A 'culture of care:' Pediatrician translates lessons from family to clinic

Published on Monday, March 4, 2019

By: Amanda Markow

EDITOR’S NOTE: This article was originally published in the Winter 2019 edition of Mississippi Medicine, the medical alumni magazine.

Because Dr. Manisha Sethi Malhotra, a 1998 University of Mississippi School of Medicine graduate, knew from the time she was 4 that she wanted to be a doctor, she took a bit of a running start, complet­ing both high school and college years ahead of her peers and entering medical school at UMMC before she was 19.

Sethi, then a future specialist in pediatrics and internal medicine, grew up in Greenwood, the middle child of a first-generation family from India. Her parents came to Mississippi as professors, but her dad, Dr. Satnam Sethi, went into business development and owned several hotels and restaurants throughout the South.

At Pillow Academy in her hometown, Sethi met one of the most influential people in her life, near the beginning of her journey: then-headmaster Tommy Thompson.

“He took a personal interest, not just in me, but also in all students interested in preparing for college en­trance exams early,” Sethi said.

“He spent extra time with us after hours working with special classes. It was an extremely positive, important aspect of my intellectual, academic growth.”

Thompson offered extra SAT and ACT prep courses to any students who were interested. The seniors and ju­niors were burned out on their own prep, he said, but six ninth- and tenth-grade boys came – along with a seventh-grader named Manisha Sethi.

THE TRY-FECTA

“She was a precocious child,” Thompson said, “and you just knew she was something special. She was tak­ing AP physics by the time she was in ninth grade.

“Some students are just gifted, but she had the uncan­ny ability to focus. It was amazing to watch her brain process everything.”

Thanks in part to the extra after-school training, Sethi eventually scored well enough to take part in Duke University’s Talent Identification Program after her freshman year. Her parents were wary of sending her so far away at her age and suggested she look into taking a few summer classes at Millsaps College in Jackson.

“So I did, and thought maybe I’ll do well and maybe graduate a year early or something like that. I came to Jackson that summer and took a full load of summer school core classes and was very challenged and really enjoyed it,” Sethi said.

She wrote a letter to the dean asking to be admitted, and Millsaps accepted her. Thompson, among others, was not at all surprised and supported the idea.

It’s to her father that Thompson attributes Manisha’s drive to succeed. “He is so special. He had his girls reading Peter Drucker books and immersed them in the family business,” Thompson said, referring to the author and teacher known as the Father of Modern Management Theory.

To this day, Sethi stands by one of her father’s favor­ite quotes, echoing self-help author Napoleon Hill: “

What the mind of a man can conceive and believe, it can achieve.”

 “At a very young age, I remember him taking us to school and having us say things like ‘try, try, try and you will get it; try, try, try and you will do it,’” said Sethi who has an older sister, Monica Sethi Harigill, and a younger brother, Sunny Sethi.

“He kind of trained us to keep doing, keep pushing. And I’m so grateful for that. Our mother [Dr. Raksha Sethi] is a pillar of strength for all of us, too.”

Sethi started at Millsaps that following semester, three years earlier than her peers at Pillow would begin col­lege. She lived in Jackson with her sister who had re­cently finished at Millsaps, which helped her grow in new ways, she said.

For example, Monica sent her to return pillows to a de­partment store one day, but there was no receipt. The sales clerks refused, and when Sethi called her sister to explain, Monica told her to go back and not take no for an answer. So she did, and eventually left without the pillows and with a refund.

“It seems like a funny story, but it was probably a de­fining moment from the standpoint of building up my confidence in a situation where what I was trying to achieve was not going well,” Sethi said.

“She taught me that just because somebody says, 'that’s not possible,' that’s not necessarily true. It has served me well in taking care of my patients and in how I advocate for patients.” 

‘IT CHANGES YOU’

With her eyes ever on her goal of going to medical school, Sethi completed her degree at Millsaps in three years. She walked for her college graduation and then a few weeks later got to walk with her graduating high school class, too. She started medical school when she was 18. 

“I had to work hard, and ev­eryone was out to be number one. I’m grateful for the op­portunity that UMMC created, and I was fortunate enough to have lectures by Dr. [Arthur] Guyton,” Sethi said, referring to the legendary physiologist and professor.

Sethi completed medical school in the traditional four years and stayed at UMMC to do her residency in Combined Internal Medicine & Pediatrics.

During her internship, her niece Tori got very sick at just 5 months old, developing a hole in her stomach. She was sent to the pediatric emergency room at UMMC. Once Sethi realized what the issue was, she found her way to the OR, discovered her beloved mentor Dr. Rich­ard Miller there and took him directly to the ER.

Miller, a renowned pediatric surgeon who passed away in August, performed the operation, but Tori was still very sick and ended up in the PICU for two months. Sethi spent every minute she could by her side, and was often sent to the Ronald McDonald House on campus to sleep. Her niece is perfect now, she said.

“It’s because of people like Dr. Miller, the PICU team, pediatricians and subspecialists, everyone who pulled together to help her recover. It’s an important compo­nent of who I am now. Enduring the illness of a family member changes who you are as a physician. Changes how you see the world, how you deal with patients.

“You can identify with them better. You can be more compassionate and understanding of their needs. It’s an important part of how I developed further, and made me a better physician at that point.”

SERVICE BEQUEST

When Sethi was chief resident, once again she experi­enced a life-changing moment. Her sister, the victim of a devastating car accident, was airlifted to UMMC.

