Podcast Summary: Blood, Sweat and Smears – “5 Questions with Dr. James Malone”

Date: October 23, 2025
Host: Bjorn Stromses (with possible co-host Dr. Brad Lewis)
Guest: Dr. James Malone, Clinical Associate Professor of Hematology, Stanford Medicine; Colonel and Command Surgeon, US Army Reserves

Overview

This episode of Blood, Sweat and Smears features a dynamic conversation with Dr. James Malone, a leader in both classical hematology at Stanford Medicine and as a Command Surgeon in the US Army Reserves. The hosts pose five focused questions—plus a bonus—exploring Dr. Malone’s unique blend of clinical, administrative, military, and laboratory medicine experiences. Listeners gain insights into the importance of systems-based practice, the impact of laboratory medicine, the value of teamwork, and the critical role of classical hematology across the healthcare spectrum.

Key Discussion Points & Insights

1. Physician-to-Administrator: How Doctoring Informs Administration

[01:08 – 02:31]

• Dr. Malone details the transition from clinical practice to hospital administration, drawing parallels with leadership experience gained in the Army.
• Importance of Clinical Continuity: Remaining an active clinician while serving in administrative roles helps ensure credibility and influence with medical colleagues.
  • Quote: “It was really important to be present clinically to your colleagues in order to be able to influence what they do and don't do relative to hot operations, quality and safety and service.” (Dr. James Malone, [01:56])
• His passion for hematology drives his continued involvement in patient care, despite administrative demands.

2. How Administration Shapes Clinical Hematology

[02:31 – 04:07]

• Emphasizes “systems-based practice”—the need to understand and navigate the full complexity of hospital systems.
• Extensive time spent learning hospital operations improved his clinical teaching and patient care.
  • Quote: “A hospital...it's got all these different departments or organs that work together, hopefully sometimes don't. And the better we understand its strengths and weaknesses, the more we can help others do the same.” (Dr. James Malone, [03:35])
• The COVID-19 pandemic underscored the critical, sometimes underappreciated, role of laboratory medicine.
  • Malone is proud to identify as a laboratory professional at heart, citing early career experiences in transfusion services and coagulation labs ([04:12 – 04:39]).

3. Dual Roles: Army vs. Academia

[04:40 – 06:17]

• Discusses contrasts and surprising similarities between military medicine and academic practice.
• Core competencies in both roles include understanding complex systems, leading small teams, and maintaining mission focus.
  • Quote: “You have to be able to know what your mission is and what your desired end state and goals are....there's nothing that substitutes for just being in the trenches with each other.” (Dr. James Malone, [05:27])
• Highlights the irreplaceable value of in-person teamwork within both military and medical contexts.

4. Case Highlight: Applying Hematology in Combat Zones

[06:17 – 08:58]

• Dr. Malone recounts a recent high-stakes deployment during military conflict, where his specialized hematology expertise was called upon.
• Case involved a young US service member with suspected thrombotic microangiopathy (TMA).
  • He worked with Machaon Diagnostics to perform rapid TMA genetic testing to confirm a diagnosis of an inherited proclivity.
  • Quote: “It was really clear to me that this poor individual had a severe, life-threatening thrombotic microangiopathy....I was able to draw blood specimens from him and Bjorn, with your and your team's help able to rapidly get a TMA genetic panel done.” (Dr. James Malone, [07:07])
• Despite the patient’s passing, the genetic diagnosis brought critical closure and informed family care.
  • “It was critical to be able to tell his family...why we thought his 26 year old brother died...and to be also share with them that yeah, there is a genetic predilection...” (Dr. James Malone, [08:08])

5. Elevator Pitch: Why Classical Hematology Matters

[08:58 – 11:03]

• Dr. Malone highlights the centrality of hematology: the CBC is the most commonly ordered test in the US.
• Classical hematology is foundational, intersecting with every corner of medicine and enabling effective care in diverse scenarios.
  • “There's no corner of patient care where classical hematology doesn't touch. And we're a huge enabler of all these other important life-saving services.” (Dr. James Malone, [10:15])
• Stresses the necessity of on-site hematology and laboratory diagnostic expertise for tertiary and quaternary centers.

Bonus Question: Advice for Listeners

[11:03 – 11:54]

• Dr. Malone encourages listeners to “make yourself uncomfortable” and regularly seek experiences beyond their comfort zones.
  • “Life begins at the end of your comfort zone...It's only when I do that that I start to learn about myself, about others and about the world.” (Dr. James Malone, [11:20])

Notable Quotes & Memorable Moments

• Systems as Organisms:
  “A hospital...it's got all these different departments or organs that work together, hopefully sometimes don't. And the better we understand its strengths and weaknesses, the more we can help others do the same.”
  — Dr. James Malone, [03:35]

• On Teamwork and Presence:
  “There's nothing that substitutes for just being in the trenches with each other. And that's the same whether I'm over there in the desert or...at Stanford.”
  — Dr. James Malone, [05:29]

• On Laboratory Medicine:
  “I've always told everybody I'm a laboratory professional at heart...That's often where my heart lives.”
  — Dr. James Malone, [04:12]

• Why Hematology:
  “There's no corner of patient care where classical hematology doesn't touch....Classical hematology and systems-based hematology is critical to the ability to run tertiary and quaternary care centers.”
  — Dr. James Malone, [10:15]

• Personal Growth:
  “Life begins at the end of your comfort zone....get out there, get a little bit uncomfortable and you'll actually be better off because of it.”
  — Dr. James Malone, [11:21]

Timestamps of Key Segments

• Transitioning from Clinician to Administrator: [01:08 – 02:31]
• Operations and Systems-Based Practice: [02:31 – 04:07]
• Laboratory Medicine’s Value: [04:12 – 04:39]
• Military vs. Academic Medicine: [04:40 – 06:17]
• Combat Zone Hematology Case: [06:17 – 08:58]
• Defending Classical Hematology: [08:58 – 11:03]
• Bonus: Advice to Listeners: [11:03 – 11:54]

Closing Sentiment

Dr. Malone closes by praising the synergy between his military philosophy—“mission first, people always”—and the values of Machaon Diagnostics, emphasizing dedication to both task and team ([12:08]).

For listeners seeking an inside look at the intersections of hematology, hospital administration, and military medicine, this episode offers practical wisdom, deeply held values, and memorable stories from the front lines of patient care and leadership.