Generosa Grana’s Journey
words by Maryann Brinley / photograph by John Emerson
She grew up in the little village of Villerino, “in the middle of nowhere,” in Galicia,
the part of Spain just north of Portugal. “I didn’t come to America until I was 10,” explains Generosa Grana, MD, associate professor, UMDNJ - Robert Wood Johnson Medical School (RWJMS), Camden. Though she has traveled a long way since then…geographically, personally and professionally…one of her favorite places in the world is still a “river about a mile away from the village, covered with trees and filled with rocks. It is a place that embodies peace for me, a beautiful spot. My family returns to Spain each year in August for two weeks to touch base and see our many relatives.”
ust the other day when this director of the Breast Cancer Program at Cooper University Hospital had a moment to reflect during an interview, she laughed about how strong this image of the river tugs at her. Like a line in the Judy Collins song, “In My Life,” there are places you remember all your life…and this is one of them.
“It was funny because I had been talking to my 17-year-old daughter and said, ‘Oh Stephanie, I went to my favorite place.’
“Immediately, my daughter said, ‘Oh the river. It’s my favorite place too.’”
Grana has three children: Stephanie, who is a “joy. Bright, dynamic, strong-willed, she is a truly beautiful person” (and much like herself, according to her husband, Temple University Hospital cardiologist William VanDecker, MD). She also has twin 15-year-old sons, Chris and Bill, who are “full of life and wonderful.”
Pausing to consider the disparate sides of her life, she says “being a mother, with the task of molding a mind and a life, can be even more challenging than being a physician. After all, there are guidebooks on medical care” but the way forward in parenting is not always clear.
Her parents were not in medicine but they ingrained in her how important education is. It is the way to move ahead in life, she was told. A graduate of Notre Dame, she earned her medical degree from Northwestern University, pursued a residency in internal medicine at Temple University and completed a fellowship in hematology and oncology at Fox Chase Cancer Center. Her mother, who was a seamstress, and her father, a former steelworker, live with her now and help with the homemaking and care-giving.
“They have always been there for me and for us. Not everyone is so fortunate,” she admits.
Almost every woman in medicine whom she knows is challenged with the demands of mingling family, personal and professional responsibilities. “I think a key for female physicians is to find a system that works and that will support you. I’m married to a physician with his own demanding career but he is also incredibly understanding. I can do the things that make me happy but if he didn’t step in to pinch hit, that wouldn’t be possible. A spouse has a tremendous role to play for a woman in medicine.”
This kind of 24/7 foundation at home allows Grana to go to those other places that feed her soul. “Professionally, I think the place I’ve gone that I feel best about is in my interactions with my patients and my relationships with them.” Her clinical and breast cancer genetics research work is purely focused on women, a fact that she loves. “I do think that being a woman who deals with women’s issues gives you a closer identity to what patients are going through.” And, although she is involved in the day to day affairs and administration of the hospital and honestly likes that aspect of her job, “The most rewarding part for me is patient care. You share experiences at a time in someone’s life that is so tumultuous. Whether the journey is successful or not, it’s really the journey of self that is so important. This is an experience that the physician and the patient share.”
Google Generosa Grana and you soon find this physician in chat rooms, online discussions and entrenched in breast cancer support networks. “I think it’s important for physicians to be involved and available to patients,” she explains. In the old days, that might call for empathetic care given one-on-one to individuals or perhaps speaking at community lectures or educational events. Not now. For Grana, sharing her wisdom and getting the message out means creating a virtual but very personal presence on the Web. She credits groups like Breastcancer.org, Cancer Care, Living Beyond Breast Cancer, and organizations like the American Society of Clinical Oncology (ASCO) and The Susan G. Komen Foundation for making great strides onto this internet stage. “I’ve been so impressed by how many people these call-in, Web-based programs and online discussions reach. Patients in this day and age are seeking information and the challenge for us is to guide them. Some of the stuff you can find online is dubious.”
Out in the real neighborhood surrounding the hospital, the Cancer Education Early Detection (CEED) program is federally funded and provides screening and education for uninsured and underinsured individuals. Alerting women to the risk factors for cancer and what they can do to modify these risks are important parts of her mission and her staff coordinates the majority of these services in Camden County. “We are very, very, very active” with funding from the state, and the Centers for Disease Control and Prevention (CDC). As a leader at Cooper — and there are increasing numbers of women right at the top of her own organization, she reports — Grana is also proud of the eight to 10 continuing medical education (CME) courses on cancer offered each year to faculty and primary care physicians.
“We have a large number of different kinds of support groups for women here,” she says proudly. But one program in particular that stands out for Grana is the Doctor Diane Barton Complementary Medicine Program. “This one is amazing, free for patients, and focused on healing through yoga, tai chi, meditation, and the arts,” she explains. Diane Barton was a Cooper physician who died of ovarian cancer three years ago. According to Grana, she was a real force in their academic community, a “dynamic woman who dealt with her disease by looking at complementary approaches that would help her handle the side effects of treatment and the emotional impact. "
“I will tell you that helping another physician traverse the cancer journey, going from the early stage, when she was newly diagnosed, to the end stage of her disease, was humbling.” Admittedly, along the way, it was very difficult for this physician and friend to maintain a professional balance. “Being there for someone going through the dying process is just so hard. This was one of my most difficult yet rewarding experiences.”
Because she believes so strongly in treating the emotional and psychological needs of the individual woman, as well as providing clinical care, one group of her patients is heart-rending: the young mothers with breast cancer. “I am touched by them. I have several in that category now. They are facing cancer, chemotherapy, loss of their hair, their breasts and all that, in what should be the most beautiful time of their lives. Here they are in their late 20s and early 30s. They are beautiful human beings: new mothers with full lives ahead of them. Suddenly, this devastating disease comes out of nowhere.”
What amazes Grana is their strength. “They deal with their own emotional and physical changes but continue to be parents who worry about and nurture their children.”
As a physician / educator, Grana thrives in her role as a mentor for students, residents and fellows, especially women. She’s always asking herself: “How do we help these young women mold their careers? We may not be doing it perfectly ourselves but we have to serve as guides. How can we give them flexibility so they can take care of families and still maintain success in academics and medicine? This is a real challenge.
“Of course, we are imparting medical knowledge but we are also showing them the caring side of this profession.” She believes that women can bring a special gift to medicine, which is more than just science, and more than conducting clinical trials, collecting data, or giving clinical care. “There is still a healing art to being a physician which is so vital.” And that’s the place where Generosa Grana goes to find “the real beauty in medicine.”