“I’m probably one of the relatively few people at City of Hope who doesn’t focus on cancer,” Cohen, 35, said, “although I work with a lot of people who have survived cancer or are living with cancer. I see a lot of patients who are just dealing with the challenges of aging. People shouldn’t have to live with fecal incontinence or urinary incontinence. No one wants to talk about the pelvic floor. It’s a black box.”
Cohen, who is married with a 15-month-old son, received his medical doctorate and Bachelor of Arts degrees at Northwestern University through the prestigious Honors Program in Medical Education, which allowed for direct matriculation into medical school after three years of undergraduate work.
He completed his postgraduate training in California, including an internship in the Department of Surgery at UC San Francisco, a residency in urology at UC San Diego and a fellowship in Female Pelvic Medicine and Reconstructive Surgery at UCLA.
He was attracted to medicine because, he says, “I wanted to go into a profession that was going to make a difference, and I enjoy interacting with people, learning about people.”
Cohen volunteered as a hospital candy-striper in high school and was struck by how “even the smallest thing you did for a person going through a significant health issue could have the biggest impact. I wanted to be a part of that.
“As much as medicine is a hard science, it’s also about people,” he said.
He was drawn to surgery because he is “more of a hands-on person. I liked doing activity-based, tactile work, and I enjoy the high-intensity environment of the operating room.”
He gravitated toward urology because “it is such a wonderful mix of medicine and surgery,” he said. “You’re engaged in the management of patient care, not just the surgery. With urology you’re involved in a long-term relationship with patients even after the surgical intervention.”
Cohen said he became more acutely aware of the significant impact of pelvic floor issues when he was doing a residency rotation in a spinal cord injury unit. “It’s amazing how not being able to empty your bladder regularly can dramatically decrease the quality of your life,” he said. Neurological disorders, such as spinal cord injury, can devastate voiding function.
During his medical training, he also became cognizant of pelvic floor disorders commonly impacting mothers and postmenopausal women, such as vaginal prolapse, urinary incontinence and fecal incontinence. It was his connections with these patient populations that fostered his interest in his specialty. He notes, “I really found a home for both my intellectual interests and where I felt I could make a significant difference.”
Cohen describes himself as a reconstructionist and a “survivorship advocate.”
“My job is to put it all back together after it’s taken apart and give you back your quality of life,” he said. That includes cancer patients who have gone through chemotherapy and radiation, mothers experiencing fistulas postchildbirth and postmenopausal women suffering with incontinence or chronic urinary tract infections.
“I’ve had women come to me with serious issues that haven’t been treated for months,” he said. “To some extent it’s like the ugly stepchild of women’s care. We talk about mammograms, we talk about pap smears, we talk about childbirth. We don’t talk about when happens when you’re 50 or 60 and every time you pick up your grandchild you’re incontinent. I want people to know that you are not alone. I see this all the time, and there is help.”
“Women always put everyone else ahead of themselves — their husband, their kids, their grandkids,” he continued. “I want to empower them to take care of themselves. A lot of people don’t seek the care and don’t know the care is there.”
Cohen joined City of Hope because the hospital did not have a urologist who specialized in female pelvic medicine and reconstructive surgery.
“A lot of those patients were being sent elsewhere for their care,” Cohen said. “We now really have a wonderful core to build a very comprehensive pelvic floor program. We can offer A-to-Z care for people with devastating pelvic floor processes.”
A “large population” of cancer survivors need medical assistance in this area as well, he said. “We want them to get beyond surviving cancer — we want to get them to live the best quality of life that they can. I want to get them past that finish line.”
He was also attracted to the fact that City of Hope is also a research institution. Cohen has published in a variety of medical journals on topics including mesh-associated complications, robotic cystectomy and radiation exposure during lithotripsy (kidney stone treatment).
He currently is seeking to expand a clinical trial of a rapid urinary tract infection test that identifies the bacteria and the antibiotic that it is sensitive to in just two hours rather than two to four days.
In addition, at City of Hope “they live what they preach,” he said. “They understand the importance of nourishing the spirit, in addition to treating the disease. I saw myself as of the same ilk. There is a lot of emotionality in pelvic floor disorders. My specialty certainly incorporates the treatment of both body and soul.”
“There’s no reason to have these disorders in the shadows,” he added. “We want to give everybody the opportunity to have the quality of life they deserve.”
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