Physician at Work: Blending high-tech and compassionate care
James B. Yu, MD, learned early that good care goes beyond treatment
James B. Yu, MD was an undergraduate at Yale University when he first worked as a counselor for the Hole in the Wall Gang Camp in Connecticut, founded by the late actor Paul Newman as a getaway for children with cancer and other illnesses. “I worked there for three summers, and it cemented my desire to become a doctor,” he said.
Camp counselors caring for children were his first example of compassionate care, and he was struck by the young patients he saw who were surviving cancer thanks to medical advances. He later gravitated to therapeutic radiology because it was a perfect fit with his interests in physics—his undergraduate major—and in medicine.
Radiation is more common for adults than children, and as a Yale therapeutic radiologist Dr. Yu primarily treats adults with genitourinary cancers and cancers of the central nervous system. Working alongside medical residents, nurses, physicists and radiation technologists, he uses such machines as the Novalis Tx linear accelerator and the Gamma Knife Perfexion machine to deliver radiation in a highly precise manner that he believes will become a common treatment for more patients in the future. “We think the tumor pain relief is more rapid with this treatment and the effects are longer lasting,” he said.
Early lessons in compassionate care
When he first meets a patient, Dr. Yu goes through the diagnosis, implications of radiation, its risks and benefits and how it will be delivered. Patients undergo a CT simulation to map their bodies, which Dr. Yu uses to outline where the tumor is, as well as critical structures in the body to be avoided.
The work demands a high level of concentration, but Dr. Yu still draws upon lessons learned at the Hole in the Wall Gang Camp to make sure the patient feels comfortable and well cared for. “Radiation is involved in a lot of cure and also palliation of pain, but there is also the day-to-day helping people come to grips with their disease. There’s a lot of trepidation about what the treatment is like, so we spend a lot of time in discussion. We go through it with them,” he said.
A few years ago, he was called upon to provide a second opinion for a patient with prostate cancer. While some tumors are treated in a few sessions, this patient needed 44 radiation treatments. He was in a motorized wheelchair and wearing an arm brace, and had been told by another physician that it would be too difficult to administer that many treatments to someone with his physical limitations.
“I asked him how hard it would be to get on and off the table, and he said it would be no problem,” recalled Dr. Yu. “Patients are much more resilient than you think they’ll be. Even the frailest looking patient has an emotional reserve that you sometimes don’t know about.” He was able to treat the patient successfully.
Name: James B. Yu, MD
Title: Assistant professor of therapeutic radiology
Area of expertise: Genitourinary and prostate cancer, central nervous system cancers, gamma knife radiosurgery
Place of birth: Washington, DC
College: Yale College
Medical School: University of Michigan
Training: Yale-New Haven Hospital (chief resident, therapeutic radiology)
Family: Wife: Brenna, writer and artist; children: Lucy, 4, Sophie, 1
What is most rewarding? Being able to tell a patient that treatment went well or the cancer is in remission
What do you like most about your practice? It’s constantly changing and constantly stimulating. I’m able to make an impact locally and nationally, through research.
Personal interests or pastimes? Right now, I spend all my time either working or with my family, but I used to play music and I’d like to get back to that someday. I play trombone and I just bought an electric bass. Ranjit Bindra, MD, PhD, who is joining the faculty, plays drums. We played in a band together in college so hopefully we’ll be able to do it again.
Last book read: The Emperor of All Maladies, by Siddhartha Mukherjee. I don’t feel guilty spending time reading it because it’s cancer-related, but it’s also a pleasure to read.