Jacob Shreve, MD
Episode 187

Narrator:

Welcome friends to another episode of The Story & Experience Podcast. Join your host, Japhet De Oliveira with his guest today and discover the moments that shape us, our families and communities.

Japhet De Oliveira:

Hey, welcome friends to another episode of The Story & Experience Podcast. I'm delighted to be here at Adventist Health Castle in Hawaii. It's a phenomenal experience to be able to sit across the table from our guest today. If you're brand new to the podcast, we have 100 questions. They progressively become more vulnerable, closer to the 100. They're about stories and experiences that shape this person into the leader that they are today. I'm going to begin with the first 10, and then I'm going to hand over to them and they can pick a number and I'll start with the first one. Could you tell us your name and does anybody ever mispronounce it?

Jacob Shreve:

My name is Jacob Shreve, and despite having a short last name of Shreve, it's in so many ways. Trees, Shreevie, Trivay, just every combination.

Japhet De Oliveira:

Did I say your name wrong as I came out?

Jacob Shreve:

I don't even hear it anymore.

Japhet De Oliveira:

You don't even hear it?

Jacob Shreve:

I just assume that it's something-

Japhet De Oliveira:

Dr. Shreve.

Jacob Shreve:

Yeah.

Japhet De Oliveira:

All right.

Jacob Shreve:

You got it.

Japhet De Oliveira:

All right, that's good. Jacob, great name. I like that too. That's great. So what do you do for work?

Jacob Shreve:

I'm a medical oncologist, so I'm a cancer specialist. I'm also a blood specialist, but my primary focus is cancer care.

Japhet De Oliveira:

Really? Okay. That must be pretty intense.

Jacob Shreve:

It's everyday life for me.

Japhet De Oliveira:

Everyday life.

Jacob Shreve:

Yeah. It's an excellent career.

Japhet De Oliveira:

Oh, wow, wow. How long have you been doing this?

Jacob Shreve:

I mean, I've been in medicine for a little more than 10 years now, specifically focusing only on cancer for about four years. But realistically, ever since I entered medicine, it was within the goal of caring for cancer patients and being within that mindset. So I've been doing medical care for 10 years, but my professional life predates that. I was doing research in a number of venues for a long time.

Japhet De Oliveira:

Okay, all right. So Jacob, where were you born?

Jacob Shreve:

I was born in a tiny little town in Michigan, rural Michigan. A little lakeside town that population would double every summer as the Chicago tourists would fill their summer homes. So a tiny town, sleepy place.

Japhet De Oliveira:

Yeah. Do you ever do the missing for Michigan?

Jacob Shreve:

Oh my God. We're down here, bottom left of the mitt. Yeah, you got it.

Japhet De Oliveira:

Oh my gosh, man. That's great. I lived in Michigan for a few years.

Jacob Shreve:

Oh, wonderful.

Japhet De Oliveira:

In Berrien Springs, near St. Joe for a while. I'm acutely familiar. I'm intimately knowledgeable of those areas.

Jacob Shreve:

Okay, all right. That's fantastic. That's great. Hey, Jacob, when you were a child growing up in Michigan, what did you imagine you would've grew up to be?

I thought I was going to be a pilot.

Japhet De Oliveira:

Yeah?

Jacob Shreve:

Yeah. I don't know. When I was a kid, I was all about airplanes, probably because my grandfather and my father had a love for aviation in general.

Japhet De Oliveira:

Oh, really?

Jacob Shreve:

Yeah. So I guess I thought that, and also I didn't think too much about it. I was not a kid who thought like, "Oh, I'm going to be a doctor one day or I'm going to do this." I just kind of went with the flow, I think.

Japhet De Oliveira:

Oh, really? Okay. So how did it go from becoming the dream of being a pilot or flying some kind of plane to working in medicine?

Jacob Shreve:

Oh my gosh.

Japhet De Oliveira:

Yeah, yeah. I got to hear that story.

Jacob Shreve:

Yeah, that's a doozy.

Japhet De Oliveira:

Okay, all right.

Jacob Shreve:

To simplify it, I just kind of followed what my interests were. I had a lot of interests and early in life I started with some computer programming and electrical engineering. I felt that was really interesting. You know technical quandaries, right?

Japhet De Oliveira:

Yeah, yeah.

