Vascular Voices: Mara Nuñez Toscano, M.D.

In this series, World Thrombosis Day shares interviews with members of its Scientific Steering Committee. In today’s profile, read about Mara Nuñez Toscano, M.D., Attending Physician in the Hematology Department, Instituto Nacional de Pediatria, in Mexico City, Mexico.

Why did you choose to pursue a career in the hematology field?

There are many reasons I chose to pursue this field:

• Impact on patient health: As a pediatric hematologist, I understand that it is essential for the diagnosis and treatment of blood disorders such as anemia, leukemia, lymphomas, coagulation disorders and hemorrhages. This means that as a hematologist, you can significantly improve the quality of life and, in many cases, save the lives of your patients, and know I am involved even in the liver transplant, which means the hematology is spread in diverse sites.
• Challenges and complexity: Hematology is a discipline that combines clinical medicine with lab, making it a challenging but stimulating field. Diagnoses can be complex, and hematologists should always be learning about new techniques and advances in treatment.
• Innovation and breakthroughs: Hematology is an ever-evolving field, with advances in genetics, targeted therapies, immunotherapy and stem cell transplants. This offers the opportunity to be at the forefront of medicine and to participate in the research of new therapeutic options.
• Diversity of disorders: It covers a wide variety of disorders, from benign diseases, such as anemia to malignant pathologies, to leukemias and lymphomas. For me, especially the coagulation field, with a lot of questions, there are many areas to study and so many challenges to fight, this gives the hematologist a variety of clinical cases, which makes their medical practice interesting and diverse.
• Interdisciplinary collaboration: Hematologists work closely with cardiologist oncologists, pathologists, radiologists, surgeons, laboratory staff and other specialists. This fosters a collaborative work environment where shared decisions about patient care can be made.
• Professional satisfaction: Many hematologists are attracted to the idea of being able to offer effective treatment to patients with diseases that, at other times in medical history, did not have many options. Hematology makes it possible to make a real difference in people’s lives.
• Research: Hematology offers many opportunities to explore new forms of treatment, and to explore the need for treatment.

In short, being a hematologist is a choice that can offer you the satisfaction of solving complex problems, the possibility of making a tangible difference in the lives of patients and the opportunity to be at the center of cutting-edge medicine.

What is an average day like for you in the clinic?

On my regular day, I have 3 to 5 consultations with my fellows. I have two clinical days where I see 15 to 20 patients related to benign hematology, bleeding and thrombosis diseases in the pediatric population. Some days, I collaborate with the procedures that we have to do as bone marrow aspirations, lumbar punctures, etc. I also participate in the education of medical students, residents and fellows.

 What inspired you to join the World Thrombosis Day Steering Committee?

I was inspired by the desire to be able to contribute to spreading the knowledge of thrombosis in pediatric patients, to be able to meet other doctors dedicated to the care of the pediatric patient, to know the risk factors and how it is possible to prevent or treat it appropriately, as well as to demystify the fact that a pediatric patient does not have thrombosis.

 How do you rate awareness of thrombosis in Mexico? Is it generally understood among the public?

The knowledge not only in Mexico, I think, but in all of Latin America about thrombosis is not that much. In general, the population does not know about thrombosis. Through SOMETH I have been able to increase the knowledge in the general and medical population about thrombosis, and that is much less within the pediatric population and those who care for them. That is why being in an international society, especially as part of this committee, allows me to increase knowledge about thrombosis.

 What are the biggest challenges you see in thrombosis treatment and prevention?

Being able to accept that thrombosis exists in children in particular, the lack of knowledge of risk factors, not having the clinical suspicion, and most importantly, the barrier that exists within even health professionals to apply prevention known as thromboprophylaxis and to demonstrate that there is a thrombosis to give adequate management. I believe that being able to spread knowledge about thrombosis will allow us to break down these barriers.

Are you working on any interesting research projects right now?

I am currently working on the development of a thromboprophylaxis committee for pediatric patients at the institute in Mexico where I work, as well as a small local guide that will allow us to provide homogeneous treatment for thrombosis in pediatric patients. In the area of ​​hemorrhage, I am designing some strategies for diagnosing von Willebrand disease and changing the concept of carrier in female patients with hemophilia.

What are you most proud of in terms of Mexico’s work for World Thrombosis Day and blood clot treatment and prevention?

The work that has been done in these years with SOMETH, spreading knowledge about thrombosis with workshops in hospitals, including medical and psychological management for patients with thrombosis, as well as thromboprophylaxis workshops, we created a drawing contest for children and adolescents about thrombosis. We even created a playlist on Spotify to keep us active, as well as activities on Avenida Reforma, an important avenue in Mexico City, with the general population informing them about what thrombosis is. I am very proud to be part of all these activities that we have promoted at SOMETH.

 What do you enjoy doing outside of work?

I love being with my family. Reading is one of the things I enjoy the most — I must confess that I love Korean series and something that I undoubtedly love and enjoy is traveling and getting to know new places, food, culture, and new people. It is something that I enjoy and try to do continuously. It is exciting to know and discover new places.