New London County oncologist Dr. Mithlesh Govil — "Mithi" to those who know her — has a particular appreciation for her patients, one complemented by some interesting observations on modern American society. Though Americans are sometimes criticized for being reluctant to have public, straightforward conversations about death and dying, Dr. Govil, a native of India, has her own take on how we cope with the ultimate question:
"People really live until they die, in this culture. And there's good in that," she said. "You see 90-year-olds here getting married; you see them learning a new skill set, learning a new game ... Americans have a great love for life. They are continuously living; they are continuously learning new things. That is their strength. They're very positive, forward-moving people. Why not enjoy your life until you can't?"
Why not, indeed.
Dr. Govil's own love for life — evident in her warm, feisty manner — becomes even more apparent when she talks about her "hobbies."
Each decade, she challenges herself to learn something — swimming, computers, knitting, making jewelry, you name it. She earned her master's degree in business in her 50s — with a 3.9 GPA from Rensselaer Polytechnic Institute, no less.
She is an artist — at the encouragement of her daughter, Sarah, she began studying painting at 60 — and donates the proceeds from her sales to charity.
This year, she took up golf.
Her zeal for life also shines in the colorful murals and artwork which adorn nearly every wall of her medical practice, the New London Cancer Center at the Crossroads Professional Building in Waterford. Her clear love for aesthetic detail makes the treatment rooms feel more like a living space than a medical facility, which uplifts both patients and staff, she said.
You have to wonder what such an upbeat person is doing in the difficult field of cancer care.
Dr. Govil wondered that too, in the early days of her career.
"I wanted to be a hematologist," she said. "I love art, as you can see, and hematology is a very visual field. You see cells," she explained. But as a self-described "people person," she knew she preferred working directly with patients, to research.
She finished her residency in internal medicine in 1979, "way before there were all these beautiful therapies for cancer patients." She could see the path ahead and knew there would be victories but also unavoidable losses. But she decided, "I may not be able to cure them but I'm going to do the best I can. It's not an easy field but it's also very gratifying."
Three decades later, the New London Cancer Center now includes four board-certified medical oncologists and hematologists, three nurse practitioners/physician assistants (including Govil's daughter, Sarah), and 12 staff members.
Govil believes people need clear commitment and compassion from their health care providers. To demonstrate her group's dedication to the quality of life of their patients, in 2003, Dr. Govil created the Guardian Fund, a nonprofit that helps patients meet their financial needs during their illness. The fund has donated roughly $10,000 to those in need over the last year.
Most of all, she stressed, people confronting a serious diagnosis need frank, open communication.
"I tell you something, I give the hardest news to patients, the most difficult news to them. But people are smart. When you're honest about what is happening and what it will achieve for them, people make good decisions. Quality of life is a very personal issue," she said, adding, "my patients give me more than I give them, I know that, on any given day."
But there is no question that the terminal cases are hard. Govil views that particular emotional component as part of the fabric of her work.
"We make very deep relationships with our patients," she said. "We miss them. We talk about them. We think about them after years have gone by. What gives us comfort is that we have done what we could to add to their lives, or their family members' lives."
There is sadness, but ultimately, she said, "I think we're richer for having exposed ourselves to so many people."
And Dr. Govil has witnessed great strides in her field over the last three decades. The advent of nausea medications for chemotherapy in 1991 for instance, and the use of molecular markers to fine-tune a diagnosis have changed the landscape of cancer care, as have targeted therapies.Inpatient care has become outpatient care, she said. More therapies can be given, safely and with fewer side effects.
"It changed the life expectancy of our patients. So I tell people, that is the joy of oncology. Every day you live, somebody discovers some new therapy. Every day somebody lives is a great day."
Embracing the future
Dr. Govil's goals for the next decade extend beyond the walls of her own thriving practice. She recently started a consulting firm, Practice Innovation Consulting, to help other physicians improve efficiency through technology.
Her article on achieving "Meaningful Use of Electronic Medical Records" was published in the American Society of Clinical Oncology's "Journal of Oncology Practice" and was presented at their annual meeting held last October in Chicago.
"Electronic records can be seen by any physician, in an instant, anywhere in the world," she explained. "It ensures a continuity of care for the patient. When you see them in the hospital, there is no missing data. You can see what happened ten seconds ago."
To promote the use of these records, federal incentives were established under the Health Information Technology for Economic and Clinical Health Act in 2009. Dr. Govil's group quickly met the requirements, she said, because they had been using electronic records "for years." Now as she works to spread the word about the advantages of technology, she finds herself, characteristically, stressing the human aspect:
"We spend more time with patients because it takes less time to do all the paperwork."