Imagine guiding patient after patient, family after family, through cancer’s relentlessly brutal repercussions day in, day out, for more than 25 years. If you or a loved one have endured the ravages of cancer, you know the upheaval it causes, and you understand the extraordinary strength needed for a patient and family to persevere. Surviving this
storm tests limits and sometimes breaks them. To weather that storm on a daily basis—in volume—and not burn out takes an extraordinary person. Philadelphia is lucky to have just such a person fighting for our cancer patients and their families. Meet Greg Garber, Director of Oncology Support Services at Jefferson Health.
Talking with Garber about his critical role at Jefferson, his hand-in-glove collaboration with Legacy of Hope, and his love for running left me refreshingly hopeful. He’s a straight shooter—no fluff, no posturing, and not one iota of attitude. Just nuanced, caring insight based on decades of experience. Garber exudes a genuine, nearly palpable, care and concern for doing right by the cancer patients seen by him and his team at the Sidney Kimmel Cancer Center. Even after 25 years, it’s clear that he’s not been burned out by demanding work with Philly’s oncology population. And Philly is better for it.
Garber shares that he avoids burnout by diversifying what he does. Not doing all direct practice certainly helps in that regard. He guides his team to ask important questions and come up with innovative solutions, which in turn helps them make big impacts. “We’re always willing to try something out and see if it works—and be okay if it doesn’t, as long as we learn from our mistakes. We see what we do as kind of a continuous quality improvement project, in terms of how we can best meet the needs of our patients and their caregivers. My team is amazing; I’ve never worked with a better bunch of people. They blow my mind every single day. They’re fiercely dedicated, interested, devoted. Any one of them could just pick up tomorrow and go into the private sector and probably do a lot better financially, but they stay and do this work; and that’s tremendously inspiring to me. Not a week passes that I’m not awed by things done by our team, by our patients—their bravery, determination, sitting in a very frightening place and allowing strangers essentially to take care of them. We have the opportunity to break down barriers, break down healthcare disparities, to really think about how we are taking this opportunity of illness to work with our patients, to create some kind of lasting, meaningful change—meaningful to them, to us, to their families.”
“Somebody said to me early on in my career when I was working in another cancer center, ‘Do you have any idea how hard it is to sit in a chair when you’re getting an oncology, a chemotherapy infusion from a complete stranger? And the amount of trust that is inherent in that?’ And it has stuck with me to this day. What an awful experience! To not run out of the room, or say ‘I am not doing this. Like, I don’t know you. This is a toxic drug that could be beneficial, but this is scary. Watching that day in and day out is inspiring.”
“This perspective is critical. You can go out there and look at all kinds of support programming throughout the country and much of it is wonderful. But the question that comes to me is: is this stuff truly patient driven? Are we giving patients what they really need? Asking that question, and working with our team to get into the hearts and the minds of our patients, and address their needs is incredibly satisfying, and helps stave off burnout. Fighting for new positions and other administrative things I do are exhausting, but there’s a lot of good stuff in there too. You can find some really nice wins, and with those wins comes rejuvenation.”
Perhaps one of the biggest recent wins for Garber and his team has been helping to create the Emergency Patient Support Network by collaborating with Legacy of Hope. “Mike [Rowe] and Gina [Mancuso] are two of the most patient-centric and driven people I’ve ever met. That they have identified and operationalized ways to address food insecurity in our city—which has a long history of chronic food insecurity, and food deserts, and poverty—I think is fantastic. And looking at oncology or cancer on top of that?!? Honestly, we weren’t connecting the dots, you know? Yes. We thought about it. A patient comes in, they need groceries. We of course can get them groceries, but now we’re taking a systemic approach to address the problem, and not just putting fires out.”
Garber’s commitment to patient centrism has helped his team understand and identify the problem in order to address it, and to do that comprehensively. “All this has started a fantastic conversation and initiative with Legacy of Hope, the Philadelphia Police Department, Brown’s ShopRite, our Population Science Department, our Patient Support services, and our Welcome Center. It’s gotten all the right people into the room.”
Garber elaborates, “The cancer world is aware that food insecurity is an issue, and what we are doing in Philadelphia right now is probably quite novel in terms of boots on the ground and working academically and clinically to understand the problem. Looking at patients more holistically exposes factors that might otherwise preclude them receiving those treatments; and helps to effect positive change in their disease, survivorship or long-term living. Put more succinctly: what good is a treatment that can cure disease if the patient can’t get to that treatment? Imagine receiving three cycles of a cancer treatment drug, but you need four, and you can’t find somebody to watch your young children so that you can get to your treatment. These kinds of situations are tremendous determinants of health and can compromise outcomes.”
