Mentoring pearls of wisdom: Lessons learned by mentees of Arti Hurria, MD

1. Introduction

Mentorship is an important factor that fosters the pursuit of an academic research career [1,2]. Investigators with mentorship are more likely to succeed in academia with more time spent in research, greater number of publications and grant funding, and higher job satisfaction [3]. Finding mentorship may be especially problematic for young investigators in geriatric oncology, as potential mentors are geographically dispersed and young investigators are often the sole cancer and aging researcher at their institutions. In order for these young investigators to thrive and succeed, it is critical for them to have senior mentors who can guide them on how to bridge the worlds of oncology and geriatrics. Mentors help foster the careers of the next generation of researchers, and advance scientific discovery in cancer and aging research.

Outstanding mentorship embodies five key elements: [4] 1) a focus on achievement or acquisition of knowledge; 2) provides emotional and psychological support, direct assistance with career and professional development, and role modeling; 3) is reciprocal, where both mentor and mentee derive emotional or tangible benefits; 4) is personal in nature, involving direct interaction; and 5) emphasizes the mentor’s greater experience, influence, and achievement within a particular organization. Dr. Arti Hurria embodied all of these qualities and was one of the most influential mentors in geriatric oncology. She infused the world with her infectious passion for improving the lives of older adults with cancer and inspired many others to follow her lead. As Dr. Hurria’s mentees, we have been fortunate to witness her outstanding mentoring skills first-hand, and to directly benefit from her mentorship on both a personal and professional level; helping us to become not only better researchers and clinicians, but also better people. As we endeavor to carry her tremendous work forward and take on mentoring roles ourselves, we reflect on some of the mentoring “pearls” we learned from her and now strive to emulate.

1.1. Remember the Mission: “Let Your Patients Guide You”

Dr. Hurria’s mission was first and foremost fueled by patients. She advocated to her mentees to always maintain patients at the core of what we do. She emphasized that, by taking time with each patient, you learn what questions to address through research – each encounter has the direct potential to be a seed that grows into a world-changing idea. This is the true value of academic medicine as clinician scientists, allowing researchers to make a palpable difference in the world. For Dr. Hurria, success was not measured by grants, publications, and curricula, but instead by improving the lives of the people we care for. To that end, she sought partnerships with patient advocates in her own work [5,6], and encouraged her mentees to do the same.

1.2. Work Together: “Teamwork Makes the Dream Work”

Dr. Hurria deliberately and strategically built a research community dedicated to improving the care of older adults with cancer, often citing the African proverb, “If you want to go fast, go alone. If you want to go far, go together.” During Dr. Hurria’s celebration of life at City of Hope in March 2019, her husband, Dr. Thomas Lee, described her as having a unique ability to go both far and fast, thanks to the value she placed on teamwork. Dr. Hurria recognized that, in order to achieve the mission of bringing geriatric oncology to the forefront of cancer care and research, she would need to bring together like-minded and highly motivated individuals to combine efforts. Keeping in mind this key value of collaboration, she laid the foundations of a geriatric oncology community, the Cancer and Aging Research Group (CARG; mycarg.org) [7], where colleagues celebrate one another’s achievements, provide guidance and support on developing academic and clinical concepts, learn from collective successes and failures, and develop collaborations. To join CARG, a prospective member must meet a single requirement: the desire to help older adults with cancer. In this vision, members of CARG hail from diverse personal and professional backgrounds, training, and research interests, as Dr. Hurria recognized that diversity affords unique perspectives, promotes creativity, and fosters innovation.

Furthermore, Dr. Hurria instilled in each of us to value our collaborators and partners, and to be grateful for their efforts. She understood that her success stemmed from having an excellent team, and celebrated the successes of each team member as if they were her own. She made time to obtain each team member’s feedback on how to manage patients or troubleshoot issues in a study, and always tried to make sure that the work they were doing helped them grow professionally and personally. Each Christmas, Dr. Hurria and her team would stroll around City of Hope and hand out plates of cookies at each hospital unit to thank the nurses and healthcare team for their support and dedication. In addition, the entire team would sign individual Christmas cards to thank the patients who had participated in studies.