Jacob Shreve:

And so I did that a lot and I did that during undergrad and I bounced around and I didn't have one particular major. I would change it. I went to grad school, I really started to focus more on computer science and using computer science to answer questions in various fields, including medicine. And then I concentrated more succinctly on human healthcare using computer science and using genome sequencing and bioinformatics. And I became a specialist in bioinformatics. And then very soon after I realized that this is all interesting and I'm really enjoying it, but I'm publishing articles, but they're not really amounting to much. I'm not interacting with people at that intimate level that I'd like to be. And so I wanted to really kind of segue and go into medicine and bring all that research with me and continue that in that new arena.

Japhet De Oliveira:

Wow. So did you go back and retrain?

Jacob Shreve:

Yeah, yeah. No, I left a good career and went to medical school and kind of start all over.

Japhet De Oliveira:

No way.

Jacob Shreve:

Yeah.

Japhet De Oliveira:

Okay. That's pretty tenacious.

Jacob Shreve:

That's a great word for it. Yeah, it's been described in other ways as well.

Japhet De Oliveira:

Okay, okay. Not as positive.

Jacob Shreve:

Yeah, it's pretty, it feels a bit tenuous when you first get into it, but it was the absolute best decision. I mean, I couldn't be in a better place in my career than I am right now.

Japhet De Oliveira:

Do you have family?

Jacob Shreve:

I do have family, yeah.

Japhet De Oliveira:

Okay. And so were you with your family when you made this decision, or your family came after you went to medical school?

Jacob Shreve:

No, I was with my long-term partner when I made that decision, although I didn't have children yet. And then children were along the way. But really, it's like you can't think too much of the logistics about these things.

Japhet De Oliveira:

You sure? You sure?

Jacob Shreve:

Yeah. I mean-

Japhet De Oliveira:

I mean, you really should.

Jacob Shreve:

You probably should, but that's... Yeah.

Japhet De Oliveira:

Interesting advice.

Jacob Shreve:

Well, honestly, you got to just got to follow your heart and what you're good at. And if you don't do those things, then you're going to be missing out and regretting later. And whatever you do is going to bring some difficult times. I mean, there's going to be struggles and obstacles, but I think that if you have a drive to do something and you ignore it, especially if that drive seems to be helpful to other people in some way, or you're benefiting in some other greater good, I mean, that's really irreplaceable. It's really hard to find those things. You got to embrace it.

Japhet De Oliveira:

All right, Jacob, I'm still, before I get through these questions, it's so interesting for me, but where did this come from? This absolute passion? Were you supported by people who said, "Jacob, go do this. Quit your job, go back to school." Or is this something you just had?

Jacob Shreve:

I never really thought about it. I guess, I think there was a lot of encouragement growing up from my parents that if you're good at something, just work at it. And if it's interesting to you and you're good at it, then that's the best. Because you have a natural predilection, you want to do it. It's something you do in your free time, even if it wasn't part of your career.

Japhet De Oliveira:

That's good.

Jacob Shreve:

And then it segues so nicely. I mean, how can you keep up with somebody else who's doing the same research but they don't love what they're doing?

Japhet De Oliveira:

I like that a lot. Well, that's an encouraging word. We could end the podcast right now, that'd be great. Great insights. Hey, a couple of other just personal things. Are you an early riser or a late night owl now?

Jacob Shreve:

I'm both. I'm both.

Japhet De Oliveira:

You're both?

Jacob Shreve:

Yeah, I don't sleep much.

Japhet De Oliveira:

Really?

Jacob Shreve:

I really don't, but it really works out.

Japhet De Oliveira:

So what's early for you then?

Jacob Shreve:

I get up every day at about 5:45.

Japhet De Oliveira:

Okay. All right, all right. First thought that went through today, this morning at 5:45, what did you think about?

Jacob Shreve:

Thought about driving to work and bring my daughter to school and it's her last week of school, the summer, so lots of big days. Each day has got a little celebration, so looking forward to that.

Japhet De Oliveira:

That's good. That's good. That's fantastic. All right, now when you get up in the morning, I see you have some water with you. Do you drink water, coffee, tea? What's your first drink of the day?

Jacob Shreve:

Black coffee.

Japhet De Oliveira:

Black coffee?

Jacob Shreve:

Yes, sir.

Japhet De Oliveira:

Nothing. And how do you have your black coffee? Is it like drip or espresso?

Jacob Shreve:

Oh gosh, if there's enough time it's going to be pour over.

