Laurel Coleman, MD ’89, Resident Alum : Cherishing the Personal in Palliative Care

For geriatric and palliative care physician Laurel Coleman, no two days, or two patients, are alike. 

During her medical training at UCSF, Coleman learned that was true even within her own family when her grandmother passed away. She and Coleman’s grandfather had been married for more than 50 years. 

“They were similar in every way except that my grandmother didn’t want to take blood pressure medicine or see physicians, but my grandfather had about eight specialists, one for every organ system,” she says. “I thought, ‘These people are married?’”  

It helped her realize, and appreciate, that older adults “have their own rationales, their own stories, that inform their health decisions.” 

That appreciation, her UCSF training, and her desire to help others – “humanitarian volunteering, that’s kind of in my DNA,” she says – has guided her through a career that has taken her from Maine to Hawaii to all corners of Africa. Now, it has led to Coleman receiving the Humanitarian Service Award from the Alumni Association of UCSF – recognition she calls “incredible and humbling.” 

A compassionate presence 

Coleman grew up in Washington and California. None of her family members had worked in medicine, but she felt it in her bones from the start.  

“I have always been interested in being a physician,” she says. “I was the kid who, when other children were injured, would check on them and alert their parents.”  

She attended high school in Sacramento, then college at Stanford University, and was married soon after. Her husband, Steve, had started at UC San Diego for his medical training. Coleman was not initially accepted, so instead, she enrolled at San Diego State University, where she earned a Master of Public Health degree.  

Being denied that initial entry into medical school was a blessing in disguise because it led her to UCSF, where she thrived. 

“I was so privileged to have extraordinary classmates,” Coleman says. “Our class was diverse in every way. I had such inspiring professors. From the moment I got there, I felt like I had won the lottery.”  

The prevalence of HIV in 1980s San Francisco meant physicians were all too urgently needed. “I did not shy away from HIV,” she says. “It was such a big part of our experience in medical school and residency.” 

After graduation, she completed a geriatric fellowship at the University of North Carolina at Chapel Hill. Then she saw an ad in the New England Journal of Medicine about the need for physicians in the central lakes region of Maine. It was the right fit for her and her family. 

There, Coleman became medical director for a group of nursing homes, a hospice, and one of the first specialized residential memory care facilities in the country. She joined the board of the Maine Chapter of the Alzheimer’s Association and then was asked to serve on the national board.  

After reading about a Gates Foundation-supported AIDS orphan care project in Otse, Botswana, she invited friends to join her to help. The trip began a new chapter for Coleman. 

“It opened my eyes to the great need there,” she says. “HIV was still having a huge impact in Africa, and I had a skill set to help them cope and improve their quality of life.” 

She was invited to teach palliative care principles at a hospital in Zambia, then at a medical school in Tanzania. Medical trainees were not taught how to deliver difficult news to patients. In fact, they believed they would be blamed for their inability to provide a cure. 

“I helped these trainees realize that if they were the patient, they likely would want this information to help make plans for any time they had left,” Coleman says. 

Eventually, training at the London School of Hygiene and Tropical Medicine made her work even more effective. She’s now been serving for many years on humanitarian medical trips to Africa, Haiti, and Mexico, and with refugees on the Greek island of Lesvos. Wherever Coleman goes, she doesn’t just treat illness; she also tries to teach local clinicians new skills. 

“It is about changing a mindset,” she says. “People tend to ostracize those who are dying. I am privileged to model compassionate presence, to help with symptoms even if we can’t cure the patient.” 

Hawaii as a new home base 

With her son and daughter grown, Coleman moved to Hawaii 10 years ago at the behest of her winter-weary husband. 

There, she has worked as a geriatric and palliative care physician at Kauai Medical Clinic and as director of supportive care services at HMSA, Hawaii’s Blue Cross affiliate. She left those positions in early 2019 for an extended volunteer/teaching trip in Kigali, Rwanda, and northern Uganda with Steve.  

When the COVID-19 pandemic broke out, Coleman was a visiting clinical professor in the UCSF Division of Palliative Medicine, but it was another challenge that brought opportunity. 

Working with Brie Williams, MD, MS, director of the UCSF Center for Vulnerable Populations, Coleman began caring for incarcerated men at San Quentin State Prison (now San Quentin Rehabilitation Center), where there was a major outbreak of COVID-19, and the facility was locked down in an attempt to limit transmission of the SARS-CoV-2 virus.  

“It was one of the most rewarding experiences that I have had,” she says. “I visited sick and isolated men who had chosen not to go to the hospital or who had just returned. Each man had a different perspective on their situation that informed their health care decisions. Some died, some didn’t, but we promised that we would walk with them through it.”