Faculty Interview: Tracy Minichiello, MD

A Conversation with Tracy Minichiello, Professor in the SFVA Division of Hematology

There is a guitar in your office. Who plays?

Tracy Minichiello
Tracy Minichiello,

I wish I could say me, but I can’t. I don’t have any music skills. The guitar belongs to my officemate, Heather Nye (a hospitalist at the VA), who plays and sings. She wasn’t finding time to play at home so she brought it here in hopes that it might inspire people, and it does! People walk by, double take, and then stroll in, sit on the couch and strum. This month we have had a cardiologist, an environmental engineer, and a patient wander in and play.

Where were you born and raised? Tell me about your family, please.

I was born in Boston.  We are Italian with a sprinkle of Irish. My grandfather was one of ten (nine boys and one girl) who were from the west end of Boston, and most of the family stayed in the area. I have LOTS of cousins. While technically I am half Irish, we are very Italian in our culture, our volume, and our love of food. For instance, our Thanksgiving table has a bird but it is usually dwarfed by the lasagna, the pasta, the meatballs, and the bread and everything else.

Who do you hold close?

I am blessed with a handful of amazing women friends who fill my heart with love and my belly with laughter.  But I am closest to my mother, my sister, and my husband. I talk to my mother and sister every day. My mom is an amazing woman. She was a single mom (in my early years) who worked really hard during the day and studied hard at night.  She was always in school: first nursing school, then became a nurse practitioner, then got her Masters, and finally went on to a PhD. She was always volunteering, giving back to the community.  She was quietly powerful as a parent. She did what she did and never pushed her views onto us, allowing us to either follow in her footsteps or find our own paths. How am I like her?  I am a crazy optimist; I see the good in everybody and work to help those in need, but I have only about 1/15 of her energy. Her version of retirement is to teach ESL, volunteer at the homeless clinic, work as a master gardener for her city, campaign with the League of Women Voters, teach in the community college nursing program, and play the flute in a local symphony.   My sister is also a powerful female force who seems to always be running some health-care related empire, and is a fiercely strong advocate for women in business. She is levelheaded, brilliant and big-hearted. She is definitely the older sister who is always in charge. Growing up, we did whatever she said. We still do.   

My husband is a rock. My rock. Formerly a federal prosecutor then in a branch of law enforcement, he is unflappable, centered and cool as a cucumber-- tough on the outside, all heart on the inside. And funny. Really funny. He has changed quite a bit since we met in 2nd grade, but for the better.

When was your last “Aha!” moment? What was your epiphany and what did you do about it?

Something that has dawned on me over the past year or two is the idea that food IS medicine. I realize, the more I read and learn, what a missed opportunity this has been in my education and how I care for my patients. I would like to see this awareness grow to a larger policy level to help impact patients’ overall health and the health of our country.  I have gained tremendous respect for the healing power of foods, and how much damage our standard American diet has wreaked on our population.   Now, I spend more time talking with patients, helping them understand how food choices may be able to help them manage their conditions and prevent and ward off disease. Maybe it’s the Italian in me, but food is an easy way to bond with people. It’s a common language, and patients have been very appreciative of this counsel.

Have you ever gulped at a question asked by your child?

Almost every day, I wonder how to answer her questions. When she was four, she threw this one out from the back seat:  “Well, if Daddy doesn’t believe in God, what will happen to him?” She was distraught that he may not go to heaven. Stalling for time, I asked her what God meant to her, then explained God meant different things to different people, detoured into religious tolerance, bumped up against the theory of evolution, and brought it home with a spin on the law of conservation of energy: that we are all connected and that nothing, or no one, ever really goes away.  Children’s questions make us gulp all the time, especially now, as they question the safety of the world, what is happening today and how the world was different for us than for them. They make us realize not only who we are, but how we want to be seen.  

How do you monitor the impact of pop culture on your child? What do you encourage and what do you filter?

We are constantly grappling with that. We have chosen not to have a lot of technology in our home so our daughter doesn’t have a lot of exposure to television or computers, at least at this point. Still, she does use a device occasionally for school or to watch some heavily vetted program and like most children, she is always asking for more. I explained that science shows devices are not good for brain development.  Her response? “Sometimes, I wish my mom was not a doctor and didn’t know all this stuff." While she has no knowledge of social media yet, we are teaching her now that she is defined by what is inside, not outside, that she has a voice that she must use but not abuse, that her body is a gift to be cared for and cherished and not judged.

Describe why you love living where you do.

We are very fortunate to live where we live, at the base of Mount Tam in a redwood grove near a creek and trails. Nature - that’s my happy place, where my soul is refueled. We spend a lot of time outdoors and walk to everything whenever we can, without getting into a car and using up resources. Our friends in our community are lovely, hardworking people who are thoughtful about their impact on the world, making conscious choices and taking action to change the world.

You came to the VA around ten years ago from the UCSF Health Division of Hospital Medicine. Describe why you love working at the VA.

I loved my time at Moffitt and the amazing things I got to do there. While I miss the people and some of the intensity, I have time here' time to teach, time to connect with patients.  I went from doing multiple things to being able to dive deep into my field of thrombosis here. It’s what I treat and what I teach. The VA faculty is phenomenal and hugely committed to the veteran population. The courage, commitment and integrity veterans share is awe-inspiring; I have tremendous respect for them. They do what they do or did for the rest of us and often receive very little gratitude for protecting our freedoms. It’s important to me to serve those who have given so much to our country.

What life-changing event should everyone get to experience at least once?

Everyone should have a dog (or a cat, I suppose).  We have a mastiff, and she and my daughter are “like sisters”(my daughter's words). Dogs make you think about your choices. They don’t hold grudges and they give you exercise and unconditional love. At the VA, where you see a lot of service dogs, you can witness the power of the human-animal connection.

Share a belief that you suspect may not be entirely true or even possible, but you cling to it anyway.

I want to believe that the earth will remain, filled with natural beauty and that we (humans) won’t destroy it.  I want to believe this for myself and for my child, and for generations to come.

Tracy, thank you very much.

Interviewed by Oralia Schatzman