Japhet De Oliveira:

Oh, really?

Jacob Shreve:

But realistically, these days it's Keurig. I'm so sorry.

Japhet De Oliveira:

You wanted to admit that publicly.

Jacob Shreve:

That's right.

Japhet De Oliveira:

No, no, I hear you. That's great. Hey, that's fantastic. Personality wise, would people describe you as an introvert or an extrovert, and would you agree?

Jacob Shreve:

I think people would probably find me pretty sociable, so they'd probably think it's more of an extrovert. And I don't know, it's hard to classify, but I like my solitude as well. I could definitely spend a good day by myself.

Japhet De Oliveira:

Okay, that's good. All right, last question in this block here, and then I hand over to you. It's a leadership question. Are you a backseat driver?

Jacob Shreve:

Oh, a backseat driver. You know what? That's a great question. I think backseat driving is really difficult. I don't like to be in the position when there's a person who's backseat driving and I'm in the car and I'm the driver and so I try to keep that in mind. I think that the hardest thing about leadership is trusting someone and giving them the wherewithal to do it, and then stepping back and being like, "Well, if you crash the car, you crash the car." But you never get the trust that you receive from your superiors unless you're allowed that opportunity and so I hope I'm not a backseat driver. I try not to be.

Japhet De Oliveira:

That's good. Well, thank you Jacob. All right, where would you like to go first? Anywhere between 10 and 100.

Jacob Shreve:

Let's go with an 18.

Japhet De Oliveira:

18, all right. If you had to eat just one meal for a month, same meal three times a day, what would you choose?

Jacob Shreve:

It'd be a Fairlife farm protein shake from the hospital, because that's pretty much what I already do.

Japhet De Oliveira:

They're pretty good. They're pretty good.

Jacob Shreve:

They really are.

Japhet De Oliveira:

Okay, all right. You already do this. All great, great. All right, where next up to 18?

Jacob Shreve:

We'll crank it up. We can go to 28 this time.

Japhet De Oliveira:

28, all right. Oh, if you had to give, this is great for you. If you had to give an impromptu 30 minute presentation, what would it be about?

Jacob Shreve:

Oh gosh. It'd probably be about stereo building or artificial intelligence. Two things that I would love to talk anybody's ears off about.

Japhet De Oliveira:

Did you say stairwell building?

Jacob Shreve:

Oh, I'm sorry. Stereo. Yeah, stereos. I built a lot of stereos.

Japhet De Oliveira:

Oh really?

Jacob Shreve:

And I continue to build stereos. They just sound nice and it's fun to do. That's great.

Japhet De Oliveira:

So you're a real sound fiend.

Jacob Shreve:

Yeah, I guess so. Honestly, I don't have a very good ear, which really doesn't pair well. I'm not very, I'm a bit tone-deaf I think, but I do enjoy listening to music. Nice, loud music.

Japhet De Oliveira:

Hey, that's great. That's great. Good. Good to hear. All right. That was 28, where now?

Jacob Shreve:

38.

Japhet De Oliveira:

38. Oh, if you need encouragement, who would you call?

Jacob Shreve:

Oh gosh, good question. I think that encouragement for me, it's often bolstered by these longer-term relationships, especially mentorships that I've had throughout my training and my careers. And I'm always struck by the amount of encouragement I receive from a call kind of out of the blue from a mentor. Either they need something or they want to catch up real quick or something. And just rekindling those relationships that you've worked on for years. And then maybe you've gone off in your career and you've done bigger and better things. But speaking with those previous mentors, again, even if it's just catching up and it's not really focused on a particular question, I find few things as encouraging and as perspective driving than those interactions. It's kind of revisiting a childhood town after you've been gone for 20, 30 years.

Japhet De Oliveira:

But come with all that experience and knowledge, you see it differently.

Jacob Shreve:

Exactly.

Japhet De Oliveira:

Yeah, yeah. I like it. Oh good. All right, were next after 38?

Jacob Shreve:

48.

Japhet De Oliveira:

48, all right. Oh, tell us about your best personality trait.

Jacob Shreve:

Oh gosh. Oh boy. Best personality trait. I feel like this is an interview question where you're like, "Tell me something that's really wrong about you." We got to really frame it as a positive.

Japhet De Oliveira:

Okay, all right.

