Discovering a Career and a Community

Jennifer Davila, M.D.

Jennifer Davila, M.D., is a pediatric hematologist and co-director of the Hemophilia Treatment Center at Montefiore Einstein in the Bronx, New York, where she is also an associate professor of pediatrics at Albert Einstein College of Medicine.

Why I Chose Hematology

My mom says that in kindergarten there was a form that asked, “What do you want to be when you grow up?” and I wrote “doctor.” I don’t remember ever thinking I was going to be anything else — all roads just led to medicine.

I had immune thrombocytopenia (ITP) when I was about 12, and it lasted into college, so that was my first real introduction to being a patient with a problem that deviates from the norm. I needed a bone marrow biopsy, steroids, intravenous immunoglobulin (IVIG) — things I didn’t understand then but certainly do now. I was treated by two hematologists who were both women of color, and I remember seeing them and thinking, “Look at this great thing they’re doing. I can do that.”

I always knew I wanted to do benign hematology, not oncology. With oncology, it can feel very protocol-based: The surgeon gets the tissue, the pathologist looks at it, and you follow a regimen. In hematology, I’m the one looking under the microscope, looking at the smears and assays, making the diagnosis, and figuring out interventions that aren’t always protocol-based. I loved that aspect of it — the discovery part, the curiosity, the “cowboy” part of making it work for each patient.

Being There at Every Stage

When you’re a hematologist, you become like a family member. I've been an attending physician for 12 years now, so there are children who came to me when they were super little and are now taller than me, going off to college. Moms are sending me graduation pictures; the kids are talking to me about their girlfriends, their boyfriends, their choices.

I can look at that young man and say, “I know your target joints, where you’ve bled, what we did to treat you.” You build this incredibly deep relationship with the whole family. When it’s time to transition a patient to adult care at 21, the parents cry. They ask, “What are we going to do? Can we still call you?” And of course they do. Moms still send messages asking, “I know they have a new hematologist, but I just want to make sure you agree with this.”

From Terror to Confidence

What’s so powerful is seeing the arc that parents of children with hemophilia go through. In the beginning, when they have a brand-new baby, the parents are terrified. You’ve dropped this bomb on them — “your child has hemophilia”— and then you’re telling them, “You’re going to be able to inject them, you’re going to know what to do.” A couple of years later, you see the confidence in them. They’ve got it. You think to yourself, “See? I told you.” It’s more than just the child; it’s the entire family, and it’s a beautiful, beautiful thing.

The Value of Mentorship

When I was a resident at SUNY Downstate in Brooklyn, I met a hematologist named Dr. Scott Miller who became a huge influence on me. I always describe him as this grandpa, like a bear. He took me under his wing and talked to me like I was already a hematologist, not just a trainee. He had really high expectations of me, and that mattered — I felt like he saw something in me before I fully saw it in myself.

Years later, when I got my current position, he told me, “You have my dream job,” which was such a powerful thing to hear from someone I admired so much. And then, even later, he emailed me about a patient and basically asked, “What would you do?” It was such a full-circle moment — from being the resident who looked up to him to being the person he reached out to for advice. That’s what mentorship can do.

Filling the Gaps

Not everybody in the world has the privilege of being a doctor, and so if you are one of the privileged, you should try to take care of those patients who need you the most. You have to acknowledge where the gaps in care are — or where the future gaps in care are going to be — and try to fill those gaps so your patients don’t find themselves at some point without someone to take care of them.

We can have all the novel treatments in the world, but if you don’t have a doctor who understands how to use them to bring them to the patient, they’re just novel treatments in the ether.

Representation Matters

I’m a first-generation American. Spanish was the first language I spoke, and I still speak it fluently. When you’re dealing with complex care, it’s very hard to navigate all of that as a person who doesn’t speak the language of the country you’re living in.

So I’ve always felt very lucky and blessed that I went into such a complex area of medicine, because now I’m able to help these patients and explain everything in their language. There’s something very comforting about having someone walk into the room who looks like you and who understands your language.

Embracing the Art — and Uncertainty — of Hematology

With hematology, you have to be somebody who doesn’t get tired of asking questions and really wants to understand the pathology of the patient and how to help them. A lot of my fellows and trainees want to have an algorithm that tells them, “If not this, then this; if not this, then that,” and hematology doesn’t work like that.

I tell them it’s OK to feel uncomfortable with not having an answer. That’s why medicine is an art. Yes, there’s science that is concrete, but there’s also a finesse to it. Part of being a hematologist is being comfortable with that finesse, and knowing there’s not always going to be an easy answer — it may take you a little time to get there.

If You’re Considering Hematology . . .

I always tell medical students: "You have to do what gets you out of bed in the morning, what puts that pep in your step.” I didn’t want to be the jack of all trades; I wanted to be the master of one, to know that thing super well and have people come to me with questions.

If you’re interested in hematology, reach out to a hematologist, go on the American Society of Hematology and Hemostasis & Thrombosis Research Society websites, ask at your hospital, and find someone to shadow. People think hematology is just iron deficiency all day, but there is so much more: pathology, interpretation, research, and these deep, longitudinal relationships with patients and families. If you’re curious and you like asking questions, it’s an incredibly fulfilling field.