A Day in the Life: Celiac disease expert Alessio Fasano

A typical day for Alessio Fasano, M.D., a world-renowned expert on celiac disease and gluten sensitivity, doesn’t seem to exist.  This isn’t surprising given his many roles, or hats as he describes them, at Mass General Hospital for Children and in the gluten-free world at large.

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Alessio Fasano juggles administrative work with research and patient care

As director of the Center for Celiac Research, chief of the division of pediatric gastroenterology and nutrition and associate chief of the department of pediatrics research, Fasano spends his days overseeing research, working with physicians, seeing patients and handling numerous administrative duties.

Although his days are full of responsibilities and discoveries, he begins and ends them like many of us. Fasano says he has to have his coffee in the morning, and in the evening he enjoys cooking dinner. He’s even tapped into WhatsApp to communicate with colleagues, friends and family.

 Fasano, who grew up and was educated in Italy, recently described what his atypical days are like.  Although he noted that every day is different, his pursuit of knowledge through research and his commitment to helping those in the gluten-free community are common threads.

 What time do you wake up? 

In general about 6 to 6:30 a.m.

 What’s for breakfast?

I have my cup of espresso, first and foremost. I am not able to do anything intellectual unless I make my espresso.

I typically put on the espresso machine and then I get my newspaper. By the time the coffee is ready, I start to read the news. In general, that’s my breakfast. Honestly, I am not a role model when it comes to eating a healthy breakfast. I would not recommend this to anybody. But that’s the way I function.

 Do you check your email in the morning?

I go through my emails very quickly because I have connections, friends and collaborators all over the world in different time zones. I see if there is anything urgent. If I have time, I read the Italian news.

What time do you get to work?

It depends on the day of the week, in general between 7:30 and 8:00 a.m. Some days I have commitments even earlier than that.

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Fasano in the lab at the celiac center

 What’s an average day like for you?

Every day is different, but every day I systematically manage problems. There is always something that I have to fix and take care of. I have to deal with administrative issues with physicians, the center and the lab. I typically spend a fair amount of time with folks if they have troubleshooting problems with experiments or issues in the clinic.

And I go to meetings — a lot of meetings. I don’t like that, but I spend a fair amount of time pushing papers back and forth. Almost every day I have an interview like this one because of my new book, Gluten Freedom. A lot of people ask me about that.

There are days when I am more focused on the lab. People come on a weekly basis to discuss their research with us. Thursdays are totally dedicated to clinic, and from 9 a.m. until 7 p.m., I see patients.

In general, in terms of commitments and finishing rounds, my day is over at about 6 p.m., and between 6 and 8 p.m., I do charts and catch up with the rest of the stuff that I was unable to do during the day. Then I get back home.

If I have stamina, I go running. I cook dinner, I watch the news and at midnight, I go to bed.

I also travel a lot. When I travel, all of this goes off the plan. Then I’m always in the catching up mode, and I always have stuff on my desk.

 What’s for lunch?

Nothing. Unless there is a lunch meeting and lunch is provided and I have to be there, I do not have lunch. Again, I am not a healthy eating role model. Maybe over the years my stomach shrank, but definitely I do not have the time.

 Is there anything surprising about your day?

You know that’s the beauty of my job. I really never know what the day holds for me. It’s always a little bit of a surprise. Good surprise. Bad surprise.

Do you have a favorite part of the day?

Six in the evening. That’s when I have a little bit more time for myself to really wrap it up with the turmoil of the day. It really stems from the fact that I wear so many hats. I’m division chief and director of the lab. I run the celiac center, and there is a lot of stuff going on.

 If you don’t eat breakfast or lunch, what’s for dinner?

Well, I need to really make sure that the dinner is the right meal. One thing that I love is to cook. I don’t like to clean, but I like to cook. So I really take time to cook from scratch. I never eat stuff that is precooked or is made in the microwave.

In general, good food doesn’t need much time to be made. Twenty minutes, you should be fine. I make a lot of vegetables and fish. I’m trying to use whatever is available.

For example, yesterday I had eggplant that was really getting to the end of the line and needed to be used. So, I carved the eggplant to take out the inside and sautéed it with red and green pepper. I put this mix put back into the eggplant and baked it in the oven for 45 minutes. Then I added some gorgonzola cheese on top. I have to say, it was a heck of a dish, particularly the gorgonzola crust I made by broiling it for a few minutes. By the way, this was gluten free.

I have a son in Florida. He’s also a heck of a cook. We exchange WhatsApp messages in which he sends me plates that he did, and I ping back with mine.

What have you learned from the gluten-free community? 

I don’t live with celiac disease or gluten sensitivity, so the more I deal with people and meet with them, the more respect I have for people who do live with these conditions.

 Has researching celiac disease and serving as a physician in the gluten-free community changed you?

Big time. I have to say, you try to put yourself in people’s shoes. You realize that it has an impact on the person, his or her social network and family. You think about the challenges for the person depending on age. I really believe that treating the patient with his or her complexities gives me a different perspective.

 What does helping the community mean to you? 

This is a tough job. You live your life in the fast track. The failures by far surpass the successes. The stamina to continue working comes from the community that you serve. If you go back and you think about it, many, many times as a physician, as a researcher you really face failures that will make you consider things.

I have to fail 100 times to have one success. There is a lot of frustration. There is a lot of sacrifice. There is a lot of behind the scenes work. The only reason you keep going is because someone writes you a thank-you note saying you made a difference in their life. That is really what the community gives. I don’t think it’s just me, but everybody who does a job with passion and dedication.

Guest Blogger Susan Cohen is a freelance writer who often writes for Gluten-Free Living. This is the 6th in her Day in the Life series.

(This interview has been edited for length and clarity.)