Jacob Shreve:

I mean, really, probably my best personality trait, especially professionally, I guess, would be that I try to be very thorough and this thoroughness extends to how I do a lot of things in my personal life and also my professional life. And when I say thorough, it means this idea of cutting corners or not doing something to its conclusion. I definitely take a lot longer to do certain things because I just want to make sure I'm doing it in a way that I find respectable and complete and that I could be proud of or that's open to scrutiny from whoever and I can stand by it. I feel that's very important, especially I do a lot of research and a lot of the research I do is in arenas where you could very easily get away with certain things, shortcuts and things.

I do a lot of artificial intelligence research, you can imagine it's fraught with shortcuts. And honestly, even patient care things. We do complex diseases and it's very easy to reach for the guidelines and then not dig a little deeper. And especially as the patient panel kind of mounts and you have more patients, there's always things that you could do to be more efficient at the cost of completeness. But I feel that a lot of my worth is from being very complete and thorough. And I think that also comes through with my personal life. My daughter's a bilingual and it's really hard to raise a very bilingual child and you can't do it the easy way. You really got to continuously work at it. I think that's been a very important feature that's helped me achieve the things I've wanted to get done.

Japhet De Oliveira:

Okay. So being thorough in medicine, that must mean taking care of your patients, being thorough with them. And in your field, do you ever feel like it's just too emotionally difficult to be that thorough?

Jacob Shreve:

Oh gosh.

Japhet De Oliveira:

That was a bonus question.

Jacob Shreve:

Yeah, I feel like that's a 58 [inaudible 00:12:55] 48. That's okay, we should go there.

Japhet De Oliveira:

Yeah.

Jacob Shreve:

Yeah, the thing about cancer care is that, I mean, I'm biased, I'm a cancer doctor. It's the most rewarding patient population in medicine. I'm so sorry, other professions, but it's the best one. You just have the best relationships with your patients. Your patients have life-threatening diseases, they take it seriously. They look to you for trust. You have to have good, clear communication. You have to be able to be connected with the patient in order to head off toxicities and understand where they're going on their journey and be able to advise them in ways that are meaningful instead of just guideline driven. It's hard to do that. And you also can't burn out emotionally. You can't have an intimate relationship with these patients for every case who comes through the door.

I noticed early on in my training when I was rotating and working through pediatric hematology oncology, that it was too difficult for me to separate myself from that emotionality. And so I decisively did not pursue pediatrics. With my adult population, I definitely am invested in my patients and it can be emotionally taxing and it often is. Truthfully, today was a pretty emotionally taxing day. But I also feel that I'm granted an extremely privileged position in order to be important in these people's lives. And I think that that trust really balances out the loss that you feel from losing a lot of patients. And then also understanding that these patients, their families feel a loss of so much of a greater magnitude. But it is definitely something that, that's the first thing people ask me, "How can you do this job every day? How can you deal with it?" And it's because the majority of cancers I see are in natural parts of aging, and you're just in an extremely privileged position to assist people with that aging transition and that part of their lives.

Japhet De Oliveira:

Yeah, that's beautiful. Hey, thank you for sharing that. All right, where next?

Jacob Shreve:

Oh, let's do like a 21.

Japhet De Oliveira:

21. That's great. I like 21. Share the best compliment you've ever received. You're like [inaudible 00:15:08] and no, let's go back.

Jacob Shreve:

That's great. That's hilarious. I don't really know the best compliment, but one thing that comes to mind, I remember I was a resident, no, I was a medical school student, little medical school student. And I remember I was really tired. It was in the morning. I was probably up all night. I was in pediatrics, by the way, and I gave a patient presentation of some kid, and it wasn't too serious, it wasn't a serious case. It wasn't very sick, but a hospitalized child. And then I gave the presentation and my superior asked me if I had military experience. I was like, "Gosh, I'm glad I gave that impression." I feel like I'm must've come off very structured, but I felt like that was a good one.

Japhet De Oliveira:

Okay. Hey, that's nice. That's nice. You got it on the dot, all the data. All right, all right. Where next then after 21?

Jacob Shreve:

Let's do a 22.

Japhet De Oliveira:

22, all right. If you could be anywhere right now, anywhere, where would you be?

Jacob Shreve:

Oh gosh. Anywhere at all?

Japhet De Oliveira:

And you can say here.

Jacob Shreve:

Yeah.

Japhet De Oliveira:

No, I'm kidding. I'm kidding.

Jacob Shreve:

Oh gosh.

