a heavy burden to bear. When a child, your child has cancer, that child could go through any number of things that could cause long term disability, or certainly all of the patients go through situations that cause short term disabilities, what we find is these patients have to tolerate high dose chemotherapy or this chemotherapy causes really significant side effects, including nausea and vomiting, extreme fatigue, and can also cause long term side effects, things like putting you at risk for other cancers. And it certainly can also cause things like infertility, they also have to go through surgery. So some of the types of cancer that our children get, some of them might be a bone tumor of a leg. And so sometimes you have to amputate that leg to take the tumor fully out. Or if you can imagine children with brain tumors, you just can't take only the brain tumor out, you have either the brain tumors eked into other areas, or otherwise. And after the surgery, it's very common that these children will be left with some sort of long term disability, we also provide radiation and radiation is incredibly helpful to treat cancers. Unfortunately, the long term side effects are things like additional cancers, or stopping the growth of say, a bone that you treated with radiation, it will no longer grow appropriately after that, or there could be significant hormonal imbalances, because you're using radiation in the brain. And so you have to think about the long term consequences not only at the cancer, but also the treatment of that cancer, right. And what we now know is that five years and beyond after a child's cancer diagnosis after they basically are cured, the vast majority of them go on to some sort of chronic illness, some sort of chronic complication, most commonly are things like pain or chronic fatigue. But there's all sorts of other mental health related issues, things like stigma, anxiety, and depression, significant financial stressors, because of a little bit harder time getting jobs. So there's all sorts of disabilities that come in the long term and where these patients and families need tremendous support, not only through the acute treatment of this disease, but also in the long inlaid effects after the disease. Wow.

Naveh Eldar  23:23  
I was aware of some just by reading and because I was curious myself, but you you lay it out so much more than I even like thought about or realized. So I appreciate that. I want to jump back to something we were talking about earlier in the episode, which is the hospital itself. So I want people to really think about this. We are 1962, you said the doors open. This is the middle of the civil rights movement. And you're in Tennessee. And this hospital opens that is not a segregated hospital. So I want to I want you to touch on what was what was the philosophy of the founder in what he decided to set up?

Justin Baker, MD  24:04  
Yeah, it's I'm not probably the best person to speak to this, but I'm so happy to give you my perspective on it. When I think about Danny Thomas, his dream truly was that no child, absolutely no child should die in the dawn of life. And there was no stipulation of which child of what child of who and where and what, this is why I'm so proud of that 1960 to start, like you said, a fully integrated hospital. And I'm so excited now because of our global process, because if you think about it, only 20% of the children around the world live in a place where cure is a reasonable and realistic possibility. So 80% of the pediatric oncology diagnoses around the world, those kids are going to die. So even though here in the United States is 80%, or cured globally, it's 80% die of that cancer. And so this feels like that. Step where it is every child everywhere. And that's so exciting because that feels so in alignment with Danny Thomas's dream, that was that no child should die in the dawn of cancer, no child. And that is so beautiful. And I'm getting so inspired even talking about I get chill bumps just thinking about how countercultural that was to the day then. And how countercultural it now is to the day now, like, what why would St. Jude invest these hundreds of millions of dollars outside the walls of St. Jude, outside the walls of simply Memphis, Tennessee, to promote a cure of his children around the globe. It's because that started with Danny Thomas's dream. And Danny Thomas's dream never had a single stipulation on it, he wrote some things like I told you doesn't matter, race, it doesn't matter. Religion, it doesn't matter from where you come, no child should die in the dawn of life. And now we see this as every child everywhere should have an opportunity to be cured of their cancer.

