In Minneapolis, the Hmong and Karen populations continue to grow as people find their way to the “State of Many Lakes.” They arrive from Myanmar, Thailand and Laos. They have often been in refugee camps for months to years before their arrival. And, for some who have immigrated, their challenges are far from over, even after arriving in Minnesota.

“Often,” said Stephanie Fritch Lilla, MD, a 2008 graduate of the University of Minnesota Medical School, “I meet them the first week they arrive in the United States. I can’t imagine what they’re facing and dealing with trying to adjust to a foreign country. On top of that, they are worried about their child and are trying to navigate a complex medical system to ensure their children receive care from our team for thalassemia. Thalassemia is an inherited blood condition that requires lifelong specialty care. Delays in care can cause complications, thus, increasing the urgency of the clinic visit upon arrival to the U.S.”

Dr. Fritch Lilla, a pediatric hematologist and oncologist in Minneapolis, focuses on caring for children with benign hematology conditions. Her areas of expertise include thalassemia and other inherited anemias, bleeding disorders and vascular anomalies. While childhood illness is hard to witness when kids have barely had time to know who they are, much less who they will be, the barriers to healthcare are a big issue. 

“The most challenging part of my work is that medicine has become too much of a business with patients and their care teams caught in the middle,” Dr. Fritch Lilla said. “There are so many barriers and hoops for the families to go through and, sometimes, that means they cannot get the medicine that their child needs. So, much of our time is now spent fighting the system, which means less time focusing on the individual we are caring for. Working to overcome barriers to care in the system is one of the hardest parts.”

Even though the healthcare system makes things challenging for doctors and patients alike, Dr. Fritch Lilla also recognizes that there are “Mount Everest” scenarios that are sometimes insurmountable: “There are things we can’t change but that we want to change. The children who struggle the most are the ones who feel most supported at the hospital and who see the doctors as family because their psycho-social environment at home is challenging for a variety of reasons. We want to be supportive, and it is heartwarming when they feel like they can count on our team, but it’s heartbreaking knowing that their care at home is challenged by so many things that are out of our control.”

Wrought with hard hours and tough nights, the work also has rewards that take Dr. Fritch Lilla back to the beginning when she first considered her future. Before applying to anything, she was on a path that diverged into two – either veterinary school or medical school. “I knew that I wanted to be an advocate for someone or somebody who could not advocate for themselves. I’m motivated by that. I’m called to that,” she said.

Early on, her experience with pediatrics was with Dr. Bronson at what was St. Mary’s and is now Essentia in the Twin Ports area. She saw Dr. Bronson as she grew up and started to think about her career. She also loved the Duluth area, and her grandmother worked as a secretary in the Department of Psychology at the University of Minnesota Duluth. 

When Dr. Fritch Lilla made an early decision to apply to the University of Minnesota Medical School, Duluth Campus, she knew that if she got in, that was where she would love to attend. “The area appealed to me, and the small class sizes and community feel were perfect. My grandma lived close to the campus – about a five-to-ten-minute walk. She had always been a role model to me, and we were very close. It was important to me that I stayed close to her while I could.”

During the summer before her first semester in medical school, Dr. Fritch Lilla volunteered at Essentia in the Twin Ports area. She worked with Dr. Weirmaa who is a pediatric hematologist oncologist. “I volunteered to help in the pediatric hematology oncology clinic, and Dr. Weirmaa kindly took me under her wing and let me shadow her. I took in everything during those visits. Her relationship with patients was what I was looking for, the medical management intrigued me and the team collaboration was exceptional,” she said.

As the years progressed and she experienced clinical rotations before embarking on her own, she realized that in order to pursue the work she really wanted to do, she had to take on a few more years of training. “After my pediatric intern year, I was tired and wasn’t excited about extending my training further, but in order to practice pediatric hematology, I needed to finish my three-year pediatric residency and then complete an additional three-year fellowship in hematology oncology and bone marrow transplant,” she said.

After completing her residency at the University of Minnesota Medical School, she flew to North Carolina to begin her fellowship in hematology and bone marrow transplant at Duke University. “I had never been to North Carolina before my interview. It was a fantastic three-year experience. It was the right choice at the right time. Life outside of medicine was at a slower pace, which gave me time to really benefit from the expertise at Duke and learn about hematology at an amazing depth,” she said.

From North Carolina, Dr. Fritch Lilla returned to Minnesota where she practices at Children’s Minnesota Cancer and Blood Disorders Clinic. She invites medical trainees to experience hematology and is the site course director for medical students, residents and fellows through the Children’s Minnesota Hematology and Oncology Electives offered through the U of M Medical School. The curriculum focuses on clinical experience for medical students during their fourth year, at any point during residency and a first-year hematology month for fellows as well as continuity clinics during their second year.  

“There are frustrations, but they’re not so different from the rest of medicine. In this profession, it’s important to find your people. Find the ones with similar goals who share the same values. They will be there on the hard days, and they will understand what you’re going through,” Dr. Fritch Lilla said. “I’m grateful for my circle and for a profession where there is care for the patients but also care for each other as physicians. Surround yourself with people who really care and want to help others. It’s inspiring and rewarding to work in that environment. It’s rewarding to be that person in return.”