In July, Jamie Flerlage ran the Mount Hood ultramarathon in Oregon. She conquered a 31-mile rocky path, with a 5,600-foot elevation gain, along the scenic Pacific Crest Trail.
Why did she do it? “I love new challenges,” says the pediatric oncologist.
Historically, cancer care for adolescents and young adults has been provided by physicians who work in their own niches. At the UR, this takes place in two separate buildings that stand next to each other: Patients are treated at either Golisano or Wilmot depending upon how they are referred into the health system, what door they happened to walk in, their own preferences, or physician expertise.
The same is true in most places, Flerlage says. Her task is to facilitate collaboration — and to bring a national perspective on new treatment trends that lean toward integrating therapies for people of all ages, particularly vulnerable adolescents and young adults. This group can get lost between a focus on younger children and middle-aged or older people, where cancer is more common.
Wilmot and Golisano leaders worked together to recruit Flerlage, MD, MS, as the new Chief and Academic Director of Pediatric Hematology/Oncology at Golisano, and Assistant Director of Clinical Research at Wilmot.
The children’s hospital has a storied and rich history, with important contributions to childhood cancer care, featuring renowned physicians such as Barbara Asselin, MD, David Korones, MD, and Craig Mullen, MD. But, as Korones says, “it’s very healthy to have a fresh perspective.”
Korones has been practicing at Golisano for 35 years, and he evaluated Flerlage (pronounced Fler-la-gee) during her interviews. “She’s smart, a dynamo, and a human with lots of charisma,” he says.
Few would argue with the “dynamo” description. While advancing her career at the extraordinary St. Jude Children’s Research Hospital in Memphis, Tenn., and leading a national group of lymphoma researchers through groundbreaking clinical trials, she and her husband were also raising two young children and tackling various athletic feats. Flerlage has been playing ice hockey since age 3, for example, and already has signed up for an adult league in Rochester that skates at night, after her daughters have gone to bed.
Late this summer, Flerlage and husband, Tim, a pediatric infectious disease and critical care physician-scientist, who is also working at URMC, packed up their busy life in the South and landed in Rochester. A native of smalltown Vestal, N.Y., near Binghamton, Flerlage is excited to begin the next chapter closer to her family — in a place where she believes she can learn and prosper.
The following is an edited transcript of a conversation with her.
Welcome to Rochester! Tell us about yourself and how you became interested in medicine.
I’m an upstate girl. It’s where I call home. My mom and dad are both from Buffalo, and so we have all of our roots here. I really love the New York area.
In high school in Vestal, I was very fortunate to be part of a program called New Visions. It’s a New York state program like no other. For most people, your senior year is sort of a wash, but this program is for career internships and they take it to a whole new level. They offer programs in education, law, communications, business, and healthcare. I was part of the healthcare program.
No one in my family is a physician, and I wasn’t 100% sure what it would look like. But my senior year I spent half a day, every day, in Lourdes Hospital (Binghamton, N.Y.), being able to observe everything from birthing babies to autopsies. These are things I didn’t do again until fourth year of medical school. It was full immersion and exposure: Let’s show you what it’s really like, behind-the-scenes, including sterile processing. I loved every day. I loved all aspects of it.
You were star-struck?
Yes! And, as I think back, I got to see some pediatric cancer patients from Binghamton during that time. I also had a little bit of personal experience, losing a grandfather to lung cancer. We have a very large family and his oncologist from the start cared not just for my grandfather but, literally, for the whole family. I always
wanted to emulate that deep relationship and connection we had with his oncologist from the moment of diagnosis.
My experience with New Visions was the first time I thought about medicine and cancer as something to focus on.
Actually, until that time, I wanted to be an astronaut! I would still love to go to space. So, if somebody said to me tomorrow that’s possible, we might have trouble here. (laughs)
Dan Bursch (another Vestal, N.Y., native and NASA astronaut, who traveled four times to space) came to my high school once and said, “You know, very few astronauts really go to space. Medicine is another aspect of science and a way to learn and grow.” So, it was an interesting intertwine.
I went to Union College (Schenectady, N.Y.). It has an eight-year leadership and medicine program, where you apply to med school and go to college at the same time. It was a perfect merge, allowing me to play hockey all four years while learning leadership in medicine. I loved the focus on leadership. I think from my sports experiences, I learned to really value effective leadership. I can see how much it drives a team and how much further you can go.
What do you think are good leadership characteristics?
A couple of things: authenticity and integrity. And someone that everybody trusts. I say that with a lot of importance.
A team functions well when everybody is able to feel valued, and play at their best. I’ve also learned how to manage peers. We’re all a team. We’re all the same, there’s no hierarchy. In college hockey, I had the honor of being a co-captain all four years and it really taught me how to lead from within. I will always be willing to do anything that I’ve ever asked someone else to do.
Cohesiveness is what drives somebody to be their best…and being part of a team and watching when that happens — and when it doesn’t happen — is very striking.
I also think people perform their best when they know their role and there’s clear expectations. In medicine, I like to understand people on a deeper level, what’s happening in their life. It helps me to meet them where they’re at… You don’t have to be best friends, but you do have to be really great colleagues.
