I was accepted to the United States Naval Academy, but then developed medical problems and had to withdraw. After much thought, I knew I enjoyed science, so I decided to become a doctor. After I finished my residency, my wife was still in medical school so I decided to do a fellowship while she finished her training. There was a demand for oncologists, therefore, I pursued a medical oncology career, and I haven’t regretted it for a minute.

I was a bone marrow transplanter for a decade at MD Anderson Cancer Center in Texas, and then I went to St. Louis University to help establish a bone marrow transplant program. After a few years there, my chief told me he needed someone to set up a head and neck cancer and lung cancer program. I resisted, however it turned out to be one of the best things I ever did. So I graduated from being a transplanter to becoming a lung and head and neck cancer doctor from 1995 to 2000.

In 2001, my wife was recruited to University of North Carolina, so I followed her to North Carolina and fortunately Dr. Jeff Crawford at Duke University Heath System, invited me to join him.

Karen Dukelow (a clinical nurse) and I work as a team. We split our time between seeing head and neck cancer patients and lung cancer patients. We offer a comprehensive program, ranging from novel cancer treatments to addressing issues of pain control, nutrition, family dynamics, intimacy, and death and dying.

We’re in the clinic all day on Mondays and Wednesdays and all morning on Tuesdays and Thursdays. On a typical Monday, I wake up at 6 a.m. and get breakfast for my daughters. I drop my younger daughter at school, and by 8:30 a.m. we’re in the clinic. We see about 20 patients, including new patients and follow-ups. We work straight through, and we’re lucky if we’re done at 5:30 p.m. Then I go to my office to enter chemo orders and billing information, schedule tests like CAT scans and bone scans, get blood counts, and return phone calls. I go home around 7 p.m., eat dinner, talk to my girls and my wife, Cherie, and put the girls to bed. By then it’s 10:00, and sometimes I do dictations.

In addition to seeing patients, Karen and I conduct clinical research. To preform clinical research in this field, you need to be in the clinic, face-to-face with patients, so you can hear their questions. We are about to start a new clinical trial for lung and throat cancer patients, a two-week chemotherapy regimen that has proven effective and improved survival in breast cancer. Throat cancer patients often have sore mouths and difficulty swallowing, which can lead to nutritional issues and weight loss, so we are addressing innovative treatments including new lozenges and pain relief maneuvers for the mouth. Patients who’ve lost their voice boxes have difficulty communicating, which rises social and career difficulties that we’re working to address. Finally, there are important family dynamic issues, including intimacy questions that arise when patients start to feel better. Lung cancer patients face similar problems.

Patients teach us how to do new things. Erik Hansen is a good example of that... Erik has advanced lung cancer, so we have treated him aggressively He is intelligent and articulate, and has helped us by reporting back to us outcomes of his new treatments.

Karen and I treat terrible diseases in an innovative fashion because standard therapy is frequently ineffective. In our work, there are a lot of ups and downs. It’s a wonderful job and a depressing job and an emotionally intoxicating job - all at the same time. To me, it’s life.

If Karen Dukelow’s career had a soundtrack, it would be composed of beeps and ringing telephones. The near-constant sound of this clinical nurse’s pager and phone is testament to the tremendous responsibility she has working with Dr. Frank Dunphy to care for patients with head, neck, and lung cancers.

Dukelow helps develop and manage patients’ plans of care, gathers histories and information for new and returning patients, makes sure treatment orders are placed and follow-up care is arranged. She also arranges for patients to see other specialists if needed, and helps address social and psychological issues that arise during the course of their cancers treatment.

After raising three children, Karen earned her degree as a registered nurse in 1982. She worked at a small hospital in Batavia, New York, for a year, and then came to Duke Hospital in 1983.

“That’s when I started working with oncology patients, and I knew that was where my heart was,” she says.

With experience working in several different oncology clinics, Karen is a perfect ambassador for the Duke Comprehensive Cancer Center. She has been a nurse in cardiothoracic surgery, on the bone marrow transplant unit, and in general medicine for oncology and other patients. She also has administrative experience handling pre-certifications and insurance verifications, and supervising the appointment center for breast cancer, thoracic and GI cancers. In 2002, she heard Dr. Dunphy was looking for a nurse on his team and told him she was ready to come back to patient care.

“Karen is great with patients, and she has an excellent work ethic,” Dr. Dunphy says. “Without her, we wouldn’t be able to accomplish everything we do for our patients.”

Karen loves her job, even with its ups and downs. “It’s hard when patients aren’t doing as well as we hoped, or are having complications. We see our patients every few weeks or months, and we really become close to them and their families. They put a lot of confidence in the treatment they’re getting, so we hold their hands real tight going through this. Karen lets her patients know that she is avaible to them and they know they can call on her with any question. “If a patient has a question or concern, they need to have an answer as soon as possible; they can not wait until their next visit to the clinic.

“The most rewarding moments are when patients get a good result of a scan and they say, ‘I want to hug you!’... and then they do!”