Japhet De Oliveira:

Yeah, anywhere.

Jacob Shreve:

Anywhere at all. Again, this is in the 40s or 50s for me.

Japhet De Oliveira:

Oh, really?

Jacob Shreve:

Yes, it's not an easy choice. I think it'd be nice to visit my childhood home as it was before. It's been paved over and turned into a different area now. But I think there's a lot of interesting introspection or framing from a more mature standpoint that comes with revisiting those places. I think that'd be an interesting experience to have.

Japhet De Oliveira:

Yeah. That's true. That's true. It's good. All right, brilliant. Where next?

Jacob Shreve:

All right, let's go 64.

Japhet De Oliveira:

64, all right. Oh, when you look back in your life, could you tell us about a moment that's like a, "What was I thinking?"

Jacob Shreve:

Oh, okay. A, "What was I thinking moment?"

Japhet De Oliveira:

Moment, yeah.

Jacob Shreve:

Oh boy. And there's been so many of those.

Japhet De Oliveira:

I'm going to go study for medicine, what was I thinking?

Jacob Shreve:

Oh boy. So I guess thinking back about questionable moments of judgment, I've worked a lot of odd jobs early in life. I guess when I was a teenager, the mindset was, as soon as you're legally allowed to get a work permit, go work somewhere. And so I've worked a lot of just questionable jobs and there are a few in there where I'm like, I could have aimed a little higher. I could have really tried to invest my time in something a little less precarious. Yeah, got a lot of burns in kitchens and that kind of stuff.

Japhet De Oliveira:

But you survived.

Jacob Shreve:

But I survived, yeah. No, they were great. They were great overall. But yeah, I guess I could have probably found some other avenues.

Japhet De Oliveira:

That's good. That's good. All right. All right, where next then?

Jacob Shreve:

All right, let's go to a 72.

Japhet De Oliveira:

72, all right. Tell us about what you want to do when you retire, and then why you're waiting?

Jacob Shreve:

Oh, yeah.

Japhet De Oliveira:

Yeah.

Jacob Shreve:

Oh, that's a great question. Retirement for me is a special time because I feel like that means you kind of have the wherewithal to pursue things that when you're busy and you have your time spoken for, you really can't pursue. There are so many things that I imagine I would like to do when I retire.

Japhet De Oliveira:

All right, like one. Give me one.

Jacob Shreve:

Okay, one.

Japhet De Oliveira:

Yeah.

Jacob Shreve:

So I have this long-term, I don't know, I'm going to call it a fantasy.

Japhet De Oliveira:

Okay, all right.

Jacob Shreve:

But I have a long-term fantasy/idea of opening this multipurpose cafe space/restaurant.

Japhet De Oliveira:

Nice.

Jacob Shreve:

And it's something that I've talked about [inaudible 00:18:35] before, but I mean, it comes from a couple of places. One, it's like I like to cook and bake and those kinds of things, my family does as well. And so it'd be a good space for that. I think that I'd like to open this with the understanding I'm going to lose money. This is not going to be financially viable. But I think that having a space that is kind of community driven is really attractive to me. And so it's like, when I think about community spaces, they're mostly places of worship and parks. There's not many areas in which you can go that are secular, that are functional, that are a place to meet people. And so I've been interested in creating a restaurant environment like that, especially for people who have certain things about their own characteristics that require a little more finesse.

For example, I was thinking about this model of basically being a non-profit restaurant where it's pay what you can for everybody. Where it's like anybody who wants to, you want to have a nice date and you want to have a nice date because you're with someone you care about. You can't pay for it, you come in and nobody even knows you don't pay for it, but you're still treated normal. You have a great time. And then it'd be supported by people who want to donate money, who want to be able to support these kind of things. And so that'd be like one night, it'd be like that kind of thing. Other nights would be like low sensory environments for people on the autistic spectrum who want to be able to have a normal night out without babies crying.

Or another night could be any other kind of developmental disability or anything like this. I read about these different kinds of programs that bring people together who have a shared history of something about themselves that make them unique and it makes them feel so inclusive and special and heard and normal. And I think that bring that to an everyday environment like a restaurant would be great.

Japhet De Oliveira:

That's true.

Jacob Shreve:

I think it'd be incredible and it'd be terribly financially viable, but I think it'd be worthwhile.

Japhet De Oliveira:

That may be part of the challenge, to actually make it financial viable at the same time it's a gift.

