Dr. Melissa Azul
Pediatric Hematologist
Dr. Melissa Azul, a pediatric hematologist, is a bridge between two worlds: pediatric and adult care for sickle cell patients. Her journey to this specialty was driven by a powerful personal and professional realization.
After training in pediatric residency and seeing firsthand the challenges patients face, she chose to focus on the transitional age group. Her experience was cemented during a fellowship at St. Jude, where she realized the significant knowledge gap between pediatric and adult providers. This inspired her to build a comprehensive transition program in the sickle cell clinic at Children’s Wisconsin.
Dr. Azul has a deep understanding of the fears that patients and their families face during this critical transition. For the young adults themselves, their concerns are often practical and immediate. They worry about the logistics of the new adult clinic: “Where do I park? What elevator do I take?” Dr. Azul and her team address these anxieties head-on, offering to meet patients at the front door and walk them to their first appointment. She reassures them that building a new relationship with their adult care team takes time, just like any other new relationship. Caregivers, on the other hand, express a different set of fears. Their worries center on the well-being and safety of their young adult. They are concerned that the new team won’t understand their child’s specific needs, like difficulty with IV access or preferred medications for pain. Dr. Azul reassures them by explaining that her team provides detailed handoffs to the adult providers, ensuring they are well-informed. She emphasizes that while the young adult is learning to take the lead, the caregiver’s role doesn’t end; it simply shifts as they remain a crucial support system.
The most rewarding part of Dr. Azul’s job is seeing her patients gain independence. She loves witnessing the transformation of a 16-year-old who doesn’t know their genotype into a 19-year-old who can advocate for themselves in the ER and clearly explain their condition. These small victories, like a patient remembering to hydrate on their own or hearing about them landing a job or getting into college, are what she cherishes most. These moments prove that her efforts to empower them are working. Collaboration with adult providers is vital. Dr. Azul and her team maintain open lines of communication, providing detailed handoffs to their colleagues to ensure a smooth transfer of care. They also set expectations for patients, particularly regarding the busier, more complex environment of an adult emergency room. By preparing patients for these differences, they help them navigate the system with greater confidence
Dr. Azul’s vision for the future of transition care is ambitious and patient-centered. In an ideal world, she would love to see designated transition coordinators who follow patients across both pediatric and adult clinics to provide continuous care. She also dreams of a future with more adult sickle cell specialists and a single “lifespan center” where patients
receive seamless care from birth to death. The most profound lesson Dr. Azul has learned from her patients is to never underestimate young adults. Despite the immense challenges they face—from the disease itself to the complexities of becoming an adult—they show a remarkable tenacity and drive. She is constantly astonished by their resilience and their aspirations for the future. Her work is a testament to the power of support and education in empowering these young adults to take ownership of their health and their lives.