Inspiring Women – Doctor Inge Aivas

Interview with Doctor Inge Aivas – “On the Romania-Canada-Great Britain-Turkey axis”

Dr. Inge Aivas – Manager of the International Services Department of Anadolu Medical Center comes from Romania and has studied, specializing through years of training, to become the esteemed doctor that she is today in countries like Romania – Canada – United Kingdom – Turkey, thus creating a link between these studies.

I could outline multiple ways to present the wonderful person Inge, but the most conclusive one is your own presentation. How would you describe yourself?

Inge, of Romanian-Tatar origin, born in Constan?a, who pursued her education in Canada, the United States, and England. When I was 11 years old, my family moved to Canada, but Romania has always been the country with which I maintained a strong connection, spending every summer vacation here, with my grandparents, cousins, and friends. Since 2014, I have been working at Anadolu Medical Center in Istanbul. Through my work, I have the opportunity to come into contact with many Romanian patients, which is also one of the decisive factors in accepting my current position.

The high school period had a decisive impact on your professional future. The practice carried out in the geriatrics department of a hospital, after school hours, left a mark on your decision to pursue a career in medicine. Tell us in detail what specifically from this experience made you choose medicine?

During high school, I had the opportunity to be involved in a two-year volunteer program in the geriatrics department of a hospital. Because both of my parents were busy with work every day, my grandmother, who focused her attention on me, played a significant role in my childhood, and therefore, the time spent in the geriatrics department impressed me greatly. The case of one of the elderly patients I interacted with during this period, a patient whose only son had not visited her for a long time due to a considerable distance, and who felt hopeless, spending her birthday alone, was another important factor in choosing this career.

Being attracted to both exact sciences and humanities, I considered medicine to be the perfect combination of the two.

Since I can remember, I have been a great lover of the arts and humanities, but ironically, at school, I excelled in the natural sciences. It was much easier for me to prepare for math, physics, and chemistry and obtain very good grades than to write essays on sociology or psychology, although I enjoyed reading materials related to these subjects.

Oncology is known to be one of the challenging branches of medicine. What factors convinced you to choose this specialization?

Indeed, oncology is known as the specialty with the highest suicide rate among medical specialties… unfortunately. As I mentioned earlier, I have always felt torn between the loving part of science, technology, and the logical side of my personality, and the emotional part that I have been endowed with by nature and which I can relate to in patients. In radiation oncology, you combine medicine with physics, working with state-of-the-art technology, with photons, electrons, protons, but at the same time, you also work with the patient.

Oncology is generally represented by an older age group. The experience I gained with elderly individuals in the geriatrics department made me opt for this specialization.

Also, the one-on-one exposure played a key role in choosing the specialization.

The satisfaction of working one-on-one with a person who needs your help, determining their treatment plan, and, at the same time, emotionally communicating with them about their loved ones, how they feel, their fears, their supervision as a patient, accesses the human side of my personality.

For an oncologist, it is different from a doctor specialized in other branches of medicine because you become part of the patient’s family and share their tears, whether they are tears of sadness or joy.

After oncology, I made the decision to specialize in neuro-radiosurgery, specifically, radiosurgery for brain tumors. The decision was based on the desire to deepen my professional and scientific knowledge.

The stories of patients diagnosed with various forms of cancer are impressive. How do you manage the various situations you encounter and avoid absorbing the pain of the patients you interact with so that at the end of a workday, what happens at work remains at work, and after closing the clinic door, you redirect your attention to your social and private life?

Support from family, friends, and acquaintances is very important. It is essential to have an active social and private life outside of clinic hours.

Devoting so much time to the profession, spending so much time at the hospital, and being surrounded by patients suffering from various types of cancer at different stages, it is easy to confuse leisure time with work and think that on the street, everywhere, life is full of illness. That’s why, during my free time, I focus 100% on the beautiful things in life, on everything that brings joy to my soul and pleases my sight.

Family support, friends, and acquaintances are very important. It is essential to have an active private social life outside clinic hours.

Dedicating so much time to my profession, spending so much time at the hospital, and being surrounded by patients suffering from various types of cancer in various stages, it is easy to blur the line between free time and work and to think that everywhere, life is full of illness. That’s why, during my free time, I focus 100% on the beautiful things in life, on everything that brings joy to my soul and pleases my eyes.

