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Profile: Lois Ramondetta, M.D.

Conquest - Fall 2008

By Nada El-Sayed

For Lois Ramondetta, M.D., caring for patients goes beyond the conventional doctor-patient relationship, whether she’s seeing patients at M. D. Anderson or at Harris County Hospital District’s Lyndon B. Johnson General Hospital in Houston.

As associate professor in the Department of Gynecologic Oncology, her focus is on having open conversations with her patients and building a stronger rapport with each encounter.

“I try to get to know people so that each time a person comes to the clinic it ends up being a real visit,” she says. “I try to figure out what I can do to help. It’s through those conversations that I find out what gives meaning to a patient’s life. Then I’m able to help her make more informed decisions about what, often times, especially with ovarian cancer, is going to be a terminal illness.”

Creating a relationship with her patients helps Ramondetta go beyond what is generally expected of physicians. It also helps her bring up more delicate issues, like spirituality, which has led to some of her research studies.

“Sometimes, if you let yourself, all you do is go in and do the exam. You say ‘hi’ and ‘bye’ and that’s it. You think, ‘I just had a woman come in to see if she had a recurrence or not’ and then it’s done. There’s no connection. I think doctors have to be careful not to let that happen.”

Personal treatment for the underserved

In Fiscal Year 2000, Ramondetta became part of M. D. Anderson’s initiative that has committed staff to underserved patient populations at Harris County’s LBJ General Hospital. With other part-time clinical faculty members, oncology fellows and research nurses, she works side by side with hospital district employees in both the outpatient gynecological cancer clinic and the inpatient service.

Since 2000, Lois Ramondetta, M.D., assistant professor in the Department of Gynecologic Oncology, has worked two days a week at Lyndon B. Johnson General Hospital in Houston. She operates a clinic on Wednesdays and performs surgery on Thursdays. M. D. Anderson partners with the hospital, a component of the Harris County Hospital District, to provide specialized oncology care at the facility in keeping with its commitment to the citizens of the state of Texas. She is pictured with uterine cancer patient LaToysha Fernandez.

“It’s a very warm clinic about the size of two of these rooms,” she says, motioning around her office. “It has three stalls, walls that don’t go to the ceiling and no doors, just curtains. But there’s always a lot of hugging and laughing. Also, I think the continuity of seeing the same doctors and nurses each time is really good for the patients. It’s very rewarding and personable.”

Another part of her work at LBJ is to conduct clinical treatment trials as well as study the psychological and social barriers to care so prevalent in this patient population.

“Last year, we did a survey assessing anxiety, depression and sexual dysfunction in patients who came through the clinic and found huge levels of sexual dysfunction,” she says. “Now, Mary Hughes, an advanced practice nurse in the Department of Psychiatry, comes out to LBJ four hours a week to see our patients.”

Ramondetta also has collaborated with Charles Cleeland, Ph.D., chair of the Department of Symptom Research, and Eduardo Bruera, M.D., chair, Department of Palliative Care and Rehabilitation Medicine, focusing on palliative care, pain and symptom management to determine who in this patient group might be eligible for clinical trials.

Spirituality: How it affects her medical practice

While Ramondetta has published numerous articles on her clinical research, she says, “The aspect of oncology that is really interesting to me is the whole conversation about what really gives meaning to our lives.”

Book sheds light on 'living a bigger life'

“The Light Within,” a book co-authored by Lois Ramondetta, M.D., and a former M. D. Anderson ovarian cancer patient, Deborah Rose Sills, Ph.D., tells the story of the doctor-patient relationship the two shared.

Written in two voices, it describes two perspectives of dealing with cancer. One is that of Sills, who was being treated for ovarian cancer; the other is of the physician, Ramondetta.

“Someone asked me what I think Deb would want women to know from the book, and I think it’s that cancer is not a gift,” Ramondetta says. “Certainly not a gift, but with every challenge there is opportunity and that opportunity allows for this existential growth as a human being with relationships. It’s an opportunity for living a bigger life than you were living before.”

In the article she co-wrote with Deborah Rose Sills, Ph.D., “Spirituality in Gynecological Oncology: A Review” (published in the International Journal of Gynecological Cancer, March-April 2004), she discusses how reproductive cancers undermine a patient’s identity as a woman and the connection between the healing of the body and the spirit.

“Religion cannot answer ‘how’ questions, and science cannot answer ‘why’ questions. What religionists and scientists-physicians share and what they share with all human beings is the knowledge that all of us ‘will surely die,’” she writes.

Having grown up with no formal religious education, her interest in the study of religion and spirituality didn’t begin until her undergraduate years at Emory University. First, she learned the basics of the Old and New Testaments. Those eventually led her into the Unitarian Universalist realm.

“In school, I was studying biology and religion and couldn’t decide which to major in,” she says. She also participated in a lay chaplaincy program, which she describes as “six months of learning how to listen.”

“I think that was actually a great course for any medical student,” she says. “I really learned how to do some medical journaling about the people I met and then learned how to reflect on that.”

Her research in the past few years has helped her learn to cope more with what is happening to her patients, while helping her learn how they cope.

“I don’t know why, but dealing with patients who are facing a potentially terminal illness as well as being able to do research on spirituality has helped me continue my ongoing attempt to understand those unanswerable questions. 

“I’m fascinated with the people I meet, especially at the county hospital, who reflect on their illness in such a way that is filled with a strength that I think I’ll never have. I’m fascinated to the point that I almost wish I could believe as strongly as they believe because what happens in the end happens to all of us.”

© 2015 The University of Texas MD Anderson Cancer Center