From Garber’s perspective, illness provides an interesting opportunity, in that people become very vulnerable in a short period of time. Vulnerability presents an opportunity to ask critical questions. “Where and what are your needs? How can we help you, do better, what can we do differently? We want to be helpful and do it in a way that makes sense and works.” Garber has his team asking all the right questions, which gives everyone involved the wins so crucial to enduring the process. But perhaps most essential to his longevity in this taxing profession is his humility—“Once we think we have it all figured out, we’re in trouble. We lose something. There’s always something to learn; that’s exciting and definitely staves off burnout.”
Garber is thankful for the extraordinarily supportive leadership in the Sidney Kimmel Cancer Center “They’ve believed in us for years. It’s important that medicine is able to reduce things in order to understand the nature of illness and its mechanisms. But there is so much more to the picture than just treating the illness, and this has been recognized by many organizations. The federal government, National Institutes of Health, National Cancer Institute, have spoken about person-centered care for years and have finally (more or less) mandated that approach. Only recently has the person-centered approach been more fully embraced in the cancer world. I’m thankful that there is more and more recognition of the importance of the whole; because it takes more than a village—we need the physicians and medical assistants, we need the social workers and the people who greet patients and check them in, we need the lab scientists.”
“There’s considerable evidence that supporting patients, in terms of symptoms, from a social work perspective, providing nutrition and financial advocacy, that they do better, and it costs less to care for them—resulting in fewer hospitalizations and ER visits. The real world pays attention to economics; we do too. But good care and economics aren’t mutually exclusive. When you do this well, it accrues to everyone’s benefit—to the patient, to the caregiver, to the hospital, to the provider, to the health insurer, to to society. It’s win-win.”
Garber started running some 20 years ago. He was between jobs, bored, took some time off, and started running one day. He quickly built up from there. Then his oldest daughter, Maddy, with whom he regularly runs on team ,Achilles, decided to run with, Back On My Feet when she was about 12 (she’s 26 now). “We did that for a couple of years—three times a week at 5:15 in the morning. In East Germantown, West Philly, and Mount Airy; it was phenomenal. Having that great kind of leveling experience of running together—whether you’re living in a shelter, have a long history of substance use disorder, or may have been incarcerated—it was fascinating. We did that for a couple years, I continued running, really got into it and did more races. I have one marathon under my belt, the Philly. It’s brutal. I don’t have any desire to do another. Four and a half hours is a long time to run, everything hurts. But it was cool because Philly’s run community saw me through—I was in Manayunk, running on Kelly Drive with five or six miles to the finish line. I was practically in tears, but people were cheering me on from the sidelines; that really kept me from throwing in the towel.”
While marathons are apparently off the table for Garber, he finds half marathons to be “a good distance;” he’ll be at the starting line on March 26th to run this year’s, Love Run Philadelphia Half Marathon. When asked about finish time goals, Garber responds in a way that typically eludes younger runners “As I get older, I find that I do better running based on how I feel that day. I want to finish the race healthy; I want to have fun. Years ago I would set time goals. But as you age, time goals sometimes result in injury. Any runner who is not 25 years old understands that—if you anger your meniscus again you’re back in PT and sidelined. I love running so much that I’m willing to give up the PR to be able to continue.”
Running is clearly a passion of Garber’s, but it’s not the only way he keeps the wind in his sails “I love to read. I love to ski, which I don’t get to do too much. I like to cook; both of my kids cook. I love traveling with my kids, my family. I’m interested in keeping well rounded and learning new things.” Perhaps his most telling response was this: “I think when we stop learning, when we stop asking questions, we die a little bit. It’s critical that we continue to push ourselves and strive towards doing things better, not just take the easy satisfaction. I think that that’s what creates greatness.” Garber espousing this standard has no doubt created great outcomes for countless cancer patients in Philly. It wouldn’t hurt for all of us to cultivate the same mindset.
,Donate to Greg’s fundraiser to help provide emergency support for cancer patients in Philadelphia. Better still, register for the Love Run Half Marathon through ,Philly Runs Free, and have your registration fee waived when you raise just $250 for Legacy of Hope. We’ll see you at the starting line.