METEOROLOGIST? SCIENTIST? ADMINISTRATOR?

Nope. He prefers clinician, teacher, and farmer.

When he was a teenager, OUM’s David Mitchell, MD, PhD, remembers telling people that he wanted to be a pediatrician. But he also remembers telling them that he wanted to be a meteorologist.

Despite these career declarations, Dr. Mitchell says that, as a kid, he really didn’t put much thought into what he wanted to do when he grew up. And he experienced more places than usual to ponder the future: His father worked for IBM, so they moved a lot, living in several US states from Kansas and Maryland, to Colorado and Illinois. But he did know he liked math and science.

Dr. David Mitchell (second from left) with his children in Colorado

“My first summer after starting college, I remember going for a walk in the woods to find a quiet place to think about what to major in once I got back to school,” says Dr. Mitchell, who teaches pathology at OUM. “I decided that I really liked to learn about what things were actually made of. Like, ‘What’s going on in this tree? In that leaf? Inside our bodies? Way down at the molecular level?’”

He earned his undergraduate degree in chemistry from Brigham Young University, followed by the MD/PhD program at the University of Illinois, starting with his doctorate in biochemistry.

In his PhD program, Dr. Mitchell studied mitochondrial membrane proteins of the respiratory chain; specifically, how cytochrome c oxidase reduces cellular oxygen and creates a pH gradient across the mitochondrial membrane. The primary method of study at the time involved making site-directed mutations in the cloned enzyme, and then studying the effects of those mutations on the function of the enzyme, which would ultimately give indirect clues about which amino acid residues of the enzyme were important in its function.

Research or patient care?

Two years after his doctoral study, Dr. Mitchell graduated from medical school and completed his Internal Medicine residency at Penn State University. Ever the scientist – though he wasn’t completely sure about that at the time – he accepted a hematology/oncology fellowship at the famed Mayo Clinic, where he was exposed to some of the early molecular therapies for cancer, like tyrosine kinase inhibitors.

“In retrospect, I probably should have tried harder to make up my mind a bit sooner on being a clinician or a research scientist,” says Dr. Mitchell of his MD/PhD studies. “At that time, there was a growing interest at academic medical centers to get dual-trained doctors, in the hope that great leaps in understanding and treating disease would be made by individuals with one foot in the clinical world, and another foot in the research world. Eventually, I realized that this intense pursuit would eclipse other important parts of my life, so I made a tough decision.”

He left the Mayo fellowship.

“I had watched doctors at Mayo who taught, saw patients, and did research, and they seemed to thrive. But I think my brain wasn’t big enough for it all. I didn’t want my career to be my life,” says Dr. Mitchell.

But, make no mistake, the decision to leave Mayo was difficult, he says.

“I had three kids and my first son was preparing for college at the time. I can remember thinking ‘Wait, I haven’t even paid off my own loans yet and soon I’ll be paying college tuition for my kids.’”

After leaving Mayo, he began locum-tenens work as a hospitalist, to see if it would be a good fit, at a time in the early 2000s when hospital medicine was growing and evolving rapidly as a specialty.

He cared for patients at hospitals throughout Missouri, Wisconsin, Tennessee, and even Alaska, eventually settling into the state of Ohio, first as the medical director of the hospitalist program at a hospital in Canton. But like many physicians who become administrators, Dr. Mitchell found it difficult to balance the needs and requests of one’s employer with the needs of the patients he took an oath to serve. His work evolved into a clinical assistant professor position in hospital medicine at Northeastern Ohio Universities College of Medicine and eventually chief of hospital medicine at Akron General Medical Center.

He liked teaching

“In 2007, I became a ‘teaching hospitalist.’ It was the first time I taught full-time and I really enjoyed the environment,” says Dr. Mitchell, who hesitated to say that during his first year he was voted Doctor of the Year by the medical residents. “I was happy with the acknowledgement and I have maintained relationships with a number of those residents who have become specialists throughout the country. I knew them when they were interns, so when I see their ultimate achievements, I feel proud to have participated in their education,” he says.

Once his children were grown, with only one left in college, he and his wife began thinking about moving somewhere pretty and owning land. They enjoyed gardening and being outside. They wanted a farm, deciding upon 120 acres in the mountains near Abingdon, Virginia with a small log house built out of reclaimed barn timbers.

“We have orchards, chickens, beehives, mushroom logs, lots of gardens, and dairy goats. We make goat cheese and goat milk yogurt, maple syrup, acorn flour, and like to bake artisan breads,” says Dr. Mitchell.

As luck would have it, there is also a teaching hospital nearby with an internal medicine residency program for which Dr. Mitchell served a one-year period as associate program director. He now focuses entirely on bedside teaching.

“I still love teaching and love the hospital environment. I’m happy to have moved away from pushing papers and spending too much time sitting at a desk,” he says. Dr. Mitchell currently spends about 30 hours each week at the hospital, including rounds with residents – and he also teaches at OUM.

A couple years ago, Dr. Mitchell was looking around online. “I was thinking that, after all, my kids are grown and settled. Do I really want to be as busy as I have been? What can I do yet still be home and able to poke around on the farm?” he says. He found himself looking into online teaching opportunities and came across OUM. He also saw that OUM faculty colleague, Dr. Ingrid Herrmann, lived about an hour away. He emailed her and she directed him to Dr. Paula Diamante, Director of Faculty Affairs.

“I was told that Dr. Brown was finding himself with more administrative duties and needed to step away from teaching pathology,” says Dr. Mitchell. “I was asked to give a guest lecture and began teaching soon after.” He has also recently begun facilitating mini cases for the GI system-based module.

Sympathetic to the obstacles

As someone who was married with three children during his MD/PhD program, Dr. Mitchell says he is sympathetic to the challenges faced by OUM students.

“Early on in a term when we are introducing ourselves, as I hear from those who have families and continue to work, I really admire them for taking this on later in life. I also tell them that ‘I’d be tired.’”

While he understands their challenges, he reminds students that if they are not 100 percent committed to becoming physicians, success is unlikely. To help the diligent, he works hard to make sure that his lectures are challenging, yet digestible. He hopes that his material is not just educational, but also practical.

Next, budding author

As Dr. Mitchell finds himself settling into his comfortable balance of teaching and working on the farm, he has also ventured into becoming a writer.

“I have written some opinion/editorial pieces that have been published on medical websites and in the Journal of Hospital Medicine, but I also have started writing a few medicine-based fiction pieces, one of which is a hospital-based murder mystery,” says Dr. Mitchell. “I have also always been frustrated by news stories that make blanket statements about health like, ‘eggs are bad,’ ‘cranberries are good.’ I’m interested in writing a book to help the general public understand what they see in the headlines, what actually makes something good or bad or toxic at the cellular level.”

He also promises that if (when) he is successful at getting any of these ideas into print, the OUM community will be the first to know.

(September 2020)