Jacob Shreve:

Yeah.

Japhet De Oliveira:

So you want to create a gift for people.

Jacob Shreve:

Yeah. I feel like it'd be just a healthy place to interact and give back and be part of the whole, and it seems like a modern solution for a community function.

Japhet De Oliveira:

Yeah. You've been dreaming about this a lot too. Have you even imagined what it looks like?

Jacob Shreve:

Yeah, pretty much.

Japhet De Oliveira:

Okay, I guess.

Jacob Shreve:

You bet.

Japhet De Oliveira:

I guess. That's great, man. Well, I hope you do that before you retire.

Jacob Shreve:

Yeah, me too.

Japhet De Oliveira:

Yeah, yeah, yeah. You should, you should. That's good. All right, where next. That was 72.

Jacob Shreve:

That was 72.

Japhet De Oliveira:

Yeah.

Jacob Shreve:

Okay, let's crank it up to an 81.

Japhet De Oliveira:

81, all right. What is something you've given you absolute best effort towards and why was it so important?

Jacob Shreve:

Realistically, becoming an oncologist. I know it's such a simple, stupid answer.

Japhet De Oliveira:

No, no.

Jacob Shreve:

But I'll tell you what-

Japhet De Oliveira:

I'm still in shock, it's so right.

Jacob Shreve:

Listen, I feel like I had a claw my way to get here. I mean, it was all sorts of personal struggles and feeling inadequate and oftentimes turning up inadequate. My history's not all success stories and there's been big, difficult challenges and failures. And being where I am today is extremely privileged. I mean, I feel like that's the best way to describe it. I'm very fortunate. I have an excellent patient population. I have a very supportive hospital I work at, my family is thriving. I feel like it's very difficult to imagine all the different ways that I could be in a different situation. And I'm sure I could be content in everything, but I'm very happy that I'm in this place right now. And it was very, very difficult to get here.

Japhet De Oliveira:

Hey, well, but you did it. So well done. Well done.

Jacob Shreve:

Thank you.

Japhet De Oliveira:

Yeah, thank you for doing it. Because I mean, look, anyone who has family or has personally gone through cancer, I mean, having a doctor that cares, it makes all the difference. And somebody who's thorough, it gives you a lot of peace. I mean, that's what you want. You want your doctors to be like not, "Sorry, who are you? What are we doing here? Why don't you give me the plan?" That's actually, it's good. So thank you for that. Where next?

Jacob Shreve:

Yeah, let's do 90.

Japhet De Oliveira:

90, all right. Tell us about how you, this is great for you, tell us about how you overcame a seemingly insurmountable obstacle.

Jacob Shreve:

Oh boy.

Japhet De Oliveira:

I feel like you've done a few of these.

Jacob Shreve:

Okay.

Japhet De Oliveira:

Yeah.

Jacob Shreve:

All right. I'm going to keep it in medicine if that's okay.

Japhet De Oliveira:

Okay. Yeah, that's great.

Jacob Shreve:

And I'm going to be extremely generic, but at one point in my career, I had a patient who came under my care, and I'm going to be very generic and completely non-identifiable. But long story short, serious medical diagnosis and the patient and the patient's family didn't like me. I didn't have a good rapport and it really was out of my control. And it was a situation in which there was just things stacked up against them and myself like getting along nicely. There were other aspects of things that happened before I met them and their perspective was very colored and it was difficult. Every time I saw them, it was difficult. It was like we were barely able to stay in the room together. And the more that kind of atmosphere comes out, that it propagates and it just sets up a bad situation.

But it was also extremely concerning to me because it's like, this person is in a bind, real trouble and this is a terrible way to conclude your life and not have that rapport and not have that trust in things. And there's a lot of things that I think that we do in order to preserve our comfort level in terms of how we speak about ourselves or how we frame our position in a person's life or anything like that. And I was just at my wits end and I had to kind of just remove those and just be extremely blunt, be extremely truthful without that kind of self-preservation language. And it was nerve-racking. It was a difficult time. It was a difficult patient interaction. It was also very effective. I feel like we really just stripped away the trappings of decorum and allowed us to see each other and understand that we're working at, we're partners in this, we're working at the same goal and whatever preconceived notions need to be reconsidered. It was very successful, but my gosh-

Japhet De Oliveira:

That seemed impossible.

Jacob Shreve:

It was, yeah. It was extremely stressful.