“Do not put off until tomorrow what you can do today” is a proverb that will be imprinted in my mind for the rest of my life.** When I was a resident, I was on night duty and admitted a patient who later became my patient and was diagnosed with metastatic cancer, passing away two months later, just after retiring.

The patient had shared with me that her dream and her husband’s dream were to save a certain amount of money so that when they retire, they can travel around the world. Unfortunately, she passed away just after retiring, never having fulfilled her dream.

A day later, I contacted my parents, who had been postponing their trip to India for the following year, and I urged them not to delay their journey any longer.

Six months later I was offered the opportunity to do an internship at the Anadolu Medical Center in Istanbul. For a long time I wanted to do an internship in Istanbul and, especially, at this hospital, thanks to the facilities in terms of technology in the field of radio-oncology and related specializations. Learning my lesson, I immediately ventured out!

“Everything happens for a reason”. In 2008, you had the opportunity to follow an internship at the Anadolu Medical Center in Istanbul, and in 2018, you became the Medical Manager of the International Services Department at the respected medical center. Please present the most important moments that best describe the implementation of this proverb in your life.

Looking back, we realize that many things in life happen for a reason.

In 2008, I came to Istanbul – Anadolu Medical Center to follow a two-month internship in the radio-oncology department. During the same period, the international services department was rapidly developing, and Romanian patients were already seeking oncological treatment at our hospital.

The hospital operates on the concept of a “hospital within a hospital,” which means a general hospital that incorporates an oncology institute, including diagnostics, oncological surgery, medical oncology, and radio-oncology.

Being fluent in English, French, Romanian, and being Romanian myself, I interacted with Romanian patients and their companions without the need for a translator. Directly connecting with patients, it was an experience that touched my heart and remained in a corner of my soul.

The two-month internship opened up new perspectives on medicine for me. Until then, I had been involved only in the pure medical aspect of healthcare (medical practice and the doctor-patient relationship). During this experience, I was exposed to how a hospital operates, the various departments that can exist within a hospital, and the types of positions that are not necessarily purely medical but have a tremendous impact on the patient.

This period of practice determined my desire to combine healthcare management with my medical/oncological experience, and I set my goal to pursue an MSC in Health Policy, Planning, and Financing at the London School of Economics and Political Science.

The master’s year at the London School of Economics and Political Science was an excellent experience, allowing me to be involved in projects with think tanks, pharmaceutical companies, NHS teams, etc. During this year, “my new interest” motivated me to start a project with the business school team of the university, creating a computer “pathway” to simulate a patient’s journey through oncological treatment to optimize treatment and systematize the process more efficiently, thus increasing the effectiveness of the hospital’s radiotherapy services.

Staying in touch with my former colleagues from the Anadolu Medical Center in Istanbul, whose international services department had been rapidly growing during this time, in 2013, I was offered the position of operations manager in this department. The offer was ideal for me as it allowed me to combine medical/oncological education and experience with healthcare policy and management.

What services does the International Services Department of Anadolu Clinic offer, and what are the stages of taking over and managing a case?

As I mentioned, Anadolu is a general hospital that includes almost all medical specialties, from check-ups to palliative oncology. Within the hospital, many international patients are admitted, and we provide them with all the necessary support and care, considering them highly important to us.

The International Services Department is composed of almost 70 members, including 13 native Romanian speakers.

For a patient who wants to come to our clinic, there are two ways:

• For a healthy patient who wants to come for a check-up, they can contact us online, by email, or by phone, and we can immediately arrange the necessary appointments. We have various check-up packages based on age, family or medical history, etc.
• For a sick patient, they send us their medical file, which is reviewed by our team of medical specialists, who offer their opinions and recommendations. Based on this, the patient decides whether they want to come for treatment. After the patient’s decision, we proceed with scheduling the appointments.

Once at Anadolu Medical Center, the patient is taken care of by a coordinator who speaks the patient’s native language.

The hospital also has a well-trained and extensive team, as mentioned before, which caters to the needs of the patient. This team consists of three doctors and a nurse who coordinate and supervise the patient, even after they return home.

The team answers the patients’ questions before they arrive at the hospital, organizes meetings with the patient, their family, and all the doctors involved in the treatment to ensure that all the patient’s queries are clarified. In the presented case, everyone, the patient, the family, and the doctors, are on the “same page.” Additionally, follow-up is essential in the overall treatment.

