Louie B. Nunn Center for Oral History

Interview with Emily Marcinkowski, March 16, 2020

Louie B. Nunn Center for Oral History, University of Kentucky Libraries
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00:00:02 - Brief educational background

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Partial Transcript: Hello. My name is Nathan Vanderford. I'm a faculty member at the University of Kentucky College of Medicine in the Department of Toxicology and Cancer Biology. I'm also the director of the Markey Cancer Center's Appalachian Career Training in Oncology Program, or ACTION Program for short.

Segment Synopsis: Emily Marcinkowski summarizes her educational history for undergraduate, medical school, and fellowship leading to her current career in surgical oncology.

Keywords: ACTION Program; Appalachian Career Training in Oncology Program (ACTION); Breast melanoma surgery; Career moves; Careers & opportunities; Doctors; Educational backgrounds; Educational histories; Endocrine surgery; General surgery; Markey Cancer Center (Lexington, Ky.) (MCC); Medical residencies; Medical schools; National Institutes of Health Care (NIH); Residencies; Southerners

Subjects: Cancer--Study and teaching; City of Hope Cancer Research Center; Education, Higher.; Louisiana State University (Baton Rouge, La.); Louisiana.; Medical colleges.; Medical students; National Institutes of Health Care Research; Physicians.; Research grants.; Residents (Medicine); Surgeons; Surgical oncology.; Undergraduate; University of Kentucky; University of North Carolina at Chapel Hill

00:02:54 - Being and becoming a surgical oncologist

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Partial Transcript: Uh, s--before we do that, could you tell us a little bit about when and why you decided to become a doctor?

Segment Synopsis: Marcinkowski discusses how her mother influenced her decision to become a doctor. She talks about experiences in medical school and residency that influenced her decision to become a surgical oncologist. She talks about rewarding aspects of her job.

Keywords: Anesthesiologists; Anesthesiology; Cancer care; Career influences; Childhood influences; Craniofacial surgery; Doctors; Family influences; Hospitals.; Medical environments; Medicine; Needles; Neonatologists; Neonatology; Personal preferences; Plastic surgery; Preferences; Teamwork; Teamwork in medicine

Subjects: Cancer--Patients.; Cancer.; Career development.; Career moves; Careers & opportunities; Health care teams.; Interpersonal relations.; Job satisfaction.; Mothers.; Physicians.; Professional relationships; Surgeons; Surgical oncology.; Teamwork essentials

00:07:24 - Training and residency experiences

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Partial Transcript: And so speaking of training, can we talk just a second about, uh, you know, that, that long period of training?

Segment Synopsis: Marcinkowski talks about what it was like to undergo training to become a surgical oncologist. She talks about how she encourages her current medical residents as they proceed through their own fellowships.

Keywords: Attending physicians; Clinics; Fellows; Hours of labor.; Job expectations; Job exposure; Life purposes; Medical fellows; Medical fellowships; Medical residencies; Medical scribes; Medical skills; Medical training; Practice; Self-discovery; Surgeries; Surgical residents; Work schedules

Subjects: Career development.; Career moves; Encouragement.; Hospitals--Medical staff; Learning.; Medical students; Medicine--Scholarships, fellowships, etc.; Residents (Medicine); Self-realization.; Surgeons; Surgical oncology.; Teaching.; Training.

00:12:32 - More on being a surgical oncologist

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Partial Transcript: So I think we've already covered this, uh, but just in case you have anything more to says, uh, in terms of what do you like most about being a doctor?

Segment Synopsis: Marcinkowski describes what she likes best about being a doctor and surgical oncologist.

Keywords: Anxieties; Calm; Cancer--Patients--Hospital care; Doctors; Emotional support; Fears; Helping; Medical care; Medical support; Patient care; Patient mentalities; Patient relationships; Relationships

Subjects: Cancer--Patients.; Cancer.; Interpersonal relations.; Physicians.; Professional relationships; Surgeons; Surgical oncology.; Transparency

00:13:35 - Patient demographics and treatment barriers

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Partial Transcript: Um, so, can you tell us more kind of specifically about your clinical practice?

Segment Synopsis: Marcinkowski summarizes her typical patient demographics, including types of cancer patients, where her patients live in Kentucky, and barriers that prevent patient access to cancer treatments.

