Podcast Summary: Blood, Sweat and Smears – A Machaon Diagnostics Podcast

Episode: 5 Questions with Dr. Ebens
Host: Bjorn Stromses (Machaon Diagnostics)
Guest: Dr. Kristen Ebens, Associate Professor, Pediatric Bone and Marrow Transplantation, University of Minnesota
Date: September 10, 2025

Episode Overview

This episode continues the series “5 Questions,” where host Bjorn Stromses interviews physicians working in thrombosis, hemostasis, and related specialties. Today’s guest is Dr. Kristen Ebens, a pediatric bone marrow transplant specialist, who shares candid insights into her journey, her field’s challenges and joys, and perspectives on immunohematology. The conversation moves from medical education gaps and the emotional realities of transplant work to the quirks of medical science and broader advice for listeners.

Key Discussion Points & Insights

1. Medical Education: The Value of Business Acumen

(01:19–04:38)

• What she wishes she'd learned:

  • Dr. Ebens reflects on her training, emphasizing that while patient communication skills were well-taught, business and finance skills were lacking but increasingly essential in current medical practice.
  • “The business of medicine plays such a larger role in every day than I had expected.” (01:35, Dr. Ebens)
  • She describes challenges in managing grants and researching funding, noting the lengthy and complex reimbursement processes in healthcare.
  • Highlights a systemic barrier to innovative therapies, especially cell and gene therapy:
    • These treatments are costly (sometimes $3M+ per patient, exclusive of associated costs), rare-disease markets lack economies of scale, and there’s a pressing need for financially viable, equitable platforms.

• Quote:

  • “We really need experts that can help us devise platform approaches that are financially viable for the field as a whole… someone who has the medical background and a business background...can really be helpful.” (04:02, Dr. Ebens)

2. Managing the Emotional Highs and Lows of Pediatric BMT

(04:38–08:01)

• On coping with “stunning wins” and “heartbreaking losses”:

  • Dr. Ebens emphasizes personal strategies—keeping perspective, staying grounded with family, and respecting both patients’ and family members’ distinct experiences of crisis.
  • The unpredictability of outcomes—even with “perfect” donors and cases—requires constant expectation management and honesty with both families and herself.
  • The field brings enormous highs (solving long-standing medical mysteries, witnessing new life-altering treatments work) as well as lows (grieving when best efforts fail).
  • Hope and continual progress in outcomes keep her motivated despite the challenges.

• Quote:

  • “There are definitely times where I have in my head that…this is going to go smoothly, and then it doesn’t…knowing what a tenuous situation it is and just approaching that realistically is…what keeps me in a sane place with processing grief and losses.” (06:05, Dr. Ebens)

3. Complement Cascade vs. Clotting Cascade: A Lighthearted Debate

(08:01–11:02)

• Bjorn’s playful “fun” question: Which is more interesting—the complement cascade or the clotting cascade?

• Dr. Ebens humorously deflects, expressing no particular love for either, joking about her real-life reluctance to handle coagulation issues, and noting that despite being a hematologist, details change so often she’d rather “Google it” than rely on old knowledge.

• She finds more practical engagement with complement due to its relevance to her patients, especially in cases linked with thrombotic microangiopathy.

• Ultimately, she finds other cellular processes even more fascinating—such as “thymopoiesis” and DNA repair pathways.

• Notable Exchange:

  • “I really don’t like coag.” (08:42, Dr. Ebens)
  • “Nothing has changed since your training.” (08:47, anonymous colleague relayed by Dr. Ebens)
  • “When I took Hem-Onc boards…something in the clotting cascade had changed since I had learned it, and I was livid. These are set in stone things. It's like the Declaration of Independence, right?” (10:27, Dr. Ebens)

4. Immunohematology’s Wide-Ranging Medical Impact

(11:02–14:47)

• On the role of immunohematology:

  • Dr. Ebens highlights how immunology and hematology are deeply inseparable; since blood-forming cells give rise to the immune system, their disorders are intertwined.
  • Stem cell transplant can, in her words, “control-alt-delete” malfunctioning cells—a unique opportunity to cure certain immune or hematologic diseases.
  • She describes the cross-disciplinary nature of immunohematology, requiring collaboration between hematology, immunology, genetics, infectious diseases, rheumatology, and more—patients often move between these fields depending on local expertise and institutional structures.
  • Stresses the lack of specialists and the “stepchild” status of immune-hematologic patients, particularly in adults.
  • Values the learning that comes from interdisciplinary collaboration.

• Quote:

  • “Immunohem is everywhere. I don’t think you can get away from it.” (14:44, Dr. Ebens)
  • “We need more immunologists for sure…peds and adult.” (14:44, Dr. Ebens)

5. The Best Part of the Job

(14:47–17:11)

• Dr. Ebens names two favorites:

  1. People and relationships: The close, collaborative work with multidisciplinary teams and the intense connections with patients and families, especially during difficult times. She values the sense of becoming “part of the family” through these experiences.
  2. Intellectual stimulation and rapid progress: The field’s fast-paced evolution keeps her continuously learning. The growth of cell and gene therapy, once “science fiction, now science nonfiction,” is especially thrilling.

• Quote:

  • “We become part of the family for better or worse, whether they want us or not...that is one of the best parts of my job.” (15:52, Dr. Ebens)
  • “I will never be done learning…and I’m all about that.” (17:07, Dr. Ebens)

Bonus Question: One Recommendation for Listeners

(17:12–18:56)

• Dr. Ebens lightheartedly rejects lutefisk, then offers life and career advice:

  • Never feel stuck; you always have options. Training may feel like closing doors, but you can always redirect, combine interests, and continue making a difference.
  • Extends this ethos to mental health—maintaining openness, recognizing universal and persistent struggles, and knowing one’s choices matter.

• Quote:

  • “Life and your career is what you make it and you never are out of options…You have the ability to make your own choices.” (18:18, Dr. Ebens)

Notable Quotes & Memorable Moments

• On the evolving business aspect of medicine:
  • “The time it takes to get something reimbursed is way different than I would expect when I buy something on a credit card.” (02:44, Dr. Ebens)
• On childhood crises vs. patient crises:
  • “When my kids have something that is like a crisis in their life, it is the most minor thing compared to what a given patient is facing. But I can’t hold them to the same sort of ruler.” (05:15, Dr. Ebens)
• On lifelong learning:
  • “Even just in the last five years, the growth in cell and gene therapy…is phenomenal…It’s like science nonfiction, which is super cool.” (16:42, Dr. Ebens)

Timestamps for Important Segments

• 01:19 – Medical education: gaps and wishes
• 03:35 – The business of gene/cell therapy and access
• 04:52 – Managing emotional highs and lows in pediatric BMT
• 08:12 – Fun: Complement cascade vs. clotting cascade
• 11:19 – Immunohematology’s clinical impact and multi-specialty overlaps
• 14:58 – The best parts of being a BMT physician
• 17:25 – Life/career advice and mental health

Tone and Style

Dr. Ebens speaks with humor, humility, and candor, often making light of challenging subjects while never minimizing their gravity. The conversation is lively, accessible, and loaded with practical wisdom for clinicians, students, and anyone interested in the realities of pediatric transplantation and rare diseases.

Summary prepared for “Blood, Sweat and Smears – A Machaon Diagnostics Podcast” episode: “5 Questions with Dr. Ebens.”