Meet VCRC-VF Fellow Sam Falde, MD
Growing up, Sam Falde, MD, shared a dream with many kids: he wanted to be a veterinarian, caring for our furry, four-legged friends. But by the time he was in college, something shifted. He knew he was still fascinated by science, but when he got the opportunity to work in the American Cancer Society’s collegiate association, it was something else that drew him in: not pets, but people. “I was inspired by patient stories,” he said.
By the time he was in medical school, he knew he wanted to choose a specialty that let him build relationships with patients, where he could listen to their unique voices, integrating not only their medical needs but their values into their care.
Eventually, he found his way into pulmonary and critical care. He loved the fast-paced environment of the ICU and the chance to help families through moments when they or their loved ones were at their sickest. “I love the puzzle work that goes into diagnosing and taking care of them,” he said. “And the team environment. You have to work with pharmacists and nurses and respiratory therapists to help take people from the brink back to health.”
After encountering several cases of vasculitis, Dr. Falde knew he had his direction; he began focusing on critical care, including pulmonary-specific manifestations of vasculitis.
Beginning in July, Dr. Falde will begin his VCRC-VF Fellowship at the Mayo Clinic in Rochester, MN. The fellowship is a partnership between the Vasculitis Clinical Research Consortium (VCRC) and the Vasculitis Foundation (VF), which aims to increase the number of highly qualified physicians and researchers who can diagnose, treat, and improve the lives of people living with vasculitis.
“The work I’ll be doing in this fellowship,” he explained, “is looking at how we classify AAV (ANCA-associated vasculitis), especially EGPA.” As he and other researchers have begun to dive into the current classification criteria, they’re seeing that the categories might not be as black-and-white as they thought. “There may be some overlap between categories,” he said. “Those lines not might not be clear. In fact, some patients may fall into intermediate categories…We want to develop tools to better classify these patients.”
As Dr. Falde explained, classification criteria are different from diagnostic criteria. Classification happens after someone has been diagnosed with AAV: as he said, classification is “what box you put them in once you have a diagnosis.” Classification criteria informs a patient’s treatment plan, their risk of relapse, how doctors may choose to monitor them, or what medications they’ll be prescribed. If a patient isn’t classified correctly, it can have a big impact on their journey. “It’s really important,” Dr. Falde said, “that we truly understand the words that we use to describe these diseases.”
During his time as a VCRC-VF Fellow, Dr. Falde will also work directly with vasculitis patients in the clinic. “I want to get training across specialties to see how patients with vasculitis are managed across the spectrum of the disease,” Dr. Falde said. He wants to better understand their care, including the web of specialists who work together to help those with the disease live their fullest lives.
It is this—time spent connecting and serving the needs of his patients—that brings Dr. Falde home to his original intention in choosing medicine. “One of the most incredible experiences in my career has been seeing patients from the time when they’re in the ICU when they’re at their sickest, when they have several organs that are not functioning well, and having the opportunity to take care of them and see them all the way through their recovery in clinic. I can see their resilience.” Taking this journey alongside his vasculitis patients has given him a sense of “the importance of developing novel therapies in acute settings and improving how”—and how fast—“we diagnose vasculitis.” The earlier patients can get a diagnosis, the better chance they have of preventing further damage and living well.
It has also made him want to more fully understand the long term impact of the medications prescribed for vasculitis. “The medications that we use are improving every year,” Dr. Falde said. “At the same time, they’re not without drawbacks for some patients. The question is: How can we tailor these therapies in a patient-centered manner and reduce side-effects? We don’t want these medications to be a double-edged sword.”
In his time working with people with vasculitis, what impresses Dr. Falde most is how “incredibly knowledgeable and self-sufficient” they are. Given that their diseases are so rare, many patients have to learn quickly how to tune into their bodies and become their best advocates. As Dr. Falde said, “A lot of vasculitis patients are very self-aware and keen on any changes in their symptoms, which is really helpful for me as a clinician. I have worked with so many patients who are strong self-advocates.”
Dr. Falde hopes his time as a fellow will help him better support these patients who have touched his life as a physician. “I continue to find myself humbled by the disease and the patients I work with,” he said. “As a fellow, I look forward to building on this foundational knowledge and pushing the field to help impact both patients and clinicians as we try to navigate this disease together.”
Written by Ashley Asti