Patient coordinators speak more than 19 foreign languages and assist patients one-on-one with all the hospital appointments and needs, available both in person and over the phone 24/7. Among the facilities provided by the clinic are free transportation from the airport to the hospital and vice versa, discounted rates for our patients in nearby areas. Furthermore, a travel agent helps international patients with hotel and transportation reservations. It is crucial for us, the team, that foreign patients can focus on their treatment.

How important is it for Romanian patients to be addressed by the doctor in their native language, without a third party facilitating communication – in this case, a translator?

For a patient who, in addition to suffering from an illness, travels to another country and comes into contact with a different culture, the possibility of communicating with a doctor in their native language, describing symptoms, and discussing health-related aspects provides a sense of calm and alleviates pain during a stressful period. It prevents them from feeling like they are in a completely foreign world and makes them feel understood.

If you hadn’t chosen to pursue a career in medicine, what other path would you have chosen?

At this question, I know many doctors who would say that medicine is the only profession they would have chosen. However, I believe that I would have pursued a Ph.D. in art history. I say this because, being exposed to illness, pain, and death, during my free time, I found refuge in the beautiful things in life.

When I am in a museum, reading about history, or traveling and visiting historical places, art monuments, I genuinely feel that in this life, there is more than just the sad things that capture our attention. In fact, the beautiful things in life are what make life worth living.

How do you spend your free time?

As I mentioned earlier, “beauty” is well integrated into my life. I appreciate art in all its forms, from painting, drawing, and sculpture to music. I am a member of the Istanbul Foundation for Arts and Culture, which organizes the Istanbul International Music Festival, Istanbul International Jazz Festival, Istanbul International Opera Festival, Biennale, etc.

After a long and tiring day at the hospital, there are moments when I feel the need to retreat to my home to recharge for the next working day. During these times, I like to attend a jazz concert, visit a mosaic art exhibition, or enjoy a concert organized on the platform of the famous Sirkeci Train Station (Orient Express), or at the Grand Bazaar or the garden of the Topkapi Palace in Istanbul.

All these things divert my attention from the tiresome thoughts that I might have while spending the evening alone at home and help me relax.

Movement, going to the gym, also relaxes me. I go to the gym physically and mentally exhausted, but after the workout session, when I leave the gym, I have a smile on my face and feel full of energy. I realized that a workout, done at an appropriate intensity for me, destresses me and helps me organize my thoughts to prepare for the next day.

Over a period of six months, I lost about ten kilograms in weight without following any specific diet but simply because I “befriended” the gym and visited it 3-4 times a week. I feel great now!

Being “a world traveler”, I realized that regardless of where I was at a given moment, even though I was a member of a gym, I did not use the facilities of that gym, not finding it “attractive”. Thus we concluded that it is very important to find, whether we are talking about a gym or a pilates or yoga studio, a place where you enjoy coming back precisely so that the training becomes a constant.

The “gym” where I currently train is in the middle of nature, surrounded by greenery. Although it is in the geographical middle of the city, it gives me the illusion that I am away from the noise and intensity of Istanbul.

I know your favorite form of exercise is Pilates. What made you become consistent in practicing a form of movement? What do you recommend to patients, and not only to them, to achieve well-being and a healthy lifestyle?

I discovered Pilates a few years ago through the FormaSheFitness magazine/website. I started one-on-one lessons, and after the first sessions, I noticed a positive effect on my cervical spine pain and headaches caused by my cervical disc herniation. Another change I observed over time was the transformation of my body shape.

These aspects convinced me to become dedicated to Pilates!

Recently, I was diagnosed with an orthopedic problem in my hips and had to switch to another form of exercise, becoming a new member of a fitness center where I practice other types of training. It is essential to remember that any form of movement is beneficial for the body!

For patients who have just undergone oncological treatment – post-treatment period, whether surgery, chemotherapy, or radiotherapy, I recommend consuming simple foods that nourish the body with healthy calories, combined with movement. What is vital to remind the family and friends of patients, who protect the patient with the best intentions by preventing them from making an effort, is that they contribute to slowing down the patient’s recovery process.

I’m not saying that the patient should go to the gym, but if the patient is in a stage where they can go outside with the knowledge and approval of the treating medical team, it is recommended that the patient should be active. Outdoor walks, even at a slightly brisk pace if possible, are beneficial for the body.

Oncological patients often experience constant fatigue, but this does not mean that the patient has to spend this period “lying down.” As it has been shown, and it is essential to know, exercise has a positive impact not only on the body but also on the mind. A patient with a positive mindset has a better chance of achieving a positive outcome.