By Dennis Rodkin
Gastroenterology, University of Chicago Medical Center
Over the past decade in the United States, the number of new cases of hepatitis C, the most common form of hepatitis, has dropped sharply. So you might expect Donald Jensen—the director of the Center for Liver Diseases at the University of Chicago Medical Center and a 20-year innovator in the fight against the disease—would have shifted to automatic pilot.
Not quite yet. Of the roughly four million people in the United States with hepatitis C, about 75 percent of them still require long-term care. And those long-term patients, says Jensen, continually present new challenges as cirrhosis, liver cancer, and other problems surface. "The next 20 years are going to be a real challenge to us," he says. "We have to fight the wave of complications."
Working at a leading research hospital such as the U. of C. puts the weapons to wage that battle in Jensen's hands. "Patients who come to us have access to the newest drugs," says Jensen, who worked in the liver program at Rush University Medical Center from 1980 to 2005. "Even if those aren't appropriate for them, they know we have them on our radar screen."
In the next two or three years, Jensen adds, several promising small-molecule inhibitor drugs should arrive on the scene; they are offshoots of drugs used successfully to treat HIV. "It's taken longer [to develop the drugs] for hepatitis C because the target was more difficult," he says. "But they are in clinical trials now." (Not all of Jensen's patients have hepatitis C; some have alcohol-related liver problems or fatty liver disease—the second and third most common threats to the liver—and some have one of the other four types of hepatitis.)
Still, a successful doctor cannot rely entirely on medical breakthroughs, insists Jensen, who is involved in four clinical trials of new treatments for liver disease. When treating illness, he says, a doctor's empathetic manner can sometimes be as effective as a cutting-edge therapy. "Putting patients at ease is important," he says, "finding out what their concerns are. And sometimes that takes time"—which is why Jensen gives his patients all the attention he would want if in their position.
"The thing that patients sometimes aren't getting enough of is the communication and consultation that they need," he says—which is why Jensen, the recipient of several teaching awards, likes to treat a patient as another kind of student. "I look at my role with patients as a teaching opportunity," he says. "The time I spend with the patient I want to spend educating them and communicating with them about their problems."
Photograph: Katrina Wittkamp