Naveh Eldar  26:04  
That's beautiful. And you know, I follow you on social media, the hospital, and it's reflected in your social media posts, right? I mean, it is just like this, all you see is children in all these different races, all these different socio economic backgrounds, you know, you enter you have posts where the parents are talking, and it's just, it's just very encouraging to know, as you talk about it, it's, um, it goes against many things that we see today. So it's wonderful to see in the know that you exist in our, our impacting, hopefully, more than even medicine, right? Just

Justin Baker, MD  26:42  
philosophy. That's right. You know, one of the beautiful things about our hospital and just the clinical care that we provide, and I'm not sure if this is gonna sound very strange to other medical providers. But I literally don't know if a child has insurance or not, I have no idea when I go and meet with a family. And then I come out and put my orders in. I don't know if they have insurance or not. All I know is that the care that I think is best for that child that care is going to be provided whether they have it or not, whether they can pay a copay or not whether they have come from a rich background, or from a really difficult background. No, I mean, we, we're going to do it, we're going to do what is right, no matter what. And that is unbelievably liberating for me as a physician, not only just knowing that this is how this institution works, and it makes me very proud. From a a social justice standpoint, but really, it frees me up just as a doctor to be able to say, Oh, I get to make some of these decisions. And and we, as a team get to decide what is best for this patient and family, not so much what the insurance says is appropriate in the situation. But what what is it that we feel as a team is going to most benefit this patient and this family. And then we do it, just as Danny Thomas said that every child needs to be treated in the exact same way in the best way possible for that child and family.

Naveh Eldar  28:08  
And so I saw that if they have insurance, it is built you don't worry about that yourself. Right. But if there is no insurance, which is probably let's be honest, a lot of people are insurance doesn't cover it is covered 100%. Right, where does that funding stream come from?

Justin Baker, MD  28:22  
Yeah, so this is the really cool thing to think about. So again, when you look at the care that we're able to provide our patients and families, we have them stay on campus for housing, we provide transportation, we give them money for food, we give them money even to go to a grocery store and buy their foods, they can cook it in the kitchen that we have in the in the rooms that we provide for them. And so all of that money plus all of the money that is used for co pays is used for patients without insurance. It comes in the majority of it from small donors from people giving through the hospital and, and through really, you me, others who are donating to st Jude. And that's the beauty of this is that we all are in this together, right? We're all in this together. And there is no more pure cause than treating these precious little children with cancer and other catastrophic illnesses. These kids did absolutely nothing to bring this on themselves. And they did nothing to be coming from the background that they may be coming from. And so each of us being able to give to this particular organization, were able to support the way that we do our work here.

Naveh Eldar  29:34  
So I used to years ago, it feels like another life ago, I used to coach a running club of elementary school, elementary school kids, and we ran. We ran them to St. Jude 5k Oh, that's great. So I don't know where the money comes from there. Yes. Um, and then

Justin Baker, MD  29:51  
you know, you're you're you probably some of those kids that are running probably did like mapathon or things like this. Yes. Right.

Naveh Eldar  29:57  
And I just saw you had a campaign. Just like Last month in the month before, something to do with going to space, let me tell you this terrifies me. So I was like, I'm not gonna get involved with that. But I believe there was some kind of way you can win a seat to go to space. Yes. Yeah. So you're very inventive. Isn't that

Justin Baker, MD  30:15  
crazy? Yeah. Imagine, you know, the group, obviously, you know, fundraising is so different in the midst of COVID. I mean, we had had an entire mechanism that was mostly kind of grating and gripping and, you know, large events, like marathons or runs or this and so there's been a large adaptations had to happen. But we're so grateful, because, you know, people have continued to give, even in the midst of really desperate times during COVID, and in the hospital has not had to pull back in any way we've been able to really love on help these children in do an incredibly important way during an incredibly devastating time. And so even though, you know, many institutions have had to pull back because of the generosity of the general public St. Jude has not had to do that.

Naveh Eldar  31:00  
And so it's amazing. You've talked about how much you cover financially. You talked about travel, housing for the entire family. So that includes siblings, is that correct?

Justin Baker, MD  31:12  
Yes, it is. It's the housing, each of the housing structures is built for a different number of people. So there's obviously some regulations around that. But yeah, it's really to support the entire family.