I attended Albany Medical College. When we went to Capitol Hill to lobby for the AMA (American Medical Association), it occurred to me that the people sitting in those seats are making decisions about our health care every day. If you don’t speak up, no one’s going to listen. It taught me that as needs arise, I will be the first to show up and use my voice for our patients and families.
Another fun thing I’ve learned in life is that there are leaders everywhere, in all shapes and sizes. And not just in academics. They are in our community, and they can teach us things. Going out externally to learn leadership styles always brings a different flavor and fresh eyes.
What are your first impressions of the University of Rochester and Wilmot?
The expectation here is that people will continue to grow, and that the institution invests in them. I say that with excitement. The expectations of leaders here are not stagnant. It’s a lifelong journey. Certainly, I have an immense amount of learning and growth to do in this role. There’s also a sense of community. Among the division chiefs, they all meet and support each other.
Getting to work with Dr. Friedberg (Wilmot Director Jonathan Friedberg) is one of the things I look forward to the most. His vision for the cancer center very much made me want to start looking here. His idea — that the Wilmot team is aligned with what patients in upstate New York need — offers a lot of opportunities.
I had been at St. Jude for 11 years, and I am incredibly grateful to have been blessed with an amazing team there. Taking all of the things I learned and bringing them back home to upstate New York is very meaningful, at a university that I’ve found to be very inspiring. It’s a place that believes in the “better together” premise.
What are your plans for the pediatric oncology division?
One is, I really hope to expand the division and to recruit team faculty. The current team is incredibly strong… so, there’s no rush. We need to bring in the right people that are the right fit, to keep the team balanced.
Another goal is to increase our ability to run clinical trials in pediatrics. We will probably need some additional support, and the cancer center is well aware of this.
As we grow, certain aspects of the job will be more exciting to certain people… so, really figuring out what role each person would like to play, and where they’d like to be in three to five years. What are their big dreams and how do we make sure that happens? I look forward to doing that.
One of the concepts I’ve talked about is “visioning,” where everyone has a clear vision of where you’re going. You actually script the goals. Let’s say we’re sitting here on this day and we have a shared goal of bringing in new recruits by September of 2025. In the two years of work in between, you actually script out what that looks like. It brings out value sets.
Another thing I’ve heard here is that people have a life outside of work that matters.
I feel very strongly about work-life balance. We all learned during COVID what tips our balance. Physically and mentally, we need to allow people to fill their cups and come back to work to treat patients that are all-consuming of your heart, soul, and mind. We have to have a strategy for that, as a team.
My excitement is that we’re going to be able to grow the program, and make sure that everyone in the group feels invested and has a shared vision as that happens.
At Wilmot, you will have a leadership role in the Clinical Trials Office. Tell us your thoughts on clinical trials.
Treating cancer patients — better tomorrow than we did today — is what literally drives my soul.
I run the Pediatric Hodgkin Consortium in the U.S. with Stanford University, Dana-Farber Cancer Institute (Boston) and St. Jude, so I have a lot of clinical trial experience. I also synergize with the Children’s Oncology Group (COG).
Clinical trials allow patients access to new drugs, and the rigorous testing of drugs that are making many cancers curable. In pediatric cancer, very rarely do trials create a risk that is worse than a patient’s current options. Usually, clinical trials offer the chance to have less-toxic therapy, or to cure the cancer with less-aggressive amounts of treatment. So, it’s a premise of ‘curing better.’
I look forward to figuring out how we can continue to increase access for trials that make sense for our patient population — and hopefully bring in newer therapies throughout the area.
Because we’re a regional center, we want to be able to harmonize with the other medical centers in upstate New York. We want to harmonize and strategize with them. I look forward to learning that landscape over the next year.
You came to Rochester from one of the world’s best pediatric cancer hospitals. Where do things stand in the treatment of childhood cancer?
Many childhood blood cancers have cure rates of 90% or above. We still have work to do with solid tumors, particularly in neurooncology (brain cancer), and certain acute leukemias.
We’re learning so many things from the genetics of tumors. We’re learning why some patients don’t do as well on standard therapies because they have certain gene mutations, and those genes are able to escape some of the therapy. People have discovered new drugs to overcome some of those “whys” and target those mutations.
This new era… is truly an era of precision medicine that’s started to make a difference.
The things we know now in medicine will not be true at the end of my career, and I love the promise of a better tomorrow. That promise, even in the hardest times, leaves me incredibly hopeful and motivated to continue to do research and to do better.
Why is pediatric oncology rewarding to you?
It’s a common question when I tell people what I do. Although it’s often the worst day of a family’s life to hear their kid has cancer, it is an honor of a lifetime to be there for that family and that patient.
I mentioned that I had the gift of having someone do that for us (with grandfather’s illness), and that has always been motivating. It is my pay-it-forward gift to do it for others.
Kids make me tick. They are so resilient — the things they go through and bounce back stronger. I am inspired and learn from them every single day.
I also love teenagers! I adore them. It’s a really interesting time in life; they are becoming their own people. I can remember being 18 and probably struggling to decide what to wear in the morning. And yet they’re sitting in front of us and we’re asking them to choose between cancer therapies.
Everything is hard when you’re a teenager and young adult. It’s so important to bond with them, to meet them where they’re at — which is sometimes not where we think they should be. But meet them where they’re at. It’s very challenging, but it’s an honor to be part of that phase of their lives.