“The adult orthopaedic department put her back to­gether,” Sethi said. “I learned at a different stage in my physician development more lessons in compassion and in caring for family members and being vulnerable as a pa­tient. I saw great providers tak­ing care of my family, but I also learned a lot about feeling what the patients feel.

“I believe having had those expe­riences is one of the things that makes me different.”

After finishing residency, Sethi worked at UMMC and the Vet­erans Affairs Medical Center in Jackson, as well as part-time at St. Dominic Memorial Hospital. Dur­ing that time, she built her own clinic, Internal Medicine and Pedi­atric Associates in Ridgeland.

“One of the primary reasons I wanted to have my own business is because that’s what my family did,” she said. “I wanted to be able to see patients the way I wanted to. I wanted to create an en­vironment that was unique and welcoming to patients. I wanted service to be of paramount importance.

“Our motto is ‘caring for your family is our culture.’ I wanted to be able to create that culture of care.”

Even as a young girl, she learned the importance of ser­vice to others from her father, in the way he conducted business. “I grew up in a household tied to the service industry,” Sethi said. 

“My father’s business serves people from the stand­point of food and lodging and different businesses. We grew up going to restaurants and seeing him interact with people and asking managers and waiters, ’Why is this on the floor? Have you checked on that customer? We have to take care of the customer.’

“It was very clear that you always had to take care of the customer’s needs.” That is her calling, she said.

M.D. DNA

Sethi managed to open her clinic doors when she was 29, just in time for the two-week checkup for the grand­child of a fellow board member of the Ronald McDon­ald House, which provides lodging for families of hos­pitalized children.

“When I opened the practice, I don’t think I realized what an investment and risk I took, because I was so young. I just knew I wanted to do it and failure was not an option. Never entered my mind. Never, Sethi said.

Her father later admitted he was nervous about the size of his daughter’s undertaking, but his confidence in her outweighed his concerns. “She was a new doc­tor and had no experience, but I was not worried,” said Satnam Sethi, president and CEO of Jackie’s Interna­tional, Inc., headquartered in Canton.

She was a self-contained child, he said, and was very caring even then; he still remembers her exception­ally good grades and her GPA’s over the years.

He knew she could handle the work load and trusted that patients would find her, he said. “Working hard is part of the DNA of our family. She learned to work 20 hours a day; she carhopped for us while finishing her M.D.”

Always a “baby and kid person,” Manisha Sethi said, she loves her pediatric patients and “the challenge of internal medicine.

“I wanted to help a lot of people. That’s why I chose my specialty, because I could touch a lot more peo­ple than someone who restricted themselves to just one population.”

Her patients range in age from newborn to 100 every day. Often she sees each member of a family. “It’s in­teresting to have the opportunity to see generations and know what things have evolved in the grandparent or parent and keep that in mind as you’re seeing the baby,” she said. 

Several people who have helped her along the way are now her patients, including Tommy Thompson, her ex-headmaster; he gives her excellent marks as a physician.

HEART-TO-HART

Dr. Michael McMullan, professor of medicine and director of the Adult Congenital Heart Program at UMMC, worked with Sethi when she was a resident. Now he entrusts his family to her care. He remembers her for her positive attitude, inquisitive nature and at­tention to detail; her compassion and empathy for her patients, and her eternal smile.

“She does such an excellent job with both pediatrics and adult medicine that I have asked her to take care of both my children and my wife,” McMullan said. “And that is the best compliment that I can give her.”

Sethi’s father gets wind of such compliments, too. “I hear from people all of the time that she is their doctor and how much they appreciate her,” he said. “I have friends from McComb to Greenwood who travel to her.

“They all tell me how kind she is, how she is never in a hurry or in and out the door. She always takes time with each patient.”

Those patients visit her in a clinic that has been open now for more than 13 years. It has grown from the staff of three that started it all. Stacy Miranda joined her team just six months after the clinic’s debut and remains her nurse and nursing supervisor.

“Dr. Sethi takes the time to ac­tively listen to the patients, an­swer any questions and make them feel comfortable with their visit,” Miranda said. “She values her team members and treats everyone with respect.

“The patients love how thor­ough Dr. Sethi is.”

Among those patients are Valerie and Alan Hart, who have been taking their entire family to Sethi for over 12 years. They appreciate the convenience of a clinic that caters to all family members and the care they receive there, they said.

“The feeling that your family physician is truly a fam­ily friend is probably rare, but we really feel that way about Dr. Sethi,” Valerie Hart said.

When the Harts' daughter recently needed emergen­cy care for her eye, Sethi called ahead to the ER and prepped the staff on the injuries to ensure the best immediate care, Valerie Hart said.

“The personal support and comfort Dr. Sethi gave us and our daughter during this event, and many oth­ers, was invaluable. Her treatment towards us in this particular event was not unique. This is just how she is with all her patients all the time.”

Sethi believes she is responding to her life’s calling every day, and, for that, she acknowledges the encouragement of many, including her husband Vikram Malhotra and twin 8-year-old girls Asha and Priya. Having reached her goal of becoming a doctor early, she hasn’t slowed down or lost any focus since her days in school.

“It’s been a labor of love,” she said. “I had no patients when I opened, but I had faith. God has always been with me. I believe that keeps me grounded and straight and keeps me providing the care that I am supposed to provide.