Japhet De Oliveira:

Some people, when they go through a difficult thing like that and overcome it and find a solution, feel like they are so much stronger. Nothing phases them after that. Do you feel that way or do you feel like, hey...

Jacob Shreve:

I do not feel that way. I feel like I can be phased very easily.

Japhet De Oliveira:

Okay, all right.

Jacob Shreve:

I'm full of phases.

Japhet De Oliveira:

All right, all right. That's good. That's good. All right, that was 90, so we actually have time for two more. Can you believe that?

Jacob Shreve:

Oh my gosh. Yeah.

Japhet De Oliveira:

Where'd you want to go?

Jacob Shreve:

Yeah, well, we'll do an easy and a hard.

Japhet De Oliveira:

Okay.

Jacob Shreve:

So let's start at a, let's kick it back to 16.

Japhet De Oliveira:

16, all right. Tell us about one of the places you've traveled to and why you want to go back.

Jacob Shreve:

Oh my gosh. I went to Japan several times. It's a beautiful country. I love the countryside. I love renting a car, driving on the wrong side of the road, getting lost. You can't understand the GPS anyway.

Japhet De Oliveira:

Do you speak any Japanese?

Jacob Shreve:

Just enough so I don't understand. It tells me to go straight, I get that part, and then after that, I don't really get it.

Japhet De Oliveira:

Good for you.

Jacob Shreve:

Yeah, yeah. No, I think that's a lot of fun memories of cruising around Japan and exploring locations and things.

Japhet De Oliveira:

Beautiful.

Jacob Shreve:

So yeah.

Japhet De Oliveira:

Beautiful.

Jacob Shreve:

Crazy.

Japhet De Oliveira:

Where [inaudible 00:26:32]?

Jacob Shreve:

Okay, well, I mean, we'll go between 90 and a hundred. So let's take a 99.

Japhet De Oliveira:

99, all right. Oh, this is really good for you. Jacob, what is the most difficult truth you've ever told?

Jacob Shreve:

I think for the most difficult that we've told people in our lives, there's two answers. There's our personal life difficult truth, and there's our professional life.

Japhet De Oliveira:

Sure.

Jacob Shreve:

The personal lives, I feel like that's like 109. I feel like that's not a 99. But for my professional life, I mean, I'm sure you can understand what it would be. And it's that there's no more options left. I mean, when I'm treating people for difficult diagnoses, eventually you get to a point where additional treatment doesn't make sense. And you try to make sure that when you're connecting with a patient and you're setting expectations that there's no surprises. You don't want to be surprised by these things. But every once in a while you get to a situation where it's difficult for a person to come to terms and understanding of their situation.

And you have to lay it out for them clearly, that despite them wanting to have additional treatment, it will hurt them and not help them and you really can't ethically offer that. And you have to explain that there's no additional options. And that's extremely difficult. And it's even more so when you have a young person and so young people with difficult diagnoses, there's no way around that hardship. There's no magic bullet that I could use in order to get out of that bind. And so you have to just meet them at that level and be horribly honest.

Japhet De Oliveira:

Jacob, it was a privilege to be able to talk to you. Thank you for sharing these stories. And anyone listening to your story will think, "Man, maybe I should go back to school, try something else and do good with it." I mean, I can only imagine about that. But thank you for being so honest. I encourage people to do the same.

Jacob Shreve:

Yeah. And I want to end this by saying that despite a lot of these questions, we're digging deep, we're looking for difficult situations, so I expressed a lot of that about cancer care. Honestly, my profession is beautiful. Cancer care is a gift. It's a beautiful situation to be in. And I have so many more positive stories and stories of life and continuance and acceptance and growth and natural ways of living and just being a human than I do of misery and grief. And so-

Japhet De Oliveira:

I believe, I believe. And yeah, I understand that actually very well. And so I'm very thankful that you are in it. I'm very thankful that for whatever reason, you chose to make this the major change in your life. I mean, you're helping people every day with this, so thank you for doing that. I encourage people to do the same thing, sit down with a friend, ask them good questions, and we are transformed by it. We're changed by it. So it's a good thing to do. God bless you. And to everybody else, we'll connect again with another story soon. Take care.

Narrator:

Thank you for joining us for The Story & Experience Podcast. We invite you to read, watch, and submit your Story & Experience at adventisthealth.org. The Story & Experience Podcast was brought to you by Adventist Health through the Office of Culture.