1.3. Appreciate Differences: “Reframe Challenges as Opportunities”

Innovation pushes boundaries. In order to transform the “status quo”, one will inevitably encounter barriers and challenges. Dr. Hurria led the charge to integrate geriatrics into oncology, and she undoubtedly encountered significant challenges and barriers along this path. However, she was tremendously resilient, and responded to rejections and challenges with kindness and grace. Her persistence began with advocating for the incorporation of geriatric assessment into oncologic care to skeptical peers, all the way to seeing it become guideline-recommended by the American Society of Clinical Oncology. This mindset—to see beyond short-term obstacles with the vision of the greater good—is one that we all aspire to achieve, and work towards on a daily basis. She helped her mentees learn to deconstruct barriers into smaller goals, to understand the rationale of those with differing viewpoints, and to identify a path forward even in the most challenging circumstances.

1.4. Be Kind and Inclusive: “Value and Respect Yourself and Others”

Among Dr. Hurria’s most striking skills was her ability to readily form a deep personal connection with others. She instilled in every mentee the sense that they were one of her top priorities, that their ideas were of genuine importance to the field, and that their perspective carried value. At the same time, she was honest about the shortcomings of her mentees’ work, and made herself available for improving it by providing new solutions and ideas. She was an outstanding listener, who took the time to understand what each mentee was passionate about, and she worked to align opportunities accordingly. She was also keenly aware that mentees had lives and responsibilities beyond work, and she strived to understand each mentee on this personal level. Dr. Hurria taught us that a key element of being a good clinician and researcher is to first be a good person.

Further to this, she modelled work-life balance continually. It was clear that despite Dr. Hurria’s tremendous academic accolades, her daughter was her ultimate source of pride. She modelled to her mentees to value family, and that it was possible to have both a career and a family, and to be successful in both arenas.

1.5. Sponsor Others: “Bring Someone Up With You”

Our individual capacity to impart change in this world is limited; however, through sponsorship, we can extend our reach exponentially. With her tremendous talent and work ethic, Dr. Hurria transcended the ladder of academic medicine quickly. Yet, she was always conscious on each and every rung of the ladder to turn around and pull others up alongside her. She recognized that her goal of integrating geriatrics into oncology was an ambitious one and would take a village to achieve. She cultivated this by sponsoring collaborators and mentees for responsibilities and leadership positions in national and international organizations, and she mentored individuals in these roles when needed. She was strategic in engaging others who had a passion for geriatric oncology in these opportunities, in order to diversify perspectives and to extend the reach of geriatric oncology [8].

1.6. Enable Independence: “Nurture Independent Thought and Creativity”

A mentor’s role, like a parent, is ultimately to enable his/her mentee to become self-sufficient. Dr. Hurria taught us how to develop a research project, write a grant, build and manage a team, and draft and edit manuscripts. Though she was incredibly generous with her time, advice, and resources, she always made sure that the mentee took ownership of the project from inception to completion. In this, she ensured that her mentees experienced firsthand the challenges associated with research, and was there to help guide them through it, supporting them in developing the skills needed to become successful and independent researchers. As we mourn the loss of Dr. Hurria and of her future impact in further advancing geriatric oncology, we also recognize that she has empowered us and many others with the passion, skills, and affirmation to carry on the mission even in her absence.

2. Conclusions

“At the outset of my own career,” Dr. Hurria once said, “I had a limited skill set in research, grant-writing, and scientific communication. My dedication to helping older adults with cancer, coupled with the good fortune of having dedicated mentors in geriatrics and oncology, helped me develop skills in patient-oriented research. I hope to pass this forward to my mentees.” What made Dr. Hurria an exceptional mentor? Her ability to forge deep personal connections with mentees readily and to understand what fueled their passion, to foster collaborations and teamwork, to maintain a positive outlook and view challenges as opportunities, to sponsor others to extend the reach of geriatric oncology, and to continually check the internal compass of our research with those that matter the most – older adults with cancer. Her presence will be dearly missed but it is clear that Dr. Hurria’s legacy will live on in those she mentored as they rise to become leaders in the field and mentor the next generation of geriatric oncologists. Together, we will go far.