Naveh Eldar  31:23  
And then some of these kids are there, obviously, their long term and maybe the families or their long term or their like, educational supports that you provide. Yeah, that's

Justin Baker, MD  31:31  
great. I'm glad because when we were talking about the multidisciplinary team earlier, I was remiss to forget that one of the things that kids want most is they want to be normal, you know, and one of the things that normal kids obviously do is go to school. And so we have one of the best school programs you'll find in any hospital anywhere. And so our school program, our teachers, both coordinate with teachers back in the home setting for our patients, but then also provide their own curriculum, to make sure that each child is able to continue with their schooling. And the teachers are some of the most beloved people of our patients and families, teams, they love, love love school, even though they sometimes don't love the homework. They certainly love the teachers. And these teachers, just like all the other amazing care providers are so dedicated. I mean, they're just so dedicated. We actually just had a graduation yesterday and our kindergarten graduates, we were celebrating them over the past couple of weeks. So it's, it's an exciting time here to see these patients who are going through cancer treatments, and then graduating from the school programs. I mean, you just can't imagine how special it is. In fact, one of my greatest honors, and I'm sorry to say it's not speaking on this podcast, it was speaking as one of the plenary speakers for the kindergarten graduation. That was one of my highlights that I've ever done. And it was a what a remarkably inspiring time for me to be able to be in front of these young people going through this tremendously difficult time and celebrating them as they were graduating from kindergarten.

Naveh Eldar  33:11  
Very nice. It was wonderful, all the different ways you get to be involved in in. So let me this is this is coming from left field a little bit. It's not in any of my notes or anything. How do you take care of your mental health? But does it ever get difficult for you?

Justin Baker, MD  33:28  
Yeah, thank you for that question. So being in palliative care is is heavy, and the patients that we take care of our the sickest of the sick, and the situations are the saddest of the sad. And one of the things that I have grown just to incorporate into my everyday care of myself, but also in my team and trying to help all of us is to see the little victories and to celebrate those to realize that even in the midst of a tremendously difficult situation, where a child may be dying very soon, perhaps that child was able to have a celebration with their friends that day, maybe we were able to help a child. We just had somebody that returned from Hawaii that we were able to help them with a trip that would have been very difficult without our team's involvement in. So we try to celebrate those little victories and really try to look on during those pieces, that section of that patient's care and say, Wow, thank goodness, we're able to help them accomplish that goal. For me personally, when when I find myself down or getting things getting heavy, I find great solace in my faith. For me. Prayer meditation are so tremendously important. My church community I'm actually a deacon in my church, and being involved in that faith community has been so tremendously important. The other piece that is incredibly grounded For me as my family, I have the most supportive wife in the entire world, we've been married 20, we're on our 24th year now, which is just incredible. So she's gone with me through thick and thin. And she's actually a teacher at my kids school, I have four children. And so these kids, my beautiful wife, my family, you know, when I leave St. Jude, I tried to transition into kind of a home setting mentality and try to set myself up and really envision myself being fully present there, just as I do when I leave the house in the morning and come to St. Jude envision myself being fully present here, and use those kind of mindfulness techniques to try to be to try to be where I am 100% with you right now. And in the midst of that, certainly things are trying, certainly things are difficult. But I found those strategies to kind of be my most helpful. The other thing that is critically important, and I think has been tremendously helpful for me, is to be able to reach out to my team members and tell them when I'm just not able to do what is being asked of me at that moment. And it takes really a transparency and introspection, you know, one of the nurse practitioners I work with, was having a really tough day yesterday. And she said, You know what, I'm going to make it into my day off on Friday, and then I'll get recharged. And we were able to say as a team, you know what, no, you just take the afternoon off today, because we need you fully present for tomorrow. And, and the rest of this time, please go take care of you. And sometimes I'll have to reach out to the team and say, guys, I'm not at my best today. And I'm going to need you to help pick me up. And please help me in this situation. So I have a very collaborative team that really helps support this very difficult work. And all of us know how difficult it is, we all realize that in the midst of the ups and downs here at work, there's also ups and downs at home. And we have to support each other as as a family through all of that.

Naveh Eldar  36:56  
So, I mean, I think this is another secret part of your secret sauce is whenever you're providing a service, no matter who you are, if you truly believe in it, you believe in it for everybody. So what do I mean by that, like you're taking care of these families and these kids, but then you also recognize like, we need to take care of each other as well. Right? Like every person needs to be taken care of at times. So I really hope that other businesses hear what you said and can bring that into their work culture as well.

