From a formative interdisciplinary education as an Aggie undergrad to his current role as head of the UC Davis Cancer Care Network, Scott Christensen, M.D., has shared 25 years of learning, caring and teaching with UC Davis and UC Davis Health System.

The oncologist, bioethicist and community organizer reflects on taking a personalized approach to his education and career, on patients’ journeys through the human experience, and about touching lives in a small way at critical moments. Excerpts:

Q. You attended UC Davis for your undergraduate and medical education and have spent the entirety of your career here with UC Davis Health System. In your own words, how has UC Davis shaped your career?

A. I entered UC Davis as an undergraduate in the fall of 1982. I was accepted into a smaller integrated studies program modeled to simulate a small liberal arts college inside a big university, and combining different disciplines, such as the history of literature. Very early on, that informed my opinions of things in abstract ways.

I never had the sense of being yet another person at a big university; there was always this sense of connection. Along the way I was fortunate to bump into people who really supported me, and again, that sense of a personal touch kept me at the institution and instilled a value that I think is really important. Very simply put, I’m motivated to touch others in a meaningful way.

When I was looking around at medical schools one of the decision-making points was that I needed to feel comfortable; the environment was really important to me. I appreciated that my medical school class was a very diverse group of people; we weren’t all the same age, and that I think was really important as well. We had a lot of support to pursue our own things in some ways. Perhapsone of the best things I can say is that UC Davis is an institution that let me be me. It doesn’t feel as oppressive or conforming at Davis and I always appreciated that.

Q. What are some things you took from your medical education here that still hold true for you today?

A. My primary goal was to be a clinician. I don’t think that I could have received a better training program for that goal. All of the other things that are foundational and important relate to individual mentorship, examples of caring and a fundamental respect for human beings as individuals.

Q. You have chosen to channel your work into cancer care and also hospice-related endeavors. What are the rewards and challenges of working with patients battling life-threatening disease, often over the long term?

A.I knew that I was probably going to go into oncology from a very early age. My first experience in health care was serving as a volunteer in an oncology ward when I was 16 years old. Some people describe a calling or a passion, and while I don’t know if I appreciated that at the time, I always had an interest. I also knew that I needed something that had intellectual challenge, and most everything does, but again it’s finding that thing that challenges you. And so, combining complexity with diversity in breadth, oncology seemed to be a really nice fit.

When I was in medical school, not by design or request, I rotated through pediatric oncology, surgical oncology and medical oncology, and in each one of those experiences I found that I enjoyed it a great deal. It wasn’t a difficult decision to go into internal medicine, which is the first step, and then to subspecialize in oncology.

Now what motivates me is the relationship to the patient and the individual journey that they are on; how I support and guide that, and how I can touch people in a meaningful way at a very critical time in their lives. Even if patients have a disease state that we are going to cure, it is a transformational diagnosis. This is the kind of thing that gets peoples’ attention; relationships thrive or wither; new insights are gained. It’s really a very moving human experience and to be a part of that is really a gift.

Q. As medical director of the Cancer Care Network you work to extend the reach of our academic cancer center to other communities that may be lacking such resources. Why is it important to reach these communities and what has the impact been?

A. We are one of 69 cancer centers designated by the National Cancer Institute in the United States, and part of our commitment and responsibility under that designation is to translate our innovations into the community. We’ve partnered with and helped to build cancer center programs, and over the past 15 years our affiliations have helped to fundamentally alter oncology care in those communities.

We believe that by uniting the strengths of an academic center with the strengths of a local community provider — and they are different — magic happens. One of the fundamental missions of the University of California is to improve life for the people of California, through education, service and research, but that doesn’t just mean in the zip codes that border our campuses. To me, the Cancer Care Network is a very meaningful demonstration of university involvement in communities in California to effect real change. Substantive contributions to improving oncology care can range from increasing our clinical trial therapy base — an opportunity to raise the bar in cancer medicine — to improving professional standards and leveraging important resources and services not otherwise available in small communities. When it works well it’s a win-win.

Q. How has medicine for cancer patients evolved, for example, through the use of molecularly targeted therapies, or non-medical approaches in breast cancer care? What is your own approach and philosophy of care?

A. In my career there have been both big and not-so-big changes that have been transformative. The concept of multidisciplinary care has really grown. Things have become less physician-centric. It’s not that physicians don’t still play an important role, but there is increased awareness that other disciplines have important contributions to make. As the complexity of care and options has increased, you need more people in order to do excellent work.

I am a little concerned that in our rush to embrace patient-centeredness and patient-autonomy, at times it can be misconstrued as abdication of responsibility. I think it’s a difficult balance and a fine line that one always has to be attentive to; it’s one thing to guide and another thing to coerce. When people are at vulnerable points in their life, words matter, body language matters, and one has to be extremely aware of the potential impact that one may be having.

Sometimes the analogy I use is a travel agent: An individual comes to you at Point A and they want to get to Point B, and part of my job is to inform them of the ways that they can get there if possible or if not possible, and to weigh the pros and cons of each particular approach, and to involve them in that decision-making process in a shared manner.

Q. Cancer is a disease that touches most, if not all, of us in some way. How does a community create a supportive atmosphere for patients fighting this illness?

A. Cancer centers are collections of resources; the hard part is organization. Because we are blessed with an abundance of resources, appropriate stewardship of that opportunity is foundational. Maximizing resource utilization and the impacts on the individual and their support systems requires thought and insight. I’ve come to appreciate that there are unique solutions to those questions that work in specific communities. There’s not really a one-size-fits-all approach, but there are themes that everyone can benefit from. One of the really important aspects of the network is that the organizations get to know one another, and they can network and strategize together for solutions to community needs and challenges that they’re facing and for just different ways of doing things.

Q. You are speaking on the right to die at a Cancer Care Network symposium here. Why is it important to bring discussion of these issues into clinical practice?

A. I was a hospice director for about 15 years, and I served as a hospice volunteer as well as a volunteer to HIV-positive patients in the past. Managing end-of-life care has always been important to me. I’ve had the opportunity to see good deaths and not-so-good deaths, so I know experientially that good deaths are possible. I’ve done many talks on end-of-life care and worked with many groups on what that means and how it can be done well, and shared some of my experiences.

In our symposium we are going to be focusing on physician-assisted death since that has become a big topic in California. My involvement is largely stemming from my role as a bioethicist. I’ve served on the ethics committee for over 25 years now and am currently committee chair. We are going to be focusing on the ethics of the recently enacted End of Life Option Act and talking about a specific case and using it as an example to illustrate some of our specific points. We are doing this for an audience of oncologists and allied health professionals in the arena. It’s part of our commitment to begin to have more substantive discussions about what that means and hopefully that will help people to clarify their own thoughts in this arena — but it’s a difficult and complex subject.