Blood, Sweat and Smears: "5 Questions with Dr. Kelly Davidson"

Podcast: Blood, Sweat and Smears
Host: Bjorn (guest host, in for Dr. Brad Lewis)
Guest: Dr. Kelly Davidson, Associate Professor of Hematology/Oncology, Section Head for Classical Hematology at University of Virginia
Date: March 18, 2025
Episode Focus: A candid and insightful conversation with Dr. Davidson about the evolving landscape and terminology of hematology, nuances of adult vs pediatric care, interdisciplinary collaboration, medical education, breakthroughs in gene therapy, and a personal recommendation.

Episode Overview

In this episode, guest host Bjorn sits down with Dr. Kelly Davidson for the show's recurring "5 Questions" format. The discussion offers a deep dive into the language, challenges, partnerships, and innovations within hematology—especially so-called "benign" or "classical" hematology. Dr. Davidson brings forward thoughtful commentary on the importance of evolving terminology, shares her experiences working across specialties, reflects on the complexities of adult hematology, and expresses enthusiasm for recent advances in gene therapy. The show wraps up with her travel and reading recommendations.

Key Discussion Points and Insights

1. Nomenclature: "Benign Hematology" vs. "Classical Hematology"

[01:13–03:10]

• Background: The term "benign hematology" is traditionally used to differentiate from malignant (cancerous) blood disorders, but Dr. Davidson finds it misleading.
• Dr. Davidson’s Take:
  • The word "benign" underestimates the seriousness of many conditions (like catastrophic clotting disorders, TTP, and sickle cell disease) that can be life-threatening.
  • "Classical hematology," though somewhat traditional or “old-fashioned,” better encompasses the critical, non-malignant focus of the specialty.
  • Other terms like "non-malignant heme" are unsatisfying because they define the field by what it isn’t.
  • Suggests "comprehensive hematology" as a possible alternative, signaling the broad scope of the field.
• Notable Quote:

  “If you tell someone with catastrophic clotting disorder or TTP or sickle cell disease that they have a benign disease... these are really not benign diseases.” — Dr. Davidson [01:56]

2. Interdisciplinary Collaboration in Hematology

[03:10–04:45]

• Dr. Davidson often finds herself consulting with nearly every medical and surgical specialty, except pediatrics.
• Frequent collaboration with:
  • Pathology/Hematopathology: Weekly tumor boards; specialized diagnosis.
  • Special Coagulation Lab and Blood Bank: Relying on expertise for test interpretation, transfusions, and plasma exchange.
  • Immunology and Rheumatology: Many shared patients with autoimmune cytopenias or overlapping conditions (e.g., mast cell disorders).
• The comprehensive reach of hematology requires constant interaction across departments.

3. Adult vs. Pediatric Hematology – Mutual Advantages

[04:45–06:35]

• Admiration for Pediatrics:
  • Stronger institutional, state, and federal support, particularly for rare diseases.
  • More curative options and higher survival rates for pediatric blood cancers.
  • Lower comorbidity burden in pediatric populations.
• Appreciation for Adult Care:
  • Ability to have direct, mature conversations with patients who can advocate for themselves.
  • Greater therapeutic options, as most drugs are trialed in adults first.
• Notable Quote:

  “By the time they reach adulthood, these chronic conditions—they now have adult disorders too, and it makes treating them even more complicated.” — Dr. Davidson [05:33]

4. Hard-learned Lessons: The Grey Areas of Medicine

[06:37–08:04]

• Medicine is rarely black and white; significant parts remain “gray” and require nuanced judgment.
• Textbook cases are rare, and many diagnoses do not fit neatly into standard categories.
• It's important to recognize limits in knowledge—being open to consult colleagues or guidelines.
• Notable Quote:

  “Our patients didn’t read the textbooks, right? So patients don’t always fit into the box that we like...” — Dr. Davidson [07:17]
  “You’re always learning. I’m never going to know everything.” — Dr. Davidson [07:51]

5. Excitement for Advances: Gene Therapy in Hematology

[08:17–09:28]

• Dr. Davidson expresses greatest excitement for gene therapies and gene editing, especially as FDA approvals emerge for conditions like thalassemia and sickle cell disease.
• Acknowledges challenges: cost, access, toxicity, and long-term efficacy are ongoing considerations.
• Sees these advances as transformative in potentially curing previously chronic, debilitating diseases.
• Hopes for expansion of in vivo gene therapy availability to improve equity in care.
• Notable Quote:

  “Gene therapy [is] really, really an exciting option for our patients.” — Dr. Davidson [09:24]

Bonus: Recommendation – Travel and Reading

[09:40–11:07]

• Travel: Recommends Japan for its calm, respectful atmosphere, modernity, and excellent food.
• Book: The House in the Cerulean Sea; a story about magical children, acceptance, and community—timely and uplifting for today’s world.
• The hardback edition comes with creative blue-edged pages matching the book’s sea setting.
• Notable Quote:

  “It’s a really sweet, endearing story that I think is also very timely given state of the world, so would be a good choice of read.” — Dr. Davidson [10:54]

Memorable Moments and Quotes

• On terminology:

  “Maybe comprehensive hematology…indicate like the wide scope of what we do.” — Dr. Davidson [02:32]

• On lifelong learning:

  “Knowing where to look and who to ask, and that it’s always—you’re always learning.” — Dr. Davidson [07:48]

• On gene therapy’s promise:

  “The goal would really be to be able to get this therapy in the hands of all the patients who need it.” — Dr. Davidson [08:52]

• On her book recommendation:

  “They made the edges of the book blue. This aqua blue of the sea. And it’s just a really sweet, endearing story…” — Dr. Davidson [10:45]

Timestamps of Key Segments

• Introduction & nomenclature discussion: [00:32–03:10]
• Interdisciplinary collaboration: [03:10–04:45]
• Adult vs. pediatric hematology: [04:45–06:35]
• Lessons from practice: [06:37–08:04]
• Advances in gene therapy: [08:17–09:28]
• Travel and book recommendations: [09:40–11:07]

This episode offers an accessible yet thoughtfully detailed exploration of hematology's changing landscape. Dr. Davidson’s insights benefit clinicians, students, and laypeople interested in the rapidly evolving world of blood disease care.