Justin Baker, MD  37:26  
Yeah, well, I think the really interesting thing is I told you at the beginning that Palliative care is about addressing suffering, it when you think about suffering, certainly these kids with cancer are suffering at just extraordinarily high levels and their families as well. But all of us really go through difficult times. And what we have to realize is that, boy, if we would open our hearts, and really be compassionate to that human in front of us in all these circumstances, oh my goodness, this world would be such a better place, we would be such better people, we would feel so much better about ourselves if we reach out in that way. And that's really the inspiration that I see as Danny Thomas who started this hospital. And he he made it about other people. He certainly was about pediatric cancer at that point, but it was about other people throughout his life you read about him, he was that same way constantly giving to every person that he came into, to encounter. And so that's I think that's what I try to encourage people to do is to realize that maybe that person in front of you is that their kid doesn't have cancer, but that person is going through a difficult time and try to you know, really connect. It's this human connection. Yeah, it is this, this word that I told you at the beginning was my favorite word, this to suffer with comb potty compassion, being compassionate in a human way to the person right in front of you, that I think could solve so many other issues. And it really comes down, you know, to this, this love and I see it as opportunity to be compassionate to ourselves, which I think we are very rarely, I think we are so hard on ourselves. But if we could share a little compassion with ourselves, be compassionate with those in front of us and share love and grace with those all around us. Oh, my goodness, so many of these issues that that we all struggle with, that this world is struggling with, we could realize that it is not an individual struggle. It's a corporate struggle. It's a human condition. And you know, I'm very inspired by my patients and families because when I work with them, I see that there's hope for all of these other desperate situations.

Naveh Eldar  39:37  
One last question because we're running up against our at the end of our time, one and then I have some personal questions, which always end with but one last question about St. Jude. And that is your mission is diversity of patients was from day one. Like we said starting in the 60s. How does that bleed into the culture of the staff? Do you see a lot of diversity The of the staff at St. Jude is that emphasis that the hospital has?

Justin Baker, MD  40:04  
Yes, it absolutely is an emphasis of the hospital. At this point, we have actually an entire diversity and inclusion departments who are helping us not only with issues related to our patients and families and ever expanding cultural influence of, you know, opening the doors to the globe. I mean, that is complicated for all of us. And so this group is helping us with that with our patients and families, as well as with our staff. And we know that there's always opportunity to do better. And so we're looking for leadership opportunities, and through training, and through recruitment, and through retention, and looking at all these other ways that we can hopefully create an ever more diverse workforce, because we need that, because that diversity of viewpoints is what helps us take the best care of our patients and families possible, helps us be the most adept and nimble institution possible. Because we've got to be able to see the world from a whole variety of perspectives in order to be able to meet the incredible challenges that our patients and families and that this institution is meeting today. And so I'm incredibly proud of where we are today. And I'm so excited about where we're going because we still have much work to do.

Naveh Eldar  41:17  
Yeah, you know, and you talked about how there's a lot of young workers, millennials, and even now post Millennials are starting to enter the work workforce. I talked to a recruit of a major company who said, you know, they're looking for diversity, right? So if they come to your place of business, the best and the brightest, expect to see diversity in the workplace.

Justin Baker, MD  41:38  
And that's exactly it. They're, they're the two things I feel like we really have going for us. Well, the three things I really feel like we have going for us here at St. Jude. Number one is the mission, the mission, and it's what this young group of people coming in to the workforce that you know, they certainly care about money, but it is much more about mission, and much more about feeling like their job matters. And so that mission orientation of this institution, I mean, there's no better mission. The second thing is the diversity inclusion aspect of what we're doing, allows for incredible incorporation of a variety of thought processes, empowerment, great growth opportunities for people as they come here. And third, I think that Memphis, Tennessee, is a place that, my goodness, I mean, right up the street from us here, Martin Luther King, Jr. was assassinated, just right, right up the street. And so this is a place that if we can do this here in Memphis, Tennessee, it just feels like a beacon to the rest of the United States. We can pull this off here that yes, it is in Ireland. Yes, it is within our campus right now. But it is eking outside of these walls, and expanding. And that's what is so beautiful to me about about what we have here at St. Jude.

Naveh Eldar  42:54  
And so thank you for all of that. And now I just we're going to end with a few personal questions. The first one is, when you went to college, you're and my daughter is is a senior while she's graduated, she's graduating walking the stage tomorrow. And she's headed off to college to do her thing when you went to college. Is this where you thought you would be X amount of years later?

