Where Are They Now: Nicole Fleege, MD

Nicole (Grogan) Fleege, MD. Fellow physician (Hematology & Oncology), University of Michigan, Ann Arbor, MI

What were some of the projects you worked on while you were at Iowa and how did this work prepare you for your career? 

As a resident, I was lucky enough to get involved with several oncology research projects. I worked with Dr. [Sneha] Phadke on two projects in patients with breast cancer; one project looked at how patients preferred to have test results communicated to them, while the other focused on how patients with breast cancer presented with metastatic disease. This helped prepare me for my future career because it strengthened my interest in being a breast oncologist, an interest I still have today! I also worked with Dr. [Mohammed] Milhem on a review of toxicities associated with treatment of melanoma. This helped prepare me for fellowship, as I am currently focusing on clinical and translational symptom management research in patients with breast cancer.

What is a “fun fact” (however you want to interpret this) about you that folks here might not know?

I collect coffee cups from every trip I take – I wholeheartedly blame Dr. [Manish] Suneja and Java House for this coffee addiction.

What was most valuable to you during your years at the University of Iowa?

I think the community and mentorship I received at the University of Iowa was truly invaluable. I made lifelong friends during residency, many of whom were at my wedding, and I found mentors that I still reach out to regularly. (Thank you, Dr. Suneja and Dr. [Laurie] Lyckholm for always answering!)

What is one memory that stands out from your time at Iowa?

It is so hard to choose just one memory after having spent so many happy years at Iowa, but after going through pictures, I think it might be when Dr. [Gwen] Beck threw me a “going away” party after I completed my role as university chief resident. I wasn’t done with chief year but I was moving to the VA, so she brought in cupcakes, flowers, and a disco light to celebrate. We had a dance party in the chief office and it was so much fun! Dr. Beck was my associate program director during residency and then the APD I worked with as a chief, so I felt like I could talk to her about anything – and dance it all out – by the end of chief year. A close runner-up was the time that I was the VA senior resident on my birthday and Dr. [Kevin] Glenn brought in a really fancy birthday cake from Deluxe Bakery to celebrate!

What is something you learned at Iowa that you still use in your current role?

“You can’t diagnose a patient until you know a patient.” – Manish Suneja

I cannot tell you how many times Dr. Suneja emphasized that the social history and knowing a patient personally would get you just as close to a diagnosis as jumping ahead to the labs and imaging studies. As a first year Hematology/Oncology fellow, I got called to perform a bone marrow biopsy on a younger patient with unexplained neutropenia. After a thorough conversation about what medications she was taking – and some prompting to include supplements – we realized that her lab abnormalities were due to a zinc throat lozenge she was taking. She stopped the supplement and her labs normalized. She was spared an invasive procedure because residency taught me the importance of a very thorough history!

How do you maintain a life-work balance in your current role?

This one is always tough, but I’ve personally found that I have to take time to recharge in order to maximize my productivity when I’m working. Sometimes ‘recharging’ involves working out (I’m a big fan of Orange Theory Fitness and we just bought a Peloton stationary bike), but spending time with family and friends is also very important to me. When I really need to relax, I listen to a podcast and take my dog, Nala, for a walk. We’ve walked over 250 miles together since quarantine started!

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