Keywords: Appointments; Biopsies; Cancer clinics; Cancer severity; Cancer stages; Clinical practices; Clinics; Disease severity; Doctor appointments; Eastern Kentucky; Follow-up appointments; Follow-ups; Health crises; Immunotherapy; Mammograms; Medical imaging; Patient demographics; Radiation; Surgeries; Transportation resources; Treatment access; Treatment barriers; Visitations; Visits

Subjects: Appalachian Region.; Breast--Cancer.; Cancer--Patients--Hospital care; Cancer--Patients.; Cancer--Treatment--Complications.; Cancer--Treatment.; Cancer--United States--Statistics; Cancer.; Health services accessibility.; Kentucky.; Local transit accessibility.; Melanoma.; Physicians.; Public health.; Social workers.; Surgeons; Surgical oncology.; Transportation.; University of Kentucky

00:28:01 - COVID-19 and surgical oncology practice

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Partial Transcript: So let's transition a bit and talk about, uh, a current topic, um, and actually why we're doing this interview by phone when it was originally scheduled, uh, to be a video interview, um, so I really appreciate you still being available to do it by phone, um, but just, just for those listeners who might be, you know, twenty years from now listening to this.

Segment Synopsis: Marcinkowski describes how the novel COVID-19 global pandemic has affected her surgical oncology practice, patients, and day-to-day life.

Keywords: Adjustments; Anxieties; Cancer--Patients--Hospital care; Chemotherapy; Childcare; Coronavirus disease 2019 (COVID-19); Elective cases; Ethical dilemmas; Global pandemics; Healthcare systems; Hospital guidelines; Mental health.; Pandemics; Psychological impacts; Radiation; Resources; Surgeries; Treatment access; Treatment availability; Treatment barriers; Viruses.

Subjects: COVID-19 (Disease); Cancer--Patients--Long term care; Cancer--Patients.; Cancer--Treatment.; Cancer.; Daily life; Health services accessibility.; Medical ethics.; Moral dilemmas; Physicians.; Surgeons; Surgical oncology.

00:42:12 - Impressions of Kentucky

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Partial Transcript: Well, uh, let's transition again, uh, and talk more generally about, uh, cancer in Kentucky.

Segment Synopsis: Marcinkowski talks about learning about the severity of poverty in Kentucky, especially Eastern Kentucky. She talks about how this affects clinical practices in the state.

Keywords: Accessibility; Cities; Clinical practices; Coal industries; Coal miners; Coal towns; Coal vouchers; Comparisons; Eastern Kentucky; Healthcare; Healthcare infrastructures; Louisiana.; Medical resources; Patient relationships; Physician distrust; Poverty rates; Turnover rates

Subjects: Cancer.; Coal mines and mining; Coal mines and mining--Kentucky; Coal trade; Hospitals.; Job vacancies.; Kentucky.; Medical care.; Physicians.; Poverty.

00:46:30 - Impressions of Appalachia

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Partial Transcript: Uh, well we'll get more into that in just a minute, uh, but, uh, when you hear the words Appalachia, specifically Appalachian Kentucky, what specifically comes to mind?

Segment Synopsis: Marcinkowski describes positive and negative impressions of Appalachians and the Appalachian region.

Keywords: Appalachia; Appalachian attitudes; Appalachian culture; Appreciation; Attitudes; Baseline knowledge; Families.; Family-oriented; Gratefulness; Healthcare; Healthcare access; Healthcare availability; Healthcare knowledge; Healthcare resources; Impressions; Medical resources

Subjects: Appalachian Region, Southern; Appalachian Region, Southern--Social life and customs.; Appalachian Region--Economic conditions; Appalachian Region.; Appalachians (People); Culture.; Cultures, beliefs, and traditions; Health services accessibility.; Medical care.; Poverty; Poverty--Appalachian Region

00:48:16 - Feelings about cancer in Kentucky

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Partial Transcript: Um, so, you, you know this well, uh, Kentucky ranks first in the nation in overall cancer incidents and, and mortality.

Segment Synopsis: Marcinkowski describes the emotional toll of being a surgical oncologist in Kentucky. She compares the emotional work load of family medicine doctors with surgical oncologists in Kentucky.

Keywords: Anxieties; Baseline knowledge; Cancer diagnoses; Cancer incidents; Cancer rates; Chronic diseases; Chronic illnesses; Compartmentalization; Doctors; Emotional labor; Emotional stress; Family medicine; Family medicine doctors; Feelings; Healthcare education; Humanity; Reactions; Stress (Psychology)

Subjects: Cancer--Patients.; Cancer.; Education.; Emotions.; Kentucky.; Physicians.; Surgeons; Surgical oncology.; Work and everyday life; Work and family--United States.; Work and family.; Work.

00:51:39 - Prominent risk factors for cancer in Kentucky

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Partial Transcript: Uh, so, so we've talked already a good deal about, um, you know, some of the contributing factors to why rates of cancer are so high here in Kentucky, specifically in Eastern Kentucky.

Segment Synopsis: Marcinkowski discusses the greatest risk factors for cancer in Kentucky. She discusses health behaviors and medical literacy among patients.

Keywords: "Prehab"; "Prehabilitation"; Behavioral changes; Breast cancer; Breast--Cancer.; Exercise.; Families.; Fear.; Health behaviors; Health conditions; Health habits; Health management; Medical literacy; Medical procedures; Nutrition statuses; Patient management; Patient monitoring.; Poor nutrition; Smoking habits; Surgical procedures; Tobacco addiction

Subjects: Cancer--Patients.; Cancer--Risk factors; Cancer--Treatment.; Cancer.; Counseling.; Diet in disease.; Diet.; Health & fitness; Health education.; Health.; Kentucky.; Medical care.; Obesity.; Rural health needs; Rural health promotion; Rural health.; Smoking--Health aspects.; Smoking.; Surgery.

01:01:52 - Generational perspectives on cancer

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Partial Transcript: Alright, so, what's your thinking on, uh, generational views of cancer, can--and particularly cancer risk factors?

Segment Synopsis: Marcinkowski discusses how different generations may view cancer as a disease in Kentucky.

Keywords: Age populations; Attitudes; Cancer--Risk factors; Generational attitudes; Generational differences; Generational perspectives; Geographic attitudes; Geographic differences; Internet; Life experiences; Opinions; Past experiences; Perspectives; Stereotypes

Subjects: Age; Cancer.; Education.; Generations.; Kentucky.; Medical care.; Socioeconomic status; Technological literacy.; Technology and older people.; Technology.; Tobacco use.; Tobacco.

01:04:12 - Impacts of cancer rates on Appalachia

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Partial Transcript: Um, so, what do you think the impact is on, uh, cancer in Appalachia, uh, socially and economically?

Segment Synopsis: Marcinkowski describes the impacts high cancer rates have on Appalachia, particularly financial impacts.

Keywords: Accessibility; Annual salaries; Appalachia; Cancer care; Cancer care resources; Finances; Financial burdens; Healthcare accessibility; Healthcare availability; Healthcare providers; Incomes; Medical costs; Resource accessibility; Resource poor; Work.

Subjects: Appalachian Region--Economic conditions; Appalachian Region.; Appalachians (People); Cancer--Patients.; Cancer--Treatment; Cancer.; Medical care, Cost of.; Medical care.; Poverty.

01:05:33 - Potential solutions addressing cancer in Kentucky

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Partial Transcript: Alright so we've talked a lot about, uh, sort of your background, your practice, uh, we've gotten into some, uh, broader topics about cancer in Kentucky, so let's talk a few minutes, as we start to kind of close, about solutions.

Segment Synopsis: Marcinkowski discusses several ways high cancer rates in Kentucky may be addressed and barriers to achieving these methods. She discusses broadening bandwidth in the state, telemedicine, free health services, psychological aspects, education, the government's role in addressing cancer rates, and universities' roles in addressing cancer rates.

Keywords: Accessibility; Addiction; Age limits; Bandwidth; Cancer rates; Cigarette taxes; Cigarettes; Government involvement; Government roles; Health screenings; Health solutions; Healthcare; Local transit accessibility.; Problem-solving; Solutions; Technological access; Tobacco addiction

Subjects: Cancer--Patients.; Cancer.; Education.; Government agencies; Health education.; Health services accessibility.; Internet access.; Kentucky--Politics and government; Kentucky.; Medical care, Cost of.; Medical care.; Psychology & mental health; Psychology.; Substance abuse.; Technology.; Tobacco use.; Tobacco.; Universities and colleges.

01:13:28 - Training cancer care providers in Kentucky

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Partial Transcript: Do you have any thoughts on--specifically here in Kentucky, uh, do you think that--what's your thoughts on training Kentuckians specifically to play a role in helping solve these problems?

Segment Synopsis: Marcinkowski describes how healthcare providers and medical residents are being and should be trained in delivering cancer care services in Kentucky. She talks about challenges in providing adequate cancer care in Kentucky.

Keywords: Care providers; Eastern Kentucky; Education specialists; Health indexes; Healthcare providers; Healthcare resources; Job rewards; Job turnover; Kentuckians; Medical literacy; Medical resources; Patient demographics; Patient populations; Program funding; Researchers; Staff retention

Subjects: Cancer--Patients.; Cancer.; Education.; Health education.; Health services accessibility.; Job vacancies.; Kentucky.; Literacy.; Medical students; Residents (Medicine); Training.

01:18:05 - Future of cancer care in Kentucky

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Partial Transcript: So, what do you think success looks like?

Segment Synopsis: Marcinkowski describes what success in addressing cancer rates in Kentucky would look like. She discusses what may be at stake if cancer rates are not controlled in Kentucky.

Keywords: Bankruptcy; Cancer care; Cancer care resources; Cancer crises; Cancer rates; Death; Finances; Financial burdens; Future; Future planning; Healthcare resources; Life impacts; Medical resources; Regional finances; Regional impacts; Stakes; State impacts

Subjects: Cancer--Patients; Cancer--Treatment; Cancer.; Health services accessibility.; Kentucky.; Medical care.; Poverty--Appalachian Region; Poverty.; Public health.; Work.