Justin Baker, MD  43:19  
Boy is a great question. The answer is absolutely not. No. I mean, I knew I'd be in medicine, and I knew I would be a pediatrician. Okay, but the reality what's really interesting is back then when I look at what my view of the world was, it was a very narrow view. And it was, it was just frankly, wrong. You know, I mean, it was just, it was an ignorant view of what pediatrics was, what medicine was, I frankly, thought coming out, I would be like a music therapist, and an art therapist who wrote prescriptions for kids, you know, no, can feel better. And, and I just didn't understand any of these things. And I also, you know, I've really grown up in a very isolated way. So, you know, my thought process was, you know, I just didn't have very many aspects of, of life that I had walked through. And so I was as very naive. And so I think when I look at, even how I looked at the world back then to how I look at the world today, it is so profoundly, I never, ever, ever could picture. You know, how my brain works today and the incredible opportunity I have today, you know, the place that God has put me here to kind of try to be a light. You know, I just, you know, I feel so fortunate. I feel so fortunate. I know, I never ever could have pictured this being where we'd be to where I would be today.

Naveh Eldar  44:36  
And then last question, you truly are one of the nicest people I've ever met. And just everything you know, talking about your family and being a deacon in the church and you know, just you can tell community in giving and helping people as is essential to you as a person, right? Do you have like an aggressive or competitive side of you anywhere? Like when you're playing ping pong or anything like that.

Justin Baker, MD  45:03  
See, that's what's so interesting is growing up, I was one of the more competitive people around. And I have to tell you, it's it's been amazing. So my wife is from Mexico, and my family was super tight Bay, like, got away and everything got to get stuff done. It was like, you know, on time, I was always five minutes early in my father in law is actually a psychologist from Mexico. And just the clash of cultures that happened when my family, my wife's family came together, it was like, it was unreal, and the things that I have learned from taking a breath stepping back, so I'm telling you, I will used to be one of the most competitive people in the entire world. And across time, I've just come to realize that, well, the way I look at it, it's very interesting, I used to also be really into so many health things, and I was very thin and athletic, and all this stuff, I did all the sports, I played football and tennis and, and I played everything and, and soccer. But I look at kind of how I'm a little bit more rounded now as far as my body goes. And I think of that is also my personality, and who I am is, you know, many of those edges, those competitive edges are those, you know, things that that maybe were a little bit sharp or harsh. I've just really gotten kind of rounded off through the years and, and I hope that continues to happen because I you know, if there's anything that I want to be remembered for his for being a person who was filled with love and grace, and if anything was taken advantage of because he was too nice or to this or whatever. Because I just feel like that's what what Jesus in our today's society that's what he'd be viewed as he'd be viewed as way too soft to be viewed as a Why is he so grace filled and, and how love is overcoming all these things? And that's, you know, that's what I want to be known for, you know, I want to be known for somebody who, if anything was was just to a fault. Yeah, to filled with grace, too much love was coming out. He could have done so much more with his life. If he was just a little bit more competitive. Boy, I would I would love it if that was what I was remembered for.

Naveh Eldar  47:14  
Wow, that was very well put. I enjoyed that. And I'm surprised by that answer as well. So that's a great thing. Look, Dr. Baker, thank you so much for your time and thank you for the work you're doing. I'll take care of yourself as they need you there. Well, I gotta tell you, it's so great talking to you. Congratulations on your daughter. What's her name? Daphna.

Justin Baker, MD  47:35  
Daphna. That's amazing. So my oldest is Liliana. She's going to be a junior in college. My second Her name is Abby. She just graduated also. So just like doctor just graduated.

Naveh Eldar  47:45  
So here here's something interesting we have in common. My son is going to be a junior in college and find links to St. Jude Children's Research Hospital, as well as their social media pages and the episode description. And I hope this episode has inspired you to get involved with the hospital and help them further their mission and extremely important work. Next episode, I interviewed Doug Crandall of Griffin hamis Associates, and the University of Georgia's Institute on human development and disability. Doug is also an award winning author, and we have a fascinating conversation around the content of his upcoming book. We'll see you then.

Transcribed by https://otter.ai