May 17, 2013 | by Wayne Lewis
Lily Lai can still remember the personal breakthrough that reset the course of her life.
Closing in on her bachelor’s degree in East Asian languages and civilizations from Harvard, she burned away her nth hour among the library stacks. Senior thesis deadlines loomed. Graduate studies in art history lay ahead.
But there was a thought she just couldn’t shake: Perhaps the ivory tower wasn’t for her.
“I realized that probably five people in the world would read anything I would write on Chinese art history,” said Lai, M.D., now an associate clinical professor of surgery at City of Hope. “It just seemed like I needed to do something that was more physically related to people — that would really help people.”
That nagging thought drove Lai to embark on a career in medicine. As a surgeon, she puts her skilled hands to work healing patients facing colorectal or breast cancer. As an oncologist, she helps patients make treatment choices that best match the priorities they hold precious. The relationships she builds with her patients comprise a key inspiration for all she does at City of Hope — and beyond, through her work in the organization’s community clinics.
After she diverted her course from academia, Lai ultimately found training as a surgeon to be the natural landing place. No longer solely dedicated to the life of the mind, she followed a calling that was decidedly hands-on.
“I went into something where I’m really helping somebody with my hands. There’s a physical element to surgery that I gravitate toward,” said Lai.
Being a surgeon carries a certain amount of instant gratification for her — “you sort of fix that problem at that time.” Even still, Lai chose oncology because it affords her the chance to build relationships with her patients over time.
“Really it’s in cancer care that you have the capability of long-term follow-up. You begin to know your patients,” she said.
“Unfortunately in solid cancers, sometimes patients will have recurrences. So you get to continue to assist them in their cure, in their fight against their cancer.”
The positive power of listening
Lai draws inspiration from the bond between doctor and patient.
“The patients give you so much,” she said. “Their courage — some of them have what you, as an onlooker, would consider to be some pretty poor quality of life. But they’re happy, they’re doing what they want to do and they’re grateful. In them, I can see that life is really precious.”
A critical part of her job involves educating patients about their treatment options, clarifying the pros and cons of each choice. There is, however, one question she can never answer.
“Patients will always ask, ‘What would you do if it was you, doc?’ I would say, ‘I don’t know.’”
According to Lai, it doesn’t matter what the doctor would do — it matters what the patient needs from treatment and life afterward.
Therapy requires certain trade-offs. One goal of getting to know her patients is understanding what they value most. From there, she can advise them about how cancer, its treatment and any resulting side effects will impact their lives.
For instance, one patient might opt for a powerful chemotherapy that minimizes the chance of recurrence, even though it can cause neurological side effects that diminish dexterity. Another patient who is a musician might choose a different course. Perhaps they can handle a higher risk of recurrence to avoid damaging their ability to do what they love.
Said Lai: “It’s a different discussion with every individual patient. I come up with a different answer depending on my interaction with them. And I think getting better at cancer care is being able to tell where a patient is in their life, what they value, what they need to do.”
After her medical training at University of California, San Diego, Lai came to City of Hope as a surgical fellow. She joined the faculty in 2001 as a surgeon and researcher.
She spends half her time at City of Hope’s community practice in Antelope Valley, about 90 minutes’ drive away from the medical center at the Duarte campus. That clinic soon will expand with the forthcoming City of Hope | Antelope Valley facility in Lancaster, Calif.
Lai is devoted to extending the organization’s reach.
“We want to offer the best care to more people,” she said. “I’ve always been committed to the Antelope Valley, in terms of growing the practice, to help to improve the quality of cancer care in the community.”