The Hematologist

July-August 2016, Volume 13, Issue 4

Open Borders Open Minds

Charles S. Abrams, MD Professor of Medicine, Pathology, and Laboratory Medicine; Director,
PENN-CHOP Blood Center for Patient Care and Discovery, Philadelphia, PA

Published on: June 15, 2016

The ASH Executive Committee Retreat, held each year in the spring, is a wonderful way for committee members and senior staff to work and bond together. It is always rejuvenating and never fails to generate new ways of bettering the mission of ASH. The retreat location is key to stimulating an environment of innovation, inspiration, free communication, and an open and collaborative mindset. As ASH President, one of my roles is to select the location for this event, and this year, the location I chose was Havana, Cuba, which turned out to be the perfect choice. Cuba is a close neighbor of the U.S., yet vastly different in multiple respects. I think that the experience of immersion into a non-U.S. society (something we typically do not have the chance to experience at these retreats) is part of what spurred many of us to be even more introspective and flexible than usual. Furthermore, the sheer cultural richness of Havana and its people added to the mosaic of personalities, augmented the retreat environment, made a distinct contribution to the dialogues in which we participated, and highlighted the extraordinary diversity among the retreat participants. We have so much to learn from one another, and indeed we did.

It cannot be overstated how much this unique setting allowed us to think about our work as hematologists in new ways. We were limited in our use of the internet and cell phones — a shock at first, but ultimately a gift. “Shutting down” from technology for several days allowed for fertile ground to communicate one-on-one even more effectively and intimately.

If you have followed the news over the past year and a half, you know that this trip would not have been possible for ASH without the improvement and evolution of diplomatic relations between the U.S. and Cuba. Until the retreat, for even the most widely traveled among us, Cuba represented, quite literally, an unfeasible destination. Many of us knew that it would be a place frozen in time in many ways, best symbolized perhaps by the fabulous pre–Cold War automobiles. However, the educational exchange with my counterpart at the Cuban Society of Hematology (CSH), Dr. Antonio Bencomo, and with numerous CSH members, allowed us to look into the future of our field, learning about novel treatment approaches, and identifying much more common ground with our Cuban colleagues than some might have anticipated.

We learned a great deal about the Cuban health-care system, which makes free care and treatment available to all. We talked about the use in Cuba of partial splenectomies for pediatric patients with sickle cell splenic sequestration crisis, and about their treatment inductions and consolidation methods for the management of acute leukemia. The latter conversation, among others, revealed many differences between our approaches and underscored that perhaps “the American way” may be neither the best nor the only. In the case of bone marrow transplantation, the ASH and CSH contingencies were excited by the many similarities we share. Moments like these further spotlighted the critical nature of learning from each other across borders. They make us look forward to engaging in more than just one-way talks and lectures, toward opening up more meaningful discussions and interchanges of ideas.

The very roots of the word retreat mean to pull away or to take a step back. And in fact, we were able to use this occasion to step back and reposition ourselves to get a better view of the big picture of hematologic care and what it means to ASH’s members and those whom we serve. ASH exists to help patients with blood diseases worldwide. This is why we help to educate hematologists on best practices, fund researchers, and advocate for better health-care policy. It is why we strive to help hematologists to better understand everything from clinical trials to the molecular basis of various diseases. Our experience in Cuba solidified that there is an incredible value to “bridging conversations,” in which we examine different approaches all across the globe. The reality is that we can do a lot to effect change by reanalyzing the practices we accept as standard. It also became clear that we must do more to examine and understand the availability of drugs in different places around the world, and how that impacts care for all people. This is what it means to be “a global society,” and ASH is at the forefront of helping to make a difference internationally.

ASH programs such as the International Consortium on Acute Leukemia, ( exemplify how building collaborative relationships from nation to nation can make tremendous progress toward standardized practices around the world. And in the same way that we as hematologists are in a constant state of growth and place a high premium on lifelong education, hematology as a whole still has plenty of room to mature and expand. Havana and the Cuban hematologists we met illuminated the importance of looking beyond our own backyards, maintaining open minds, and doing everything we can to share our unique experiences with each other.

To learn more about ASH’s